Disease: Nasopharyngeal carcinoma

    Overview

    Nasopharyngeal (nay-zoh-fuh-RIN-jee-ul) carcinoma is cancer that occurs in the nasopharynx, which is located behind your nose and above the back of your throat.

    Nasopharyngeal carcinoma is rare in the United States. In other parts of the world — specifically Southeast Asia — nasopharyngeal carcinoma occurs much more frequently.

    Nasopharyngeal carcinoma is difficult to detect early. That's probably because the nasopharynx isn't easy to examine and symptoms of nasopharyngeal carcinoma mimic those of other, more-common conditions.

    Treatment for nasopharyngeal carcinoma usually involves radiation therapy, chemotherapy or a combination of the two. You can work with your doctor to determine the exact approach depending on your particular situation.

    Source: http://www.mayoclinic.com

    Symptoms

    In its early stages, nasopharyngeal carcinoma may not cause any symptoms. Possible noticeable symptoms of nasopharyngeal carcinoma include:

    • A lump in your neck caused by a swollen lymph node
    • Blood in your saliva
    • Bloody discharge from your nose
    • Nasal congestion
    • Hearing loss
    • Frequent ear infections
    • Headaches

    When to see a doctor

    Early nasopharyngeal carcinoma symptoms may not always prompt you to see your doctor. However, if you notice any unusual and persistent changes in your body, such as unusual nasal congestion, that don't seem right to you, see your doctor.

    Source: http://www.mayoclinic.com

    Causes

    Cancer begins when one or more genetic mutations cause normal cells to grow out of control, invade surrounding structures and eventually spread (metastasize) to other parts of the body. In nasopharyngeal carcinomas, this process begins in the squamous cells that line the surface of the nasopharynx.

    Exactly what causes the gene mutations that lead to nasopharyngeal carcinoma isn't known, though factors, such as the Epstein-Barr virus, that increase the risk of this cancer have been identified. However, it isn't clear why some people with all the risk factors never develop cancer, while others who have no apparent risk factors do.

    Source: http://www.mayoclinic.com

    Diagnosis

    Tests to diagnose nasopharyngeal carcinoma

    Tests and procedures used to diagnose nasopharyngeal carcinoma include:

    • Physical exam. Diagnosing nasopharyngeal carcinoma usually begins with a general examination. Your doctor will ask questions about your symptoms. He or she may press on your neck to feel for swelling in your lymph nodes.
    • Exam using a camera to see inside your nasopharynx. If nasopharyngeal carcinoma is suspected, your doctor may recommend a nasal endoscopy.

      This test uses a thin, flexible tube with a camera on the end to see inside your nasopharynx and look for abnormalities. The camera may be inserted through your nose or through the opening in the back of your throat that leads up into your nasopharynx.

      Nasal endoscopy may require local anesthesia.

    • Test to remove a sample of suspicious cells. Your doctor may also use the endoscope or another instrument to take a small tissue sample (biopsy) to be tested for cancer.

    Tests to determine the extent of the cancer

    Once the diagnosis is confirmed, your doctor orders other tests to determine the extent (stage) of the cancer, such as imaging tests.

    Imaging tests may include:

    • Computerized tomography (CT)
    • Magnetic resonance imaging (MRI)
    • Positron emission tomography (PET)
    • X-ray

    Once your doctor has determined the extent of your cancer, a Roman numeral that signifies its stage is assigned. The stages of nasopharyngeal cancer range from I to IV.

    The stage is used along with several other factors to determine your treatment plan and your prognosis. A lower numeral means the cancer is small and confined to the nasopharynx. A higher numeral means cancer has spread beyond the nasopharynx to lymph nodes in the neck or to other areas of the body.

    Source: http://www.mayoclinic.com

    Complications

    Nasopharyngeal carcinoma complications can include:

    • Cancer that grows to invade nearby structures. Advanced nasopharyngeal carcinoma can cause complications if it grows large enough to invade nearby structures, such as the throat, bones and brain.
    • Cancer that spreads to other areas of the body. Nasopharyngeal carcinoma frequently spreads (metastasizes) beyond the nasopharynx.

      Most people with nasopharyngeal carcinoma have regional metastases. That means cancer cells from the initial tumor have migrated to nearby areas, such as lymph nodes in the neck.

      Cancer cells that spread to other areas of the body (distant metastases) most commonly travel to the bones, lungs and liver.

    Source: http://www.mayoclinic.com

    Prevention

    No sure way exists to prevent nasopharyngeal carcinoma. However, if you're concerned about your risk of nasopharyngeal carcinoma, you may consider avoiding habits that have been associated with the disease. For instance, you may choose to cut back on the amount of salt-cured foods you eat or avoid these foods altogether.

    Tests to screen for nasopharyngeal carcinoma

    In the United States and in other areas where the disease is rare, routine screening for nasopharyngeal carcinoma isn't done.

