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Written by Pang Tze Yin and Wong Li Shien, AA Pharmacists

What is Nasopharyngeal Cancer?

Pharynx is the medical name for the throat and it is in three parts. The three parts of the pharynx are the nasopharynx, oropharynx, and hypopharynx. The nasopharynx connects the back of the nose to the back of the mouth. Nasopharyngeal cancer is a disease in which malignant (cancer) cells form in the tissues of the nasopharynx. Nasopharyngeal cancer (NPC) is a type of head and neck cancer.

In Malaysia, nasopharyngeal cancer is the fourth most common cancer. NPC is predominant among Chinese, followed by natives of Sabah and Sarawak (especially Bidayuh) and Malay.

Signs and Symptoms

  • A lump in the nose or neck
  • A sore throat
  • Trouble breathing or speaking
  • Nosebleeds
  • Trouble hearing
  • Pain or ringing in the ear
  • Headaches

    Risk Factors 


    • Ethnicity (especially Chinese and natives of Sabah & Sarawak)
    • Gender (male to female ratio is 3:1)
    • Family history of NPC
    • Lifestyle and environment (such as tobacco smoking, consumption of salted fish, exposure to domestic wood cooking fires, exposure to occupational solvents, and occupational exposure to wood dust)

    Diagnosis 

    Tests that examine the nose, throat, and nearby organs are used to detect (find), diagnose, and stage nasopharyngeal cancer.

     

    • Physical exam and history
    • Neurological Exam
    • Biopsy (Nasoscopy, Upper Endoscopy)
    • MRI (Magnetic Resonance Imaging)
    • CT Scan (CAT Scan)
    • PET Scan (Positron Emission Tomography Scan)
    • Ultrasound Exam
    • Chest X-Ray
    • Blood Chemistry Studies
    • Complete Blood Count
    • Epstein-Barr Virus (EBV Test)
    • HPV (Human Papillomavirus) Test
    • Hearing Test

    Treatment

    1. Radiation Therapy

    • External radiation therapy uses a machine outside the body to send radiation toward the cancer.
      • Intensity-modulated radiation therapy (IMRT)
      • Stereotactic radiation therapy
    • Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.

    2. Chemotherapy – Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing.

    3. Surgery – Surgery is a procedure to find out whether cancer is present, to remove cancer from the body, or to repair a body part. Also called an operation. Surgery is sometimes used for nasopharyngeal cancer that does not respond to radiation therapy.

     

    Prevention 

    Despite the fact that there is no proven way to completely prevent NPC, you may be able to lower your risk. Although some of the risk factors of NPC cannot be controlled, such as ancestry, several can be avoided by making lifestyle changes. Stopping the use of all tobacco products is the most important thing a person can do to reduce their risk of NPC, even for people who have used tobacco products for many years.

    Reference:

    1. About Nasopharyngeal Cancer [Online]. Available at: https://www.cancerresearchuk.org/about-cancer/nasopharyngeal-cancer/about (Accessed: 20th January 2020)
    2. Clinical Practical Guidelines (CPG). Management of Nasopharyngeal Carcinoma 2016 [Online]. Available at: http://www.moh.gov.my/moh/resources/Penerbitan/CPG/Kanser/QR%20Nasopharyngeal%20Carcinoma.pdf (Accessed: 20th January 2020)
    3. PDQ® Adult Treatment Editorial Board. PDQ Nasopharyngeal Cancer Treatment (Adult). Bethesda, MD: National Cancer Institute. Updated 26/07/2019. [Online]. Available at: https://www.cancer.gov/types/head-and-neck/patient/adult/nasopharyngeal-treatment-pdq. (Accessed: 20/01/2020) [PMID: 26389409]
    4. Net Editorial Board. Nasopharyngeal Cancer: Risk Factors and Prevention. Updated 01/2019. [Online] Available at: https://www.cancer.net/cancer-types/nasopharyngeal-cancer/risk-factors-and-prevention (Accessed: 20th January 2020)

     

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