What are the symptoms of nose cancer and are you at risk?
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Have a persistently blocked nose or trouble hearing? These could exist signs of nose cancer
MP Baey Yam Keng and Olympic medallist Lee Chong Wei have both been in the news for their fight against nose cancer. Notice out more than about the condition and the factors that make you lot susceptible. Males, for instance, are ii to three times more likely to develop information technology than females.
(Photo: iStock/baona)
31 Jan 2022 07:16AM (Updated: 31 Jan 2022 09:06AM)
If you take been following the news, you'd have read about Senior Parliamentary Secretary for Ship Baey Yam Keng's nose cancer diagnosis in early on January. Back in 2018, Malaysian badminton player Lee Chong Wei also had to deal with early-stage nose cancer.
What exactly is it and what are the symptoms? Olfactory organ cancer – or nasopharyngeal cancer (NPC) – affects the nasopharynx, which is the upper office of the pharynx (pharynx) behind the nose.
"The cancer typically arises from a groove known as the fossa of Rosenmuller, situated at the side of the nasopharynx," said Dr Lim Keng Hua, an otorhinolaryngologist and ENT specialist at Ear Nose Pharynx, Caput & Neck Surgery at Mountain Elizabeth Medical Centre.
While Baey and Lee did not reveal what symptoms they experienced, NPC could start off as a persistently blocked nose. Blowing into a tissue doesn't assistance to unblock it and if the patient has been living with it for a few months (and gotten used to animate through the mouth), he'd accept dismissed information technology equally just a "sinus" trouble.
But there may be more accompanying signs. The patient might also detect a painless lump on the side of the neck as well as other symptoms such as a blocked ear, blood-stained saliva or phlegm, nose bleeds, frequent headaches or earaches, change in hearing (such equally a sudden loss of hearing or ringing in the ear), and/or even double vision.
YOUR GENES AND GENDER MATTER
Baey, a Member of Parliament, is 52 years onetime, while the 3-time Olympic silver medallist was 36 when he was diagnosed. Although we aren't privy to the details of their lifestyle, both men appear to exist healthy and in adept shape. So, why did they get information technology? And are men more prone to NPC?
Certain genetic take a chance factors are strongly associated with nose cancer, said Associate Professor Melvin Chua Lee Kiang, who is the head and senior consultant at the National Cancer Centre Singapore's (NCCS) Department of Head & Neck and Thoracic, Division of Radiation Oncology. However, these mutations do not explain why men are more at risk, he added.
Women may exist protected from NPC due to their higher oestrogen levels, said Dr Lim, echoing a hypothesis held by some experts. "Others suggest that it could be due to smoking since the addiction is more than prevalent among men. Withal, there is no conclusive evidence."
In full general, males are 2 to three times more likely to develop NPC than females, according to Assoc Prof Chua.
Other than having a family history of NPC, another genetic cistron is ancestry. "The majority of NPC patients accept ancestries that are traced to the Southern Chinese provinces," said Assoc Prof Chua. "More than 70 per cent of cases occur in Eastward and Southeast Asia. Hence, for Singaporeans, dialect groups that emigrated from the Cantonese, Teochew, Hokkien and Hainanese regions have a college incidence of NPC."
NOT But OLD UNCLES
Baey and Lee aren't unusual in their historic period profiles either. Citing the latest Singapore Cancer Registry Annual Report 2018, Assoc Prof Chua highlighted that near of the cases diagnosed betwixt 2022 and 2022 were Chinese males in their 30s to 50s.
"NPC ranks as the third-most common cancer among the 30-to-39-year-erstwhile historic period group, and the second-almost common cancer among the 40-to-49-year-former age group. This observation has remained abiding over the years," said Assoc Prof Chua.
According to the five-yr report, about 240 patients were diagnosed with NPC in Singapore each yr. As comparing, the top cancer amongst men during the aforementioned menstruation was colorectal cancer. It recorded an incidence rate of six,129, which averages out to about 1,532 cases per year.
NPC'south almanac average number of cases may still seem significant but it is really a downtrend from previous data, said Dr Donovan European union, a consultant with National University Cancer Institute, Singapore's Division of Surgical Oncology (Head and Neck Surgery). "In this near updated report, the incidence of NPC has actually been excluded from the top 10 cancers in men," he said.
Commented Assoc Prof Chua on the same written report: "Such an epidemiological trend is interesting as it would suggest that different take a chance factors are at play in causing NPC in the young versus that in the elderly. The causes underlying the overall declining tendency in NPC is unknown, but it could exist healthier eating habits, pass up in smoking numbers and economical development".
