Nasopharyngeal Cancer Or Sinus Infection

Some of the symptoms of sinus infection are similar to that of nasopharyngeal cancer. Learn to distinguish between the two illnesses.

Where is the Nasopharynx?

The nasopharynx is the space situated behind our nose and below the brain. It connects our nose to our windpipe. On its sidewall, a tube connects it to the ear called the eustachian tube.

What is Nasopharyngeal Cancer?

Nasopharyngeal cancer develops when cells of the lining of the nasopharynx behave abnormally. A cancerous lump is formed which then invades out of the nasopharynx into the brain, ear and the jaw. It spreads into the lymph glands on both sides of the neck. It also spreads via the bloodstream to the lungs and bones.

Risk Factors

1. Diet

Consumption of salted vegetables, fish and meat is associated with nasopharyngeal cancer. Salted soy beans, canned pickled vegetables and salted vegetables are high-risk foods.

2. Epstein Barr Virus (EB Virus)

This virus has been found associated with nasopharyngeal cancer.

3. Genetic Factors

This may play an important role in nasopharyngeal cancer. Blood tests can identify certain people at risk. At present, these tests are not commercially available.

Nasopharyngeal Cancer Symptoms

1. Its most common presentation (90%) is a lump in the neck. That is a swollen lymph node infiltrated by cancer cells.

2. Nosebleed, blocked nostrils and mucus secretion.

3. Loss of hearing, pain, buzzing noise and discharge from the ear.

4. Hoarseness of voice and difficulty in swallowing.

5. Paralysis of one side of the face.

These symptoms may also be due to other medical conditions.

Diagnosis Of Nasaopharyngeal Cancer

1. Nasal Endoscopy

A flexible fiber-optic tube with a light at its tip is introduced via the nose. The nasopharynx is examined visually and any suspicious lump is biopsied, i.e. a small piece of the lump is removed and examined under the microscope.

2. CT scan of the head and neck

This is a special x-ray which can show the cancer and the extent of its spread. This test is used in planning the treatment.

3. Blood test to determine the level of antibodies against EB virus.

If the level of antibodies is high, a diagnosis of nasopharyngeal cancer is suspected.

4. Chest, abdominal CT scans and bone scans are performed to determine whether the cancer has spread to other parts of the body.

5. If a patient presents with swollen lymph nodes in the neck, a biopsy should be performed.

Nasopharyngeal Cancer Treatment

1. Radiotherapy

Radiotherapy is the use of high-energy x-rays to kill cancer cells. Nasopharyngeal cancer responds well to radiotherapy, hence it is used as the main treatment option. Radiotherapy is given on a daily basis for 6 weeks. Temporary side effects include redness of the skin on the neck, dryness of the mouth and throat, mouth ulcers, loss of sense of taste and appetite. The lymph nodes in the neck are also treated by radiotherapy.

2. Chemotherapy

Chemotherapy is the use of toxic drugs to kill cancer cells. Its role in nasopharyngeal cancer treatment is limited and is used in 2 situations:

a. Advanced nasopharyngeal cancer which has spread to the bones, liver and lungs.

b. In combination with radiotherapy to improve the effectiveness of chemotherapy.

3. Surgery

The role of surgery is limited in nasopharyngeal cancer because it is very difficult to remove the cancer without injuring vital neighbouring organs. If nasopharyngeal cancer recurs in an area which had received radiotherapy before, surgery can be used to remove the recurrence.

Outcome After Treatment

1. Early Stage When nasopharyngeal cancer is small and located only in the nasopharynx, the survival rate is very good (90%) after radiotherapy.

2. Intermediate Stage When the nasopharyngeal cancer has invaded the neighbouring organs or the lymph glands in the neck, the survival rate drops (40% to 50%).

3. Late Stage When the nasopharyngeal cancer has spread elsewhere in the body, the survival rate is poor (less than 10% of patients survived 5 years). Studies have shown that screening for nasopharyngeal cancer is not cost effective and therefore not recommended.

Nasopharyngeal cancer patients have a very good survival rate if detected early. By comparing the symptoms of sinus infection and nasopharyngeal cancer, you will be in a better position to decide if a visit to an ENT specialist for your condition is called for.