Nasopharyngeal carcinoma clinical manifestations

Written by Deng Bang Yu
Otolaryngology
Updated on September 17, 2024
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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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Early symptoms of nasopharyngeal carcinoma

The symptoms of nasal cancer can be numerous. In the early stages, symptoms might not be apparent because the area affected is relatively small, which can make the symptoms unclear. Possible symptoms include bloody nasal discharge and poor nasal airflow. Some patients might experience a foreign body sensation in the nasopharyngeal area. The most important thing, however, is to use diagnostic aids to make an assessment. This can include a nasopharyngoscopy, an enhanced CT of the nasopharynx, or an enhanced MRI to preliminarily determine the presence of a tumor. If a tumor is suspected, it is possible to consider performing a biopsy and lab tests under endoscopy. Only after completing the biopsy and lab tests can it be confirmed whether it is nasopharyngeal cancer, and then further treatment plans can be considered.

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Can stage IV nasopharyngeal cancer be cured?

Nasopharyngeal carcinoma is a relatively common type of malignant tumor in the head and neck region. If it is stage IV nasopharyngeal carcinoma, achieving clinical cure is very difficult; only a small portion of patients have the chance to achieve clinical cure, as stage IV nasopharyngeal carcinoma is considered advanced. The current common treatments are a combination of radiotherapy and chemotherapy. During the treatment process, regular reviews are necessary to observe the effects of the treatment. Some patients respond well to the treatment, and the tumor can be completely eliminated after treatment; however, for some patients, the treatment can only control the rapid growth of the tumor, not completely eradicate it. Even if the tumor completely subsides, there might still be a chance of local recurrence or distant metastasis after the treatment ends.

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Written by Deng Bang Yu
Otolaryngology
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How is nasopharyngeal carcinoma diagnosed?

Nasopharyngeal carcinoma is a malignant, occupying lesion that occurs in the nasopharyngeal area, and clinically it is mainly squamous cell carcinoma. Relatively speaking, although this tumor is malignant, its degree of malignancy is relatively low, especially when compared to liver cancer, lung cancer, and other malignant tumors. The definitive diagnosis of any tumor primarily relies on histopathological diagnosis, which means that pathological examination is the gold standard. In the case of nasopharyngeal carcinoma, we can make a pathological examination by using nasopharyngeal biopsy tissue with forceps under nasendoscopy. If cancer cells are found, then it is essentially confirmed. Of course, other examination methods, such as CT and MRI, are also helpful in diagnosing nasopharyngeal carcinoma and determining whether there are any metastases.

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Written by Li Rui
Otolaryngology
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Characteristics of headaches caused by nasopharyngeal carcinoma

Nasopharyngeal carcinoma is a relatively common otorhinolaryngological disease with various clinical symptoms. The more common symptoms include nasal congestion, runny nose, and bloody nasal discharge. Some patients may experience headaches, which could potentially be due to intracranial metastasis of the nasopharyngeal carcinoma or nerve invasion, causing neuropathic pain. The specific characteristics of the headache mainly manifest as persistent and severe pain. Although pain relief medications can temporarily alleviate the symptoms, the relief usually does not last long. After the effects of the medication wear off, the pain may recur. Moreover, this condition is generally challenging to treat, and treatment outcomes may not be ideal.

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Written by Li Rui
Otolaryngology
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Do people with nasopharyngeal carcinoma lose weight?

Some patients with nasopharyngeal carcinoma may experience weight loss, but individual differences exist. This is somewhat related to the condition itself as well as to the individual's resistance and their baseline physical fitness. If the condition is detected early and the clinical symptoms are not particularly obvious, most patients will not show significant weight loss, and many people may not have noticeable symptoms. If the condition is severe, and diet and nutrition are not properly managed in a timely manner, patients may experience weight loss, especially in advanced stages of the illness. This can result in a cachectic-like state, which poses greater challenges for treatment. It is necessary to seek medical attention promptly, assess the physical condition, and consider the need for radiotherapy and chemotherapy.