Nose Cancer

What is Nose Cancer (Nasopharyngeal carcinoma)?

Nose Cancer Screening

Nasopharyngeal carcinoma (NPC) is cancer that arises from the back of the nasal cavity. It is one of the most common head and neck cancers and it is prevalent in Southeast Asia.

Studies have shown that the five countries with the highest number of NPC patients are Malaysia, Singapore, Indonesia, Vietnam and Brunei. [1]

What are the risk factors for Nose Cancer?

  1. Lifestyle and Environment: Smoking and constant exposure to air pollutants.
  2. Dietary Practices: consuming preserved food (e.g. salted fish) and certain traditional Chinese medical herbs.
  3. Family history of NPC, especially those with first-degree relatives suffering from NPC (e.g. parents, siblings).
  4. Male patients are found to have a higher incidence of NPC

Patients with a positive family history of NPC are recommended for screening tests.

What are the common presenting complaints of Nose Cancer?

Common presenting complaints include:

Block nose

Headache

Double vision

Neck lumps

Nosebleed

Blood stained saliva

Loss of hearing

Nose Cancer Screening

What are the available screening blood tests?

Laboratory blood tests like EBV viral DNA and EBV IgA serology tests are performed in the screening of NPC for recommended patients.

EBV has been found to have a close association with NPC. Thus it has been used as a marker for the detection of NPC.

The EBV viral DNA test is known for both its high sensitivity and specificity above 97% and 98% respectively. [2]

Hence, this makes the EBV Viral DNA a good screening test for NPC patients who do not show any symptoms.

Another blood test like the anti-EBV IgA serology is available as well. Although this is commonly performed, it has been found to have lower sensitivity in evaluating patients who are suspected to have NPC. [3]

Detection of NPC in its early stages of the disease has a good prognosis after treatment. Studies have shown that there is a higher 5-year survival rate when NPC is detected and treated at its early stages. [2]

How is it done?

It is a fuss-free process. A simple non-fasting blood test is normally performed and sent to the lab for analysis. The report will be available shortly within 3-5 working days.

Results

Patients with a positive result for the EBV DNA test are recommended to repeat the test at a later date. [3]

If the result is again positive, it is recommended that he or she consult with an ENT specialist.

Otherwise, patients with negative results are recommended to do annual screening tests subsequently for early detection of NPC.

Nose Cancer Screening is only available in our Dr Tan & Partners @Raffles Place in Singapore.

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

Written by:

Dr. Benjamin Loh

Reference:

  1. Mahdavifar, N., Ghoncheh, M., Mohammadian-Hafshejani, A., Khosravi, B., & Salehiniya, H. (2016). Epidemiology and inequality in the incidence and mortality of nasopharynx cancer in asia. Osong Public Health and Research Perspectives7(6), 360–372. Retrieved from https://doi.org/10.1016/j.phrp.2016.11.002
  2. 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
  3. Chan, K. C. A., Hung, E. C. W., Woo, J. K. S., Chan, P. K. S., Leung, S.-F., Lai, F. P. T., … Lo, Y. M. D. (2013). Early detection of nasopharyngeal carcinoma by plasma Epstein-Barr virus DNA analysis in a surveillance program. Cancer119(10), 1838–1844. Retrieved fromhttps://doi.org/10.1002/cncr.28001

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