Cancers that occur 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.
What is Nasopharynx?
The nasopharynx is the transition zone that connects the nasal cavity and the oral cavity. It is the space that opens to the middle ear on both sides with the Eustachian tube. Since there is no visible area through 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 frequently found in every child and formed as a defense mechanism of the body. If lymphoid tissue is observed in the nasopharynx in an adult, a biopsy must be taken and sent for pathological examination.
What is Nasopharyngeal Cancer?
Nasopharyngeal cancer is cancer that occurs in the nasopharyngeal region. 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 definitely be made. Nasopharyngeal carcinomas are frequently seen in the adult group. In addition, lymphoma and leukemia in adults may also frequently involve in this region. Unlike adults, soft tissue (rhabdomyosarcoma) cancer in the nasopharynx region or benign angiofibroma or plasmacytoma can also be seen in children.
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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
Nasopharyngeal cancer Type 3 responds most quickly to treatment, it is unlikely to recur after treatment, while Type 1 squamous cell nasopharyngeal carcinoma may recur after treatment.
In addition, leukemia and lymphoma cancers can often be 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. 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 most common in adolescence at an average age of 40-50 years, 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, EBV positive people should definitely undergo a nasopharyngeal examination.
The incidence of nasopharyngeal cancer is also 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?
Masses in the neck are among the most common symptoms. Unilateral middle ear infections are among the most common symptoms in adults. The Eustachian tube opens into the nasopharynx from both sides. When the mass covers one 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 with nasopharyngeal cancer have the following findings:
- Lymph node in the neck, mass
- nasal congestion
- Nose bleeding
- persistent middle ear infection
- Ear buzz and ear congestion
A doctor can be consulted with complaints of vision problems and pain due to cranial nerve involvement.
How is Nasopharyngeal Cancer Diagnosed?
In a suspicious situation in the nasopharynx, physical examination is performed first, and then imaging methods such as tomography, MR and Pet CT are also used if necessary.
The nasopharynx area can be seen with an endoscope device from inside the nose or with a mirror from the oral cavity, this area is normally 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. The definitive diagnosis of nasopharyngeal cancer is made by biopsy. In the biopsy, the type of the mass is determined and the treatment is determined according to the type of the mass; Benign tumors can be surgically removed or followed. If the result is nasopharyngeal cancer, the treatment option is primarily radiotherapy + chemotherapy.
How Is The Treatment Of Nasopharyngeal Cancer?
Treatment of nasopharyngeal cancer is usually with radiotherapy + chemotherapy. Especially Type 3 Undifferentiated carcinoma is a type that responds quickly to radiotherapy, and treatment gives successful results with early diagnosis and regular follow-up.
Lymphoma and leukemia diseases can also be involved in the nasopharynx region, and radiotherapy and chemotherapy are used for 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.
The age and gender of the patient are among the factors affecting the course of treatment. In nasopharyngeal cancer, which is more common in men, 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 Questions
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, and the first 5 years after treatment is very important.
The transition zone connecting the nasal cavity and the oral cavity is the nasopharynx, the nasal cavity, the cavity opening to the middle ear on both sides with the Eustachian tube.
Adenoid occurs in the nasopharynx and is common in children. Benign lymphoid tissues formed as a defense mechanism of the body are called adenoids. These tissues, which are seen in children up to a certain age, are considered normal tissue.
