By Anjana Motihar Chandra
A painless lump in the neck is the most common symptom of nose cancer (also known as nasopharyngeal carcinoma or NPC), the ninth most prevalent cancer among men in Singapore. Its incidence is highest among Chinese men.
Nose cancer, which is a type of head and neck cancer, typically occurs between the ages of 35 to 55. It develops in the cells of the nasopharynx, the cavity that lies behind the nose, just above the throat.
Other symptoms of nose cancer, which does not feature among the top ten cancers for women in Singapore, include:
- Blocked nose
- Unexplained nosebleeds
- Ringing in the ears
- Sudden loss of hearing, usually in one ear
- Unusual pain or numbness in the face
- Double vision
Since its symptoms are common to other conditions, nose cancer is often detected late, when it’s at an advanced stage. However, it has a high cure rate when detected early, which is why early screening can improve outcomes.
Causes and risk factors of nose cancer
Nose cancer is usually caused by previous exposure to the Epstein Barr Virus (EBV) in genetically susceptible individuals, says Associate Professor Gopal Iyer, Senior Consultant, Division of Surgical Oncology, National Cancer Centre Singapore.
This common virus that causes glandular fever, can remain in a dormant state in the body and give rise to nose cancer at a later stage, although how and why it does so is not fully understood.
Your risk also increases if you have a family history of nose cancer and if you consume excess amounts of preserved foods such as cured meats, salted fish and fermented soy beans which contain cancer-causing nitrites.
Diagnosing and treating nose cancer
While conducting an examination for nose cancer, your doctor may examine your nasopharynx with a special angled mirror placed at the back of the throat or insert a tube called a nasoscope into one of your nostrils. A biopsy will determine if a suspicious growth is cancerous.
Once cancer is confirmed, your doctor may recommend blood tests, a chest x-ray and scans of the head and neck region to determine the spread of the disease.
Treatment for nose cancer, like other head and neck cancers, involves surgery, chemotherapy, and radiotherapy, or a combination of these and/or immunotherapy, says Dr Iyer. Early stage nose cancer is typically treated with radiotherapy. Surgery is considered an option if the cancer recurs.