Cut Downwardly THE SALT
Back to the abovementioned Chinese dialect groups that are more prone to NPC. These communities are also more than likely to include salted fish and vegetables in their diet – which could explain their high take a chance of developing the cancer.
Said Dr Lim, citing a 2022 written report in the Chinese Journal Of Cancer: "Those who consumed salted meat or vegetables at to the lowest degree once a week was found to have a four-time increased run a risk of developing NPC compared to those who never or rarely consumed salted food".
"Salted and preserved foods are high in nitrosamines, which are carcinogenic compounds linked to NPC," explained Assoc Prof Chua. This link between a high intake of salted food and NPC is also observed anecdotally, he added.
Historically, mothers would flavour porridge with salted fish before feeding it to their babies and children. Since this is now an uncommon practice, he said that it might, in some means, account for the declining NPC rates.
VIRAL CONNECTIONS
Existence exposed to the Epstein-Barr virus (EBV) is a factor. In fact, Dr Lim noted that " 2 new variants of EBV were discovered by Singaporean scientists to have a high hazard of developing NPC. Individuals infected by this unique EBV strain accept 11 times college hazard for developing NPC than not-carriers".
"An EBV infection is probably the strongest run a risk factor associated with NPC that occurs in this part of the world," concurred Assoc Prof Chua, who added that the homo papilloma virus (the virus responsible for cervical cancer) is also linked to a less common subtype of NPC.
WHAT ABOUT SMOKING?
The most immediate connect that most people would draw is smoking and NPC. But is tobacco utilize a gene in the outset place? Dr Lim said that it has been proposed that tobacco may contain substances that further activate the action of EBV if you become infected.
" Tobacco smoking is significantly associated with the risk of NPC. Compared to never smokers, current smokers had four times the risk of developing NPC, and those who had e'er smoked had double the risk," he said.
Dr Eu begged to differ. There are many types of NPC, he said. "Smoking, in general, is not a well-established hazard factor for the cancer subtypes seen in our population. But it has been shown to exist a chance factor for other subtypes of NPC."
DIAGNOSIS
NPC has an insidious way of creeping up on its victims. In its early stage, it is almost undiscernible. Nigh patients are diagnosed at a later phase and the vast majority of them nowadays with cervix lumps, according to Dr Eu.
"Early-stage NPC tends to be relatively asymptomatic and is often discovered past take chances," added Assoc Prof Chua. In fact, around 70 per cent of NCCS's patients nowadays with advanced stages 3 to 4 NPC. The symptoms range from the abovementioned signs and may besides include facial numbness and jaw tightness when the cancer has invaded the skull bones and further into the encephalon, he said.
The diagnosis is usually made after a nose telescopic known as a nasoendoscope, explained Dr Lim. It allows the doctor to search for tumour growths in the nasopharynx. If detected, a biopsy is done to confirm the diagnosis.
TREATMENT
Fortunately, most NPC cases in Singapore are "radiosensitive", meaning they respond well to radiotherapy handling, said Dr Lim.
Dr Eu agreed that radiotherapy methods such every bit Intensity Modulated Radiation Therapy (IMRT) and Intensity Modulated Proton Therapy (IMPT) in the last 10 years take undergone vast progress to deliver greater precision in the treatment of NPC.
At the NCCS, for case, pioneering technology has been developed to focus more than on minimising the side effects of radiotherapy such as persistent dry oral cavity, chronic fatigue, chronic dental infections, and the loss of taste and smell (which can showtime to improve 3 weeks to two months afterwards radiotherapy ends, according to cancer.net). This is washed by delivering the high radiation dose to the neoplasm while minimising dosing the surrounding organs such as the salivary glands and swallowing muscles, explained Assoc Prof Chua.
The intensity of the treatment can even exist customised using (surprise, surprise) the EBV load detected in the patient'southward blood. "This exam tin be used at dissimilar points of handling: At diagnosis, during treatment, and end of treatment to adjust the treatment accordingly," said Assoc Prof Chua.
For later-stage NPC, chemotherapy may be added, said Dr Lim, while surgery may be included to treat recurring cases. "The use of minimally invasive surgical approaches such as endoscopic and robotic treatment has further improved patient outcomes," said Dr Eu.
Also assuring are the statistics on recurring NPC. "Early-stage olfactory organ cancer has a very low recurrence rate. This is, however, not then much the case for patients with avant-garde NPC, who have a reported relapse rate of between 10 per cent to 20 per cent," said Dr Eu.
As for prevention measures, try these , said Dr Lim: Don't smoke, minimise your intake of salted food and get screened regularly if yous accept a family history of NPC.
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Source: https://cnalifestyle.channelnewsasia.com/wellness/nose-cancer-symptoms-singapore-stage-1-299526
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