Nasopharyngeal Cancer
Nasopharyngeal carcinoma presents often as a neck lump. This is termed lymphadenopathy, where lymph nodes become enlarged. On presentation, symptoms are those of local invasion in the area. These include cranial nerve abnormalities, difficulty eating, pain on swallowing, and hoarseness of the voice, in addition to numerous others. Symptoms of sinus obstruction can also be evident. Risks for nasopharyngeal cancer include smoking, being from south-east asia, previous radiation, and beetle nut chew. When symptoms of nasopharyngeal cancer may be present, begin to look also for other primary cancers in the aerodigestive tract, throughout the chest.
Staging for nasopharyngeal cancer is through MRI of the head and neck, and a CT chest.
Treatment for nasopharyngeal cancer is surgical excision if possible, with complete neck dissection of nodes. This is concurrent with radiation therapy to the area. If surgery is not an option, or the cancer is disseminated widely, radiation therapy with concurrent chemotherapy, usually cisplatin chemotherapy given on Days 1, 17, 43 of a regimen of 35 radiation cycles. Chemotherapy can only sensitize the tissues to the radiation therapy. Overall, chemotherapy does not really improve survival. It is thought however, to improve quality of life and symptoms from tumor cell growth, but has its own side-effects.
Treatment of the head and neck region with radiation is notorious for causing inflammation of the mucous membrances of the mouth and upper gastrointestinal tract. Mucositis is severe and patients need a G-tube to supplement feeding. The risks of radiation therapy to the head and neck region are not benign, but can lead to optic nerve atrophy, blindness and hypothyroidism, and also xerostomia (dry mouth) indefinitely.