Nasopharyngeal Cancer: Causes, Symptoms, and Treatment Methods
Nasopharyngeal cancer is a type of head and neck cancer that develops in the nasopharynx, the area located behind the nasal cavity and above the throat, which also connects to the middle ear via the Eustachian tube. This cancer type is more common in Asian countries and is associated with both environmental and genetic factors.
Nasopharyngeal cancer responds better to treatment when diagnosed early!
Causes of Nasopharyngeal Cancer
Although the exact cause is unknown, a combination of genetic and environmental factors is believed to play a role.
Genetic Factors (Family History):
- Risk increases in individuals with a family history of nasopharyngeal cancer.
- It is more prevalent in regions such as Southeast Asia and China due to genetic predisposition.
Viral Infections
Epstein-Barr Virus (EBV): The majority of patients with nasopharyngeal cancer test positive for EBV antigens. However, not all EBV carriers develop this cancer.
Dietary Habits
- Salted and smoked foods: High nitrite content can contribute to cancer development.
- Consumption of foods exposed to pesticides and agricultural chemicals: May increase cancer risk.
- Deficiencies in protein and vitamins A and B: Can weaken the immune system and increase vulnerability to cancer.
Chemical and Environmental Factors
- Smoking and tobacco use: Long-term smoking increases risk.
- Air pollution and chemical exposure: Higher risk among those working in chemical industries.
Other Factors
- Ethnicity: More common in China, Southeast Asia, and North Africa (incidence 80–120/100,000).
- Gender: Occurs 4–5 times more frequently in men than in women.
- Alcohol consumption: No clear link has been established with nasopharyngeal cancer.
Early diagnosis significantly increases the chances of successful treatment!
Symptoms of Nasopharyngeal Cancer
Nasopharyngeal cancer may not show clear symptoms in early stages. In later stages, the following symptoms may appear:
Ear-Related Symptoms (due to Eustachian tube blockage):
- Unilateral hearing loss or reduction
- Sensation of fullness or blockage in the ear
- Tinnitus (ringing in the ear)
Nasal Symptoms:
- Unilateral nasal congestion
- Bloody nasal discharge
- Bad breath
Neck Swelling:
Swollen lymph nodes in the neck (the most common reason for seeking medical attention).
Cranial Nerve Involvement Symptoms
- Double vision (due to cranial nerve involvement)
- Numbness or pain in the face
- Difficulty swallowing
Patients often present with ear and nasal complaints, but serious symptoms like nerve involvement may emerge in advanced stages!
Diagnosis of Nasopharyngeal Cancer
Since the nasopharynx is not visible with standard examination, detailed ENT evaluation is required.
Endoscopic Examination:
An endoscope is inserted through the nose to visualize the nasopharyngeal area.
Imaging Methods
- Magnetic Resonance Imaging (MRI): Shows tumor spread and effect on nearby tissues.
- Computed Tomography (CT): Used to assess lymph nodes and bone structures.
- Positron Emission Tomography (PET): Detects distant metastases.
Biopsy
- A biopsy is taken from the nasopharynx under local anesthesia for definitive diagnosis.
- Pathological examination identifies the tumor type.
Treatment of Nasopharyngeal Cancer
Nasopharyngeal cancer is not suitable for surgery! The standard treatment approach is a combination of radiotherapy (radiation therapy) and chemotherapy.
Radiotherapy (Radiation Therapy)
- The primary treatment method for nasopharyngeal cancer.
- Radiation is used to control the primary tumor and lymph nodes.
- IMRT (Intensity-Modulated Radiotherapy) helps minimize side effects by targeting the tumor precisely.
Chemotherapy (Drug Therapy)
Chemotherapy is combined with radiation therapy to shrink the tumor and control distant metastases.
- In advanced stages, chemotherapy may be given before radiotherapy (neoadjuvant chemotherapy).
- It may also be used after radiotherapy to prevent recurrence.
Stages and Prognosis of Nasopharyngeal Cancer
The response to treatment depends on the cancer stage, spread, and sensitivity to radiation therapy.
- Stage 1: Tumor is localized and not spread to lymph nodes. High treatment success.
- Stage 2–3: Tumor has grown and spread to lymph nodes. Combination of radiotherapy and chemotherapy is used.
- Stage 4: Distant metastases are present. Supportive treatments are added to chemotherapy.
About 80% of patients diagnosed early can achieve disease-free survival!
Conclusion and Recommendations
When nasopharyngeal cancer is diagnosed early, treatment success is very high!
Avoid Risk Factors:
- Avoid smoking and tobacco products.
- Reduce intake of salted and smoked foods.
- Maintain a healthy and balanced diet.
Be Vigilant for Early Diagnosis:
- Take unilateral hearing loss, ear ringing, nasal congestion, and neck swelling seriously.
- Undergo a detailed ENT examination if you experience symptoms!
Consulting an ENT specialist experienced in nasopharyngeal cancer is very important for diagnosis and treatment.
Prof. Dr. Elif Aksoy
ENT Specialist – Head and Neck Cancer Surgery
