Medihub - Medical Information - ENT - Nasopharyngeal Carcinoma (Nose cancer)

Nasopharyngeal Carcinoma (NPC) is cancer of the nasopharynx (back of nasal cavity) which is commonly seen in the Chinese. The causes for this condition are genetic, viral and environmental.

The most common presenting symptom is a neck lump (figure 5). Fifty to seventy percent of patients present with a neck lumps. One third of these have lumps over both sides of the neck. Nasal symptoms such as bleeding, nasal obstruction and blood-stained sputum are second most common. Patients can also present with ear blockage from fluid in the middle ear (see otitis media with effusion under common ear conditions), diplopia (double-vision), headache.

Routine screening for nose cancer uses the Epstein-Barr Virus (EBV) serology to detect patients are higher risk. However, this test is not 100% fool-proof ie. there are false positives and negatives.

The best way to examine the postnasal space (nasopharynx) is using endoscopy. A flexible fibreoptic endoscope is passed through the nasal cavity and the postnasal space is examined. If a mass is seen (figure 6), it can be biopsied under local anaesthesia as a clinic procedure. Neck lumps are subjected to fine needle aspiration cytology (FNAC). This generally yields the diagnosis if the disease is present in 95% to 98% of the time.

The treatment for NPC depends on the stage of disease. If it is detected early, radiotherapy is the main modality of treatment. If the disease is advanced, combined chemotherapy and radiotherapy is advocated. Surgery only has a role in persistent or recurrent disease.