    But in areas of the world where nasopharyngeal carcinoma is much more common — for instance, in some areas of China — doctors may offer screenings to people thought to be at high risk of the disease. Screening may involve blood tests to detect the Epstein-Barr virus.

    Source: http://www.mayoclinic.com

    Lifestyle and home remedies

    Coping with dry mouth

    Radiation therapy for nasopharyngeal carcinoma often causes dry mouth (xerostomia).

    Having a dry mouth can be uncomfortable. It can also lead to frequent infections in your mouth and difficulty eating, swallowing and speaking, and can increase problems with health of your teeth. Ask your doctor whether you should see a dentist if you experience dry mouth complications.

    You may find some relief from dry mouth and its complications if you:

    • Brush your teeth several times each day. Use a soft-bristled toothbrush and gently brush your teeth several times each day. Tell your doctor if your mouth becomes too sensitive to tolerate gentle brushing.
    • Rinse your mouth with a warm saltwater solution after meals. Make a mild solution of warm water, salt and baking soda. Rinse your mouth with this solution after each meal.
    • Keep your mouth moistened with water or sugarless candies. Drink water throughout the day to keep your mouth moistened. Also try sugarless gum or sugarless candies to stimulate your mouth to produce saliva.
    • Choose moist foods. Avoid dry foods. Moisten dry food with sauce, gravy, broth, butter or milk.
    • Avoid acidic or spicy foods and drinks. Choose foods and drinks that won't irritate your mouth. Avoid caffeinated and alcoholic beverages.

    Tell your doctor if you have dry mouth. He or she may provide treatments to help you cope with more-severe signs and symptoms of dry mouth. Your doctor may also refer you to a dietitian who can help you find foods that are easier to eat if you're experiencing dry mouth.

    Source: http://www.mayoclinic.com

    Coping and support

    Everyone deals with a cancer diagnosis in his or her own way. You might experience shock and fear after your diagnosis. Allow yourself time to grieve.

    A cancer diagnosis can make you feel as if you have little control, so take steps to empower yourself and control what you can about your health. Try to:

    • Learn enough to feel confident making decisions. Write down questions and ask them at the next appointment with your doctor. Get a friend or family member to come to appointments with you to take notes.

      Ask your health care team for further sources of information. Gather enough information so that you feel confident in making decisions about your treatment.

      Contact the National Cancer Institute for information online or by telephone at 800-4-CANCER (800-422-6237). The American Cancer Society also offers support and information on its website and by telephone at 800-227-2345.

    • Find someone to talk to. You may find it helps to have someone to talk to about your emotions. This may be a close friend or family member who is a good listener.

      Other people who may provide support include social workers and psychologists — ask your doctor for a referral. Talk with your pastor, rabbi or other spiritual leader.

      Other people with cancer can offer a unique perspective, so consider joining a support group — whether it's in your community or online. Contact the American Cancer Society for more information on support groups.

    • Take time for yourself when you need it. Let people know when you want to be alone. Quiet time to think or write in a journal can help you sort out all the emotions you're feeling.
    • Take care of yourself. Prepare yourself for treatment by making healthy lifestyle choices. For instance, if you smoke, quit smoking.

      Eat a variety of fruits and vegetables. Get exercise when you feel up to it, but check with your doctor before starting a new exercise program.

      Try to get enough sleep so that you wake feeling refreshed. Talk to your doctor if you're having trouble sleeping. Try to control stress by prioritizing what's important to you.

      These healthy choices can make it easier for your body to cope with the side effects of treatment.

    Source: http://www.mayoclinic.com

    Risk factors

    Researchers have identified some factors that appear to increase your risk of developing nasopharyngeal carcinoma, including:

    • Sex. Nasopharyngeal carcinoma is more common in men than it is in women.
    • Race. This type of cancer more commonly affects people in parts of China, Southeast Asia and northern Africa. In the United States, Asian immigrants have a higher risk of this type of cancer than do American-born Asians. Inuits in Alaska also have an increased risk of nasopharyngeal cancer.
    • Age. Nasopharyngeal cancer can occur at any age, but it's most commonly diagnosed in adults between the ages of 30 and 50.
    • Salt-cured foods. Chemicals released in steam when cooking salt-cured foods, such as fish and preserved vegetables, may enter the nasal cavity, increasing the risk of nasopharyngeal carcinoma. Being exposed to these chemicals at an early age may increase the risk even more.
    • Epstein-Barr virus. This common virus usually produces mild signs and symptoms, such as those of a cold. Sometimes it can cause infectious mononucleosis. Epstein-Barr virus is also linked to several rare cancers, including nasopharyngeal carcinoma.
    • Family history. Having a family member with nasopharyngeal carcinoma increases your risk of the disease.

    Source: http://www.mayoclinic.com

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