Where is the best place to treat nasopharyngeal carcinoma?

Written by Li Rui
Otolaryngology
Updated on September 11, 2024
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Nasopharyngeal carcinoma currently mainly considers radiation therapy and chemotherapy, with radiation therapy as the primary treatment. It requires staging and typing based on different ranges of lesions and pathological biopsy types. After determining the stage and type, further radiation and chemotherapy plans can be established. At present, radiation therapy is the most important. Most patients need concurrent chemotherapy or adjuvant chemotherapy and require regular follow-ups. For some patients with cervical lymph node metastasis or recurrence of nasopharyngeal carcinoma after radiation therapy, who cannot undergo radiation or chemotherapy again or for whom radiation and chemotherapy have failed, surgery may be considered. However, surgery is generally not the first choice and its effectiveness is not particularly certain.

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Written by Yao Jun
Otolaryngology - Head and Neck Surgery
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Causes of Nasopharyngeal Carcinoma

Nasopharyngeal carcinoma is a highly prevalent malignant tumor in China, especially common in the Guangdong and Guangxi regions, as well as other coastal areas including Hunan, Fujian, and Jiangxi. These regions are among the highest incidence areas for nasopharyngeal carcinoma worldwide. The incidence rate in males is three times that of females, with the age group of 40 to 50 years being particularly at risk. The occurrence of nasopharyngeal carcinoma is associated with genetic, viral, and environmental factors, exhibiting racial and familial patterns. In areas like Guangzhou and the Pearl River Delta, it is possible for five out of nine people in the same family to have nasopharyngeal carcinoma. Infection with the Epstein-Barr virus is also one of the causes of nasopharyngeal carcinoma, in addition to environmental factors. Areas with low trace elements in rice and water, as well as low fluoride levels, are prone to higher incidences of this cancer. Patients with nasopharyngeal carcinoma typically have higher fluoride levels in their hair, and nitrites are also one of the major contributing factors to the condition.

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Written by Zhang Jun
Otolaryngology
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Can nasopharyngeal carcinoma be cured?

Nasopharyngeal carcinoma cannot be completely cured, as it is a malignant tumor, and malignant tumors cannot be completely cured worldwide. Nasopharyngeal carcinoma refers to the malignant tumors that occur at the top or lateral walls of the nasopharynx. The common clinical cause is viral infection, most commonly associated with the Epstein-Barr virus, causing dryness, pain, and itching in the nasopharynx, along with backflow, blood in sputum, and swollen lymph nodes in the neck. Patients need to undergo a detailed examination with an electronic nasopharyngoscope and a CT scan of the nasopharynx for diagnosis. If an abnormal neoplasm is found, local pathological treatment is required. Once confirmed as malignant, local radiation therapy, chemotherapy, and surgical treatment are also needed. After surgery, patients need to undergo regular follow-up examinations, and further treatment may be required if abnormal proliferation is found.

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Written by Yan Chun
Oncology
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What causes nasopharyngeal carcinoma?

The specific cause of nasopharyngeal carcinoma, a type of malignant tumor, is currently unclear, but it is considered to be related to some high-risk factors that may lead to the occurrence of nasopharyngeal cancer. Firstly, there are cases of EB virus infections in the nasopharyngeal area. The long-term stimulation of the nasopharyngeal mucosa by this virus leads to hyperplasia of the mucosa, which can become malignant and eventually form nasopharyngeal cancer. Additionally, some clinical studies suggest that the occurrence of nasopharyngeal carcinoma is related to genetic factors, indicating a genetic predisposition to nasopharyngeal carcinoma, which leads to its development. Furthermore, some considerations involve external carcinogenic factors affecting the nasopharyngeal area, such as long-term smoking or environmental air pollution, which can also lead to a high incidence of nasopharyngeal cancer.

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Written by Deng Bang Yu
Otolaryngology
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Nasopharyngeal carcinoma clinical manifestations

Nasopharyngeal carcinoma is the most common malignant tumor in the nasopharyngeal area, and clinically, it is primarily squamous cell carcinoma. The incidence of nasopharyngeal carcinoma is particularly high in the southern regions of China, especially in Guangdong. Initially, nasopharyngeal carcinoma manifests locally as a tumorous mass in the nasopharyngeal area, often with ulceration on the surface. This can lead to the presence of blood in nasal mucus, known as bloody nasal discharge. As the disease progresses, there can be swelling of the cervical lymph nodes, primarily involving the upper deep cervical lymph nodes, with about 60% of patients experiencing this type of lymph node enlargement. As the tumor enlarges, it may block the nasal passage, leading to persistent nasal congestion. The tumor's pressure on the Eustachian tube can cause symptoms of secretory otitis media. Furthermore, damage to the skull base by the tumor can lead to severe headaches. As a malignant tumor, the cancer can cause systemic symptoms such as malnutrition and cachexia. In advanced stages, metastatic symptoms may appear, such as bone and liver metastases, affecting these vital organs.

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Written by Li Rui
Otolaryngology
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What is nasopharyngeal carcinoma?

Nasopharyngeal carcinoma is a relatively common malignant tumor in the nasopharyngeal area, and the main pathological type is predominantly squamous carcinoma, most of which are poorly differentiated squamous carcinomas, constituting the most common malignant tumor in the nasopharyngeal area. Currently, the primary treatment option is radiotherapy, which is the most important; some patients may need to consider concurrent or adjuvant chemotherapy. If drug and radiotherapy treatments are ineffective, or if there is cervical lymph node metastasis, and for some patients where chemoradiotherapy fails with residual lesions, surgery may be considered. However, currently, the surgical treatment approach is generally not very mature and is somewhat controversial, thus it requires treatment at major hospitals.