What is nasopharyngeal cancer?
Cancers occurring in the nasopharynx, that is, in the nasal region, are among the most common types of cancer in Turkey. Type 3 undifferentiated carcinoma is frequently seen in Turkey. From Memorial Şişli Hospital , Department of Otorhinolaryngology , Op. Dr. Nurten Küçük gave information about nasopharyngeal cancer and treatment methods.
WHAT İS THE NASOPHARYNX (NASAL)?
The transition zone connecting the nasal cavity and the oral cavity is called the nasopharynx (nasopharynx). It is the space that opens to the middle ear on both sides with the Eustachian tube. Since there is no visible area inside the nose with the naked eye, it is viewed through the nose with an endoscope device. Or it can be seen through the mouth with an instrument called a mirror. Adenoid, which is common in children, also occurs in the nasopharynx region. Adenoids are benign lymphoid tissues that are formed as the body’s defense mechanism and are common in every child. Adenoid tissue seen in children up to a certain age is not expected in adulthood, and if lymphoid tissue is observed in the nasopharynx in an adult, biopsy should be taken and sent for pathological examination.
WHAT İS NASOPHARYNGEAL CANCER?
Cancers that occur in the nasopharynx area are called nasopharyngeal cancer. It is among the most common types of cancer. Benign (benign) tumors and malignant (malignant) tumors can occur in the nasopharynx region. If the patient is an adult, adenoid formation is not expected in this region. If there is a lesion or mass in the nasopharynx region of the adult patient, an examination should be performed. Nasopharyngeal carcinomas are frequently seen in the adult group. In addition, lymphoma and leukemia in adults can be frequently involved in this region. In children, unlike adults, soft tissue (raptomyosarcoma) cancer in the nasopharynx region or benign angiofibroma or plasmacytoma can also be seen.
There are 3 types of nasopharyngeal cancer.
- Type 1 Squamous cell nasopharyngeal carcinoma ( SCC)
- Type 2 Non-keratinized well-differentiated nasopharyngeal carcinoma
- Type 3 Undifferentiated nasopharyngeal carcinoma
The nasopharyngeal cancer that responds most quickly to treatment is type 3. It is unlikely to recur after treatment. Type 1 squamous cell nasopharyngeal carcinoma can recur after treatment.
In addition , leukemia and lymphoma cancers can be frequently involved in the nasopharynx region. For this reason, a sample should be taken from suspicious tissues seen in the nasopharynx region and pathological examination should be performed and it should be determined whether the tissue is benign or a tissue with cancer risk.
WHAT ARE THE CAUSES OF NASOPHARYNGEAL CANCER?
More than one factor may play a role in nasopharyngeal cancers. Environmental factors (air pollution, exposure to chemical vapors), genetic predisposition and viruses are among these factors.
Nasopharyngeal cancer, which is seen most frequently in adolescence at an average age of 40-50, affects men more.
Having nasopharyngeal cancer in the person’s family also increases the risk.
Epstein Barr virus (EBV) is closely associated with nasopharyngeal cancer. A nasopharyngeal examination should be performed on EBV positive persons.
The incidence of nasopharyngeal cancer is higher in smokers.
Nutritional habits are also among the causes of nasopharyngeal cancer. Poor eating habits, excessive consumption of smoked foods, and cooking on wood fire increase the likelihood of this disease.
WHAT ARE THE SYMPTOMS OF NASOPHARYNGEAL CANCER?
Among the most common symptoms are masses in the neck. One of the most common symptoms in adults is unilateral middle ear infections. The Eustachian tube opens into the nasopharynx from both sides. When the mass covers any of these areas, unilateral middle ear inflammation may occur because the aeration of the ear is impaired. In unilateral ear infections in adults, nasopharyngeal examination should be performed and it should be checked whether there is a mass in this region. In general, patients in nasopharyngeal cancer;
- Lymph node in the neck, mass
- nasal congestion
- Nose bleeding
- persistent middle ear infection
- Ear ringing and ear congestion
He may consult a doctor with complaints of vision problems and pain due to cranial nerve involvement.
HOW İS THE DİAGNOSİS OF NASOPHARYNGEAL CANCER MADE?
In a suspicious situation in the Nasopharynsk region, a physical examination is performed first. Then, if necessary, imaging techniques such as tomography, MR and Pet CT are also used.
The nasopharynx region can be seen through the nose with an endoscope device or from the oral cavity with a mirror. Normally the nasopharynx
The region is flat. If there is a mass, swelling or difference in this area, the otolaryngologist should take a biopsy from this area. Nasopharyngeal cancer can sometimes involve the neck. These involvements can be clearly determined by medicated tomography or PET CT results. Definitive diagnosis of nasopharyngeal cancer is made by biopsy. The type of mass is determined in the biopsy. In nasopharyngeal masses, treatment is determined by the type of mass; Benign tumors can be surgically removed or followed. If the result is nasopharyngeal cancer, the treatment option is primarily radiotherapy + chemotherapy.
HOW İS THE TREATMENT OF NASOPHARYNGEAL CANCER?
The treatment of the mass, whose type is determined as a result of the biopsy, is also carried out in this direction. Nasopharyngeal cancer is usually treated with radiotherapy + chemotherapy . Especially Type 3 Undifferentiated carcinoma is a type that responds quickly to radiotherapy. Treatment with early diagnosis and regular follow-up gives successful results.
Lymphoma and leukemia diseases can also affect the nasopharynx region. Radiotherapy and chemotherapy are used in the treatment of these diseases.
If nasopharyngeal cancer is not caught and treated at an early stage, it can metastasize in the late stages . Since the nasopharynx region is close to the brain, skull base and nerve involvements can be seen frequently. It can especially affect the 6th, 3rd, 4th and 5th nerves. When it metastasizes to the posterior base of the head and nerves, the patient may experience double visions or fall.
The age and gender of the patient are among the factors affecting the course of treatment. In nasopharyngeal cancer, which affects men more, advanced age, lymph node involvement in the neck region, nerve involvement in the head region and cancer types not caused by Epstein Bar virus may adversely affect the course of treatment.
FREQUENTLY ASKED QUESTİONS ABOUT NASOPHARYNGEAL CANCER
How long does nasopharyngeal treatment take?
Nasopharyngeal treatment is treated with surgery, radiotherapy or chemotherapy, depending on the type of mass, whether it is a benign or malignant tumor. The treatment is decided by otolaryngologists and oncologists. After these treatments, the patient should be followed regularly by an otolaryngologist and oncology specialist. The first 5 years after treatment is very important.
What is the nasal (nasopharynx) region?
The transition zone connecting the nasal cavity and the oral cavity is called the nasopharynx (nasopharynx). It is the space that opens to the middle ear on both sides with the Eustachian tube.
What is nasal meat?
Adenoid occurs in the nasopharynx region and is common in children. The benign, lymphoid tissues formed as the body’s defense mechanism are called adenoids. These tissues, which are seen in children up to a certain age, are considered normal tissue.