Nasopharyngeal carcinoma is a malignant tumor in the nasopharyngeal region. This carcinoma is one of the head and neck tumors. Nasopharyngeal carcinoma is also referred to synonymously as epipharyngeal carcinoma or nasopharyngeal cancer. The abbreviation for the disease is NPC as a derivative of the English term "Nasopharyngeal Carcinoma".
In Central Europe and North America, nasopharyngeal carcinoma is very rarely observed. Germany, for example, only one to two out of 200, 000 people. However, nasopharyngeal carcinoma is very common in some Asian countries such as Burma, Taiwan or southern China, and in some North African countries. In Taiwan, this disease is the leading cause of death in young men.
The reason for the frequent occurrence of the disease there seems to be the chewing of betel nut. Children are particularly affected in North Africa. The reason for this is not clear yet. There are three forms of nasopharyngeal carcinoma:
There are several causes for nasopharyngeal carcinoma. So the so-called Epstein-Barr virus is responsible for the majority of the diseases. However, this virus is very common. About 98 percent of all adults are infected. The virus persists for a lifetime in the organism.
But only a few people develop a nasopharyngeal carcinoma. Therefore, a genetic component is also suspected as the cause of the development of the nose and throat cancer. The Epstein-Barr virus is among other things the trigger for the Pfeiffersche glandular fever, which is characterized by massive lymph node swelling.
During the infection, a large amount of lymphocytes is formed. However, if the proliferation of lymphocytes gets out of control, lymphoid and other lymphocyte-associated cancers such as nasopharyngeal carcinoma may form. Nasopharyngeal carcinomas based on the proliferation of squamous epithelial cells are caused by various environmental factors, improper eating habits or smoking.
All age groups may be affected by nasopharyngeal carcinoma. Usually, however, people fall ill in middle age. Often, however, the carcinoma is not diagnosed until very late because it causes no complaints for a long time. Early symptoms may include nosebleeds, otitis media, or middle ear effusion.
The patient often breathes only over the mouth because of nasal breathing problems. Often the disease becomes symptomatic only after the formation of metastases by the failure of the cranial nerves from III to VI. These metastases are regional lymph node metastases.
It comes to the emergence of the eyeballs, to see double images and sometimes to further visual disturbances and odor disorders. In addition, stubborn and violent headaches are typical, which can hardly be treated. However, the occurrence of distant metastases in the liver, lungs or bones due to the spread of cancer cells via the bloodstream is quite rare. Even those with advanced disease only develop distant metastases in about 30 percent of cases.
To diagnose a nasopharyngeal carcinoma, the methods of visual diagnostics, palpation, imaging and other device-medical procedures and serological laboratory tests are applied. During visual inspection or inspection, the absence of nasal breathing, cervical lymphoma and cranial nerve failures are noticeable. By palpation, painless swollen lymph nodes can be detected.
Important is the functional test of the various cranial nerves. Various procedures also determine the ENT status. An endoscopy of the nasopharynx can detect the tumor. The size of the tumor is determined by CT and MRI examinations. As part of the serology antibodies are detected against the Epstein-Barr virus.
Since it is a cancer of the nasopharyngeal carcinoma, it is in any case associated with various complications. As a rule, success in the treatment of the disease depends very much on the time of diagnosis and on the spread of the tumor to other regions of the body. Nasopharyngeal carcinoma may also reduce the patient's life expectancy, resulting in premature death.
Patients often suffer from nosebleeds or inflammation in the ears. Also complaints in the breathing with the nose can point to the tumor and should be examined. Above all, the transition of the tumor into the lymph nodes can lead to a rapid spread. Furthermore, the Nasopharynxkarzinom leads to vision problems and thus to double vision or a Schleiersehen.
Even severe headaches can occur that can not be relieved with the help of painkillers. The quality of life of the person affected is significantly reduced and reduced due to nasopharyngeal carcinoma. The cancer is completely removed in this disease. Whether it comes to a complete healing, however, can not be universally predicted. Those affected are usually also dependent on chemotherapy, which is associated with various side effects.
Nosebleeds, a feeling of tightness in the nose or sinuses, a general feeling of being unwell and an increasing malaise are to be imagined by a doctor. Swollen lymph, a decrease in physical and mental performance and an internal weakness are to be examined and treated.
In the case of inflammation of the middle ear, hearing or vision disorders, and an abnormality in smelling, a doctor must be consulted to determine the cause. Headaches, sleep disturbances and changes in the lameness are signs of health impairment that should be evaluated by a physician. If existing symptoms increase or if new disorders develop, a doctor is needed.
Interruptions or restrictions of breathing, a lack of oxygen in the organism or difficulty in breathing must be investigated. There is a risk of a shortage of the body, which can be life-threatening in severe cases. Changes in weight, loss of appetite and a withdrawal from social life are further indications of a disease.
Since the Nasopharynxkarzinom untreated leads to a premature end of life, a doctor's visit should be made at the first symptoms. The sooner a diagnosis is possible and therapy is initiated, the better the chances of recovery. Sudden nosebleeds, unusual taste in the mouth and swelling of the nose, throat or throat require a doctor.
The success of therapy depends on the stage of the disease. In small and localized tumors its complete removal may already lead to healing. However, this does not succeed in most cases. Due to the difficult accessibility of the tumor, complete removal is only rarely possible. That's why an operation usually does not make sense either.
The main treatment is radiotherapy. As a result, the tumor can often be treated very well. Usually only the survival time is extended. In favorable cases, however, a complete cure is possible. However, keratinizing squamous cell carcinomas respond worse to radiation treatment.
In advanced carcinomas, good results are often still achieved by a combination therapy of radiotherapy with chemotherapy. As a chemotherapeutic oxaliplatin is used. Since the Schmincke-Regaud tumor is particularly radiosensitive, the cure rate for radiation at stage I of the disease is even 90 percent.
The chances of recovery are, as generally with all malignant cancers, very much dependent on the stage of the tumor. Due to the very high radiation sensitivity of the malignant tumor tissue, there are certainly very good chances of recovery. This also applies if the cancer has already lodged in the regional lymph nodes. In those with first-stage tumors, the cure rates range from about 70 to 80%. The prognosis, however, is worse in patients with keratogenic nasopharyngeal carcinoma, as this type is considerably more resistant to radiotherapy.
The prognosis is generally best for cancer if it is detected early. Often, these are tumors that continue to grow in the anterior portion of the nasal cavity. In such tumors there is a fairly good prognosis comparable to tumors located further back in the nasopharynx. The cancer type also plays a role in the chances of recovery.
In the case of the Schmincke-Regaud type nasopharyngeal carcinoma, more than 90% of the patients can be successfully treated with timely diagnosis. This is mainly due to the high radiation sensitivity of the tumor tissue. In the fourth cancer stage, however, the chance of recovery falls to around 20 to 40%. The survival rate for 5 years varies with appropriate therapy between 90% and 58% in the early diagnosed compared to advanced disease.
The best way to prevent nasopharyngeal carcinoma is to abstain from smoking and drinking alcohol. In particular, this also applies to the chewing of chewing tobacco and betel nuts. Otherