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Nasopharynx (Nose) Cancer

  • What is Nasopharynx (Nose) Cancer?

    Nasopharynx cancer (NPC), commonly known as nose cancer, is an abnormal growth of tissue in the nasopharynx, which is the area behind the nose just above the mouth and throat. This abnormal growth is called a tumour and develops when the cells in the nasopharynx divide uncontrollably and produce extra tissue.

    NPC can be benign (non-cancerous) or malignant (cancerous). It is the sixth most common head and neck cancer in men in Singapore.

  • The exact causes of NPC are not yet known. However, there are several risk factors that can increase the chances of developing NPC:

    • Tobacco smoking
    • An Epstein-Barr virus (EBV) infection is a common viral infection and usually results in mild symptoms like fever and sore throat. It has been linked to NPC development as the virus has been found in nearly all NPC cells. However, an EBV infection on its own is not enough to cause NPC.
    • NPC is also common in Chinese (especially Cantonese) people, and in men aged between 20 – 50 years.
    • NPC has also been linked to certain dietary habits. For instance, it is very common in areas of Asia, northern Africa, and the Arctic region, which are known for diets that are high in salt, cured fish and meat.
  • The symptoms of NPC include:

    • Blocked nose and stuffiness
    • Blood-stained sputum (phlegm) from the nose and throat
    • Blurry vision
    • Difficulty speaking or breathing
    • Difficulty swallowing
    • Earache or ear discharge
    • Tiredness
    • Hearing loss or tinnitus (ringing in the ear), usually affecting one side only
    • Hoarse voice
    • Lumps in the neck or on the nose
    • Persistent sore throat
    • Reoccurring headaches
    • Reoccurring nosebleeds
    • Unexplained weight loss
  • There are different treatment options available for NPC. Your ENT (ears, nose and throat) specialist will evaluate your condition and suggest the appropriate treatment for you, depending on your cancer stage and overall general health. Treatment may include:

    • Chemotherapy using 1 or a combination of toxic drugs that circulate in the bloodstream and kill rapidly growing cells, including healthy ones. Chemotherapy helps to reduce the symptoms of NPC.
    • After resection (removal) of the primary tumour, neck dissection surgery is performed to remove nearby, cancerous lymph nodes if the NPC has spread to them. 
    • Radiation therapy, the most common form of treatment of NPC. This treatment can be given in several ways:
      1. Brachytherapy, which uses thin metal rods containing radioactive materials to deliver radiation to cancer cells
      2. Intensity modulated radiotherapy (IMRT), a radiation method that allows the accurate, computer-guided delivery of radiation beams to destroy cancer cells, while sparing surrounding healthy tissues
      3. Radiotherapy or external energy beams can be used to destroy cancer cells and reduce the symptoms of NPC.
      4. Surgery to remove nasopharyngeal tumours for the few NPC cases that do not respond to radiation therapy
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