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
A cancerous lump is formed which then invades out of the nasopharynx into the brain, ear and the
It spreads into the lymph glands on both sides of the neck. It also spreads via the bloodstream
to the lungs and bones.
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
Nasopharyngeal Cancer Treatment
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
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.
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 sinus infection symptoms and nasopharyngeal
cancer symptoms, you will be in a better position to decide if a visit to an ENT specialist for your condition
is called for.