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What Are The Sign Symptoms & Nose Cancer

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NPC stands for Nasopharyngeal Carcinoma. It is basically the most common form of cancer that arises from the back of the nose and it’s a silent killer. This is more common in Asian than in Western countries.
Over time, the tumour can grow, ulcerate and invade into nearby structures in your body, leading to nerve involvement. In its early stage, all these can occur without any symptoms. In the late stages, you might start to experience symptoms and these include:

  1. Block nose
  2. Headache
  3. Double vision
  4. Neck lumps
  5. Nose bleed
  6. Blood stained saliva
  7. Loss of hearing

RISKS FACTORS
There are various risk factors that you should be aware of.
The first is Age and Gender.
Nose cancer is more common in males and there is also a bimodal age presentation where occurrences peaked twice; once when the individual is in early adulthood and the second later in life.
The second is the presence of an infectious virus.
Studies have shown that the presence of EBV (also known as the Epstein – Barr Virus) has a positive correlation with Nose Cancer. As such, EBV antibodies and DNA are often tested for by performing simple blood tests in screening for Nose cancer.
The third is a lifestyle.
It is believed that smoking contributes to the risk of Nose cancer caused by the reactivation of EBV. Even though there is currently inconclusive evidence of this co-relation, smoking itself does cause many other diseases!
Another issue with lifestyle relates to our dietary practice. Consuming preserved foods – such as salted fish contains high levels of preservatives which increases risks of Nose cancer.
The last is Genetic Susceptibility.
Individuals with first-degree relatives that have been diagnosed with Nose cancer are also at a higher risk of being diagnosed with Nose cancer. While this is beyond your control, you can reduce your risk by limiting your exposure and watching your lifestyle.

What should you do?
As a starting point, you should undergo a physical health examination. A look into yours and your family’s medical history may also be of assistance.
If you do have a positive family history, you may consider doing a simple blood test to screen for Nose cancer. Studies have shown that there is a higher survival rate when Nose cancer is detected early.
Undergoing a non-fasting blood test is a fuss-free process and the report will usually be available within 3-5 working days. The doctors will advise you accordingly based on the results of the blood test.

If you like to know more about Nose Cancer & Nose Cancer Screening, please call or visit us at our clinics.
For more information, please email us at hello@dtapclinic.com.sg.

Nose Cancer and Nose Cancer Screening

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Nose Cancer and Nose Cancer Screening

What is Nose Cancer (Nasopharyngeal carcinoma)?

Nasopharyngeal carcinoma (NPC) is a cancer that arises from the back of the nasal cavity. It is more common in Asia than in Western countries.

What are the Signs and Symptoms of Nose Cancer?

What to look out for?
Common presenting complaints include:
• Block nose
• Headache
• Double vision
• Neck lumps and bumps
• Nosebleed
• Blood stained saliva
• Hearing loss

NPC can behave like a silent killer. One can be asymptomatic or showing no symptoms before experiencing symptoms.
Over time, the tumour can grow, ulcerate and invade into nearby structures leading to nerve involvement and other symptoms as stated above.
A tumour can also spread to distant spread to other parts of the body.

What are the risk factors for Nose Cancer?

  • Age and Gender
    It is a cancer that is more common in males.
    There is also a bimodal age presentation where occurrence peaks in younger and older adults.
  • Infective
    Epstein – Barr virus (EBV) infection
    The strong association between EBV infection and NPC is evident by anti-EBV antibody in the blood, an increased amount of EBV DNA levels in NPC tumour cells.
    This is why EBV antibodies are used in the clinical setting for the screening of Nose cancer.
    Human Papillomavirus (HPV) infection
    The role of HPV in NPC is less clear-cut in comparison to EBV in NPC but studies have shown that there might be an association with Nose Cancer.
  • Lifestyle
    Smoking
    There is postulation that smoking contributes to risks of NPC by causing reactivation of EBV.
    Even though there might not be sufficient evidence, smoking itself does cause many other diseases.
    Dietary practice
    Consuming preserved food which contains a high level of nitrosamines like salted fish, bacterial mutagens and EBV-reactivating substances is another risk of NPC.
    Some traditional Chinese medical herbs intake can lead to reactivation of EBV. 

Genetic Susceptibility
NPC has been associated with certain genetic predisposition and risks of NPC is increased in patients with first-degree relatives with NPC.

Nose Cancer Screening

  • History and Physical Examination.
    A thin camera also known as a flexible naso-endoscopy is useful for examination of the back of the nasal cavity and if needed, a tissue biopsy sample to be obtained at the same setting.
  • Future Tests include:
    Blood Tests
    A simple non-fasting screening blood test can be done to aid the detection of NPC.
    Given the close association between EBV and NPC, laboratory blood tests like EBV viral DNA and EBV IgA serology tests can be performed in the screening of NPC for patients belonging in high risks groups.
    Screening tests are recommended for patients who fall under the high risks group eg, those with positive family history.
    However, studies have also shown that early NPC being an indolent killer due to its relatively asymptomatic nature, has a higher 5-year survival rate when detected at an early stage. (see reference below)
    In addition, these tests can help to prognosticate treatment response and future recurrence of the same disease in patients diagnosed with NPC.
    Radiological
    Other imaging studies include magnetic resonance imaging (MRI) might be useful.

Treatment for Nose Cancer

Treatment options include radiotherapy, chemotherapy and surgery. Combined therapy of radiotherapy and chemotherapy together with surgery might be considered based on the location and extent of the lesion.

If you are interested in this service and wish to find out more, please call +65 6962 7144 or visit our clinic or drop us an email at hello@dtapclinic.com.sg.

Reference:
1 ) Chan, K. C. A., Woo, J. K. S., King, A., Zee, B. C. Y., Lam, W. K. J., Chan, S. L., … Lo, Y. M. D. (2017). Analysis of Plasma Epstein–Barr Virus DNA to screen for nasopharyngeal cancer. New England Journal of Medicine,378(10), 973-973. doi:10.1056/nejmx180004