What is Nose Cancer?
Nose cancer, or nasopharyngeal cancer as is more accurately named, does not actually arise from the nose, the body part that protrudes from the face. Nose cancer occurs when cells of the lining of the passageway behind the nose, called the nasopharynx multiply abnormally to form a tumour. The most common cell type for nasopharyngeal cancer in Singapore is called undifferentiated carcinoma, which is strongly associated with a virus called Epstein Barr Virus (EBV). EBV infection is endemic, meaning common, in our part of the world. Most people do not have symptoms from EBV infection.
What are the symptoms of Nose Cancer?
Early nasopharyngeal cancers that are small often may not cause any symptoms for some time. As it grows, it may cause nose or ear blockage, often one sided, or blood-stained sputum. Because these symptoms may come and go, they may be mistakenly thought to be related to upper respiratory tract infection. Therefore, nasopharyngeal carcinoma often is diagnosed at later stages, with the following symptoms:
- Headache
- Double vision
- Facial Numbness
- Lump(s) in the neck
How is Nose Cancer diagnosed?
You are advised to consult a healthcare professional if you notice any persistent or unusual symptoms. These symptoms could be a sign of a less serious condition such as a cold or sinusitis, but it is still worth to get it checked out. Some tests that might be performed include:
Lab Tests
A biopsy on the nasopharynx might be done, where a small sample of tissue is collected and examined. This is usually done during a nasal endoscopy where a long, thin, and flexible tube with a camera and light at the end is inserted into your nose to examine the area. Lastly, your doctor might use a fine needle to collect cells from a swollen neck lymph node to see it has spread there. These will be sent to the lab for examination.
Imaging Tests
If you are diagnosed with nose cancer, your doctor may order imaging scans such MRI or PET-CT scans to assess your condition and help determine the stage of the cancer.
What treatments are available for Nose Cancer?
Radiation Therapy
Radiation therapy is the main curative treatment for nasopharyngeal carcinoma. It is the use of high energy x-rays, directed at the nasopharynx and neck, that can destroy the cancer cells. For early stages, radiotherapy alone is sufficient to cure NPC. It is given daily over 6 to 7 weeks. For later stages, addition of chemotherapy is required to maximize the cure rates. Chemotherapy is the use of anti-cancer drugs to destroy cancer cells. It is usually used at the same time as radiation therapy to enhance its effect. In recent years, for the more advanced cancers, more intensive chemotherapy is given first to shrink the cancer and prevent its spread, followed by combination chemotherapy and radiotherapy to eliminate the cancer. This has resulted in increased cure rates.
Chemotherapy
For incurable cases that have spread beyond the head and neck, chemotherapy is the main treatment to shrink the cancer and prolong life. There are also newer drug therapies like targeted therapy and immunotherapy that can be used alongside chemotherapy.
