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NASOPHARYNX CANCER
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NASOPHARYNX CANCER
The "nasopharynx" is the highest portion of the throat, behind the nose. When we
breathe through our nose, the air then goes into the nasopharynx. At the top of this area,
close to the brain, is a special "sieve" (cribriform plate) where smells are made
into nerve signals and conducted up into the brain to be recognized.
Air breathed through the nose is "filtered" by the tonsil tissue in the lower nasopharynx; air carried germs are slammed directly into these tonsils and destroyed by the body's immune system. Cancer in the nasopharynx, while rare in America, is more common in the Orient.
Two openings on the
side of the nasopharynx lead into the ear, and so pain in the nasopharynx may radiate
toward the ears. The top of the nasopharynx is called the "cribriform plate", which is
a sieve-like structure that transmits the nerves for smell to the brain. The back
of the nasopharynx is next to the "cavernous sinus", an area close to the brain through
which important blood vessels and nerves travel. Thus, problems in the nasopharynx can
damage these nerves (which emanate from the brain and are called "cranial nerves")
leading to eye or facial paralysis or blood distribution problems in the brain. The
nose is in front of the nasopharynx and the throat is downward. The most dangerous places
for the cancer to grow are upward and backward, that is into the brain. People usually
go for long periods before the cancer is diagnosed, since many symptoms are much
more often due to non-cancerous causes.
What is the average age of patients with head and neck cancers?
The average age is 59 years old. Sarcomas or cancers of the salivary glands,
thyroid or paranasal sinuses are usually younger than 59 years old, while those with
squamous cell cancers of the mouth, pharynx, and larynx are generally older than
59 years old.
How common is Nasopharynx cancer?
Each year in the United States there are about 11,000 new cases of nasopharynx cancer. 8,000 males and 3,000 females. Cancer of the nasopharynx is
primarily prevalent in immigrant Chinese and slightly less prevalent in first-generation
Chinese Americans. In certain Chinese provinces, rates as high as 20,000 per 100,000 have been reported! The incidence remains high for descendants of Southern Chinese
living in other countries, suggesting a genetic predisposition to the disease, in
combination with environmental triggers.
What is Cancer of the Nasopharynx?
Cancer of the nasopharynx is a disease in which cancer (malignant) cells are
found in the tissues of the nasopharynx. Cells in the nose are subjected to lots
of injury from heat and abrasion, and thus must divide frequently to replace those
lost due to injury and old age. Normally, cells divide quickly as we develop in the womb
and through infancy, and then the rate slows down considerably, just to replace cells
that die. the division of cells in the nose and elsewhere are under very tight control, regulated by the genes within the cells. When this control is lost, the cells
may start to divide in a haphazard, uncontrolled manner, and grow to form a swelling of abnormal cells, called a "tumor" . A "benign" tumor only grows within it's local area, it does not spread to distant organs, and it is not cancer. In contrast, a "malignant" tumor can spread to any area of the body. it is cancer . It is this ability to spread, or "metastasize", to vital organs which makes a cancer so dangerous. Cancers of the nose and the
mouth tend to grow to large sizes locally before they spread, but any cancer can
spread at any time. Cancer of the nasopharynx most commonly starts in the cells which
line the area, called "squamous" cells. These are similar to the lining cells of the mouth and upper throat. they
give rise to a cancer called"squamous cell carcinoma". Less commonly, the cancer may originate from gland cells within the nasopharynx,
it is then called "adenocarcinoma". About 60% of nasopharynx cancer spreads from other "primary sites" such as lung,
prostate, breast, stomach, colon, or kidneys. When the first evidence of cancer is
found in the the neck, due to lymph gland swelling there, the most likely area it
started was in the upper respiratory tract. Likely sites are the nasopharynx, tonsils,
base of tongue, and an area behind the base of the tongue called the pyriform sinus.
As will be seen, all of these sites are routinely examined when the patient is suspected of having a nasopharynx cancer.
What is Tornwaldt's Cyst?
Also called a "nasopharyngeal cyst", it is usually found in the midline of the
nasopharynx. It tends to be on the surface lining, and is covered by the mucous membrane
of the nasopharynx. If infected, it may cause persistent discharge with a foul taste and odor, eustachian tube obstruction ( the tube that connects the middle ear with
the throat and allows the air pressure on both sides of the eardrum to be equalized),
and sore throat. A discharge may be seen at the opening of the cyst. These symptoms may initially be confused with nasopharynx cancer.
What Causes, or Increases Risk for Nasopharynx Cancer?
Like any cancer, the exact reason why one person gets nasopharynx cancer and
another does not remains unknown . However, several "risk factors" have been shown to be much more likely to be present in nasopharynx cancer patients.
These include :
1) Tobacco usage-- This is the single strongest risk factor for developing cancers of the head and neck.
Any form of tobacco taken through the mouth, whether smoked or chewed, increases
the risk over time. The more tobacco that is used, for a longer period of time, the
higher the chance is to get cancer. Likewise, when use is stopped, the risk declines to
normal over a 5 to 10 year period.
2) Infections such as syphilis and some viruses can lead to cancer over time, these cause sores
which heal poorly. The constant attempt to heal leads to"chronic cell division" and thus more chance for cancer. Viruses can also get into the cells of the nose themselves and change the genes in them to form a cancer cell.
This elaborate process is called"oncogene activation". The most common virus noted to do this in the upper respiratory tract is the Human
Papillomavirus (HPV). Some people seem genetically predisposed to getting cancer
from viruses.
3) Lowered Immunity such as from AIDS or transplant anti-rejection drugs will increase the risk for many
cancers, including those of the "aero-digestive tract" (i.e. the area from the nose and mouth to the lungs and stomach). This will be especially
important in combination with the other risk factors noted.
4) History of Cancer of the aero-digestive tract can mean as much as 5% chance of a separate simultaneous
cancer, and a 25% chance of developing another cancer in this area over time (especially
if risks like smoking are continued).
5) Breathing sawdust and smoke from certain fires increases the risk for nasopharynx and sinus cancers, probably from chronic irritation.
What are the Symptoms of Nasopharynx Cancer?
A cancer must grow to 1 billion cells to be just 1 cm. (about 1/2") across, so
a very early cancer will have no symptoms and likely to go undetected . As it grows, it produces symptoms in it's local area, and eventually in distant
areas as it spreads.
The "nasopharynx" is the highest portion of the throat, behind the nose. When we
breathe through our nose, the air then goes into the nasopharynx. At the top of this area,
close to the brain, is a special "sieve" (cribriform plate) where smells are made
into nerve signals and conducted up into the brain to be recognized.
Air breathed through the nose is "filtered" by the tonsil tissue in the lower nasopharynx; air carried germs are slammed directly into these tonsils and destroyed by the body's immune system. Cancer in the nasopharynx, while rare in America, is more common in the Orient.
It is critical to get prompt diagnosis and proper treatment for a nasopharynx cancer problem; this can literally make the difference between life and death. Understanding your options will give you the peace-of-mind of knowing you have done everything possible to ensure a successful outcome for yourself or a loved one.
The Cancer Group Institute's material explains, in plain English, the definition, types, risk factors, frequency, symptoms, evaluation, historical and latest effective treatments for nasopharynx cancer. We describe surgery, radiation and chemotherapy along with their side-effects and results. While we don't promise a cure, we tell you everything you must know to help you make the right choices today for nasopharynx cancer problem.
