Nasopharyngeal Carcinoma: Causes, Symptoms, Risk Factors, Diagnosis, Treatment, Prevention and Complications

Nasopharyngeal carcinoma is a type of cancer that affects the area above and behind the back of the throat. Nasopharyngeal carcinoma is difficult to diagnose early. This is probably because it can be challenging to examine the nasopharynx and because other, more common disorders can present with similar symptoms to nasopharyngeal cancer.

The most common treatments for nasopharyngeal cancer are radiation therapy, chemotherapy, or a combination of the two. You can choose the exact course of action with your doctor based on your particular situation.

Causes of Nasopharyngeal Carcinoma

Cancer first appears when one or more genetic mutations cause normal cells to proliferate uncontrolled, infiltrating adjacent structures, and eventually spreading (metastasizing) to other parts of the body. Squamous cells that line the surface of the nasopharynx in nasopharyngeal carcinomas are where this process begins.

The specific etiology of the gene mutations that result in nasopharyngeal carcinoma is unknown, despite the discovery of risk factors including the Epstein-Barr virus that increase the likelihood of developing this cancer. There is no clear explanation for why some people who have all the risk factors for cancer never acquire it while others who don't appear to have any risk factors do.

Symptoms of Nasopharyngeal Carcinoma

Nasopharyngeal cancer in its early stages may not exhibit any symptoms. Nasal carcinoma symptoms and indicators include the following:

• A neck lump that is caused by a swollen lymph node there
• Saliva containing blood.
• You experience nasal congestion or bleeding from the nose, as well as ringing in the ears.
• Impaired hearing
• Chronic ear infections
• Throat pain
• Headaches

Risk Factors of Nasopharyngeal Carcinoma

The following factors have a tendency to increase your risk of developing nasopharyngeal carcinoma:

• Sex: Nasal cancer is more common in men than in women.
• Race: In parts of China, Southeast Asia, and northern Africa, this type of cancer is more common. Compared to Asians who were born in the country, Asian immigrants are more likely to develop this type of cancer. Inuit people in Alaska have a higher risk of developing nasopharyngeal cancer.
• Age: Nasopharyngeal cancer can occur at any age, however, it is most usually detected in people between the ages of 30 and 50.
• The meal that has been salted: Chemicals produced during the preparation of salt-cured foods like fish and preserved vegetables may raise the risk of nasopharyngeal cancer because they may enter the nasal cavity. Exposure to these chemicals at a young age may significantly increase the risk.
• Epstein-Barr virus: This ubiquitous virus typically only manifests as a mild cold in terms of signs and symptoms. It can occasionally lead to infectious mononucleosis. The Epstein-Barr virus is also linked to a number of rare cancers, including nasopharyngeal carcinoma.
• Family history: If a family member has the disease, your risk of acquiring nasopharyngeal carcinoma is raised.
• Drinking alcohol and cigarettes: The use of tobacco products and binge drinking can raise your risk of developing nasopharyngeal cancer.

Diagnosis of Nasopharyngeal Carcinoma

Nasopharyngeal cancer is detected using the tests and procedures listed below:

• Physical examination: The initial stage in determining whether a patient has nasopharyngeal cancer is often a general examination. Your medical professional will ask you about your symptoms. To feel for swollen lymph nodes, he or she can press on your neck.
• To check your nasopharynx, you ought to use a camera: Your doctor might suggest a nasal endoscopy if nasopharyngeal cancer is suspected.
• This examination checks for irregularities by peering within your nasopharynx with a thin, flexible tube fitted with a camera. To insert the needle, utilize either your nose or the opening at the back of your throat that rises into your nasopharynx.
• To remove suspect cells from a sample, do a test: Your doctor may extract a small tissue sample (biopsy) using an endoscope or similar instrument to check for cancer.

Testing To Determine The Extent Of The Cancer

When the diagnosis is certain, your doctor may order additional tests, such as imaging examinations, to help establish the cancer's extent (stage).

Imaging examinations might include:

• Computerized tomography (CT)
• Magnetic resonance imaging (MRI)
• Positron emission tomography (PET)
• X-ray

Your doctor will assign a Roman numeral representing the cancer's stage after evaluating the severity of your condition. Stages I to IV of nasopharyngeal cancer are known.

The stage is just one of several factors considered while determining your prognosis and course of treatment. The closer the value is to zero, the more nasopharyngeal-specific the cancer is. A higher score signifies that the cancer has spread outside of the nasopharynx, such as to the neck lymph nodes or other regions of the body.

Treatment Of Nasopharyngeal Carcinoma

Depending on the stage of your cancer, your treatment goals, your overall health, and the side effects you are ready to endure, you and your doctor will jointly develop a treatment plan.

As the first stage in treating nasopharyngeal cancer, radiation therapy or a radiation and chemotherapy combination is frequently employed.

Radiation Therapy

Radiation therapy kills cancer cells by utilizing powerful energy beams, such as X-rays or protons.

When administering radiation therapy for nasopharyngeal cancer, external beam radiation is frequently used. During this procedure, you will be lying on a table while a large machine is maneuvered all around you in order to focus radiation on the precise area of your body where the cancer can be targeted.

For small nasopharyngeal cancers, radiation therapy may be the only necessary therapy. In some circumstances, chemotherapy and radiation therapy may be combined.

Radiation therapy has the potential to have negative side effects, including temporary hearing loss, dry mouth, and skin redness.

It is occasionally possible to treat recurrent nasopharyngeal cancer with brachytherapy, a type of internal radiation therapy. In this treatment, radioactive wires or seeds are inserted directly into or very close to the cancer.

Radiation therapy for the head and neck can sometimes cause severe mouth and throat sores, particularly when chemotherapy is used. While these sores are present, eating and drinking can be difficult. Your doctor may suggest inserting a tube into your stomach or throat if this occurs. Through the tube, you are fed and given drinks as your mouth and throat recover.

Chemotherapy

Chemotherapy is a prescription drug used to chemically kill cancer cells. Medication for chemotherapy can be administered intravenously, orally, or both. Nasopharyngeal cancer can be treated with chemotherapy in one of three ways:

chemotherapy in combination with radiation therapy. When radiation therapy and chemotherapy are used together, the effectiveness of radiation therapy is increased. The name of this combo therapy is concurrent therapy, sometimes known as chemoradiation.

The unfavorable effects of radiation therapy are combined with those of chemotherapy, making concurrent therapy more challenging to tolerate.

Chemotherapy follows radiation therapy. Your doctor might suggest chemotherapy as a follow-up to radiation therapy or concurrent treatment.

Chemotherapy is used to treat any cancer cells that may still be present in your body, including any that may have migrated to other organs or tissues from the main tumor.

There is some disagreement over whether further chemotherapy actually improves survival for people with nasopharyngeal cancer. Numerous people who take chemotherapy and treatment simultaneously are unable to endure the side effects and must discontinue taking the drug.

Chemotherapy Combined with Radiation therapy. 

Neoadjuvant chemotherapy is the name given to chemotherapy administered prior to radiation therapy alone or before concomitant therapy. Although more research is needed to be sure, neoadjuvant chemotherapy may improve survival rates for people with nasopharyngeal cancer.

The type of chemotherapy drugs you will take and how often will be decided by your doctor. Your chances of experiencing side effects will depend on the medications you are given.

Surgery

Surgery is the most often used form of therapy for nasopharyngeal cancer. There can be surgical removal of lymph nodes present in the neck.,

Occasionally, a surgical procedure is used to remove a tumor from the nasopharynx. Usually, a cut in the roof of your mouth needs to be made by doctors to get access to the area and remove the cancerous tissue.

Prevention of Nasopharyngeal Carcinoma

There is no proven method to prevent nasopharyngeal carcinoma. However, you might consider quitting practices that have been connected to the illness if you're concerned about your risk of developing nasopharyngeal cancer. You might opt, for instance, to cut back on or stop eating foods that have been salted.

Methods For Screening Nasopharyngeal Cancer

In areas of the world, such as some parts of China, where nasopharyngeal carcinoma is far more common, doctors may, however, recommend tests to individuals who are thought to be at high risk of the disease. During screening, blood tests may be done to check for the Epstein-Barr virus.

Complications of Nasopharyngeal carcinoma

Nasal carcinoma may cause the following complications:

• A malignancy that metastasizes to nearby structures: Difficulties may arise if an advanced nasopharyngeal carcinoma grows to the point where it invades nearby structures like the throat, bones, or brain.
• Multiple body parts are affected by a spreading malignancy: Most typically, nasopharyngeal cancer spreads (metastasizes) outside of the nasopharynx.

Nasopharyngeal carcinoma is typically characterized by regional metastases. That suggests that malignant cells from the primary tumor have moved to nearby areas, such as the lymph nodes in the neck.

The most prevalent locations for cancer cells that spread to other regions of the body are the bones, lungs, and liver.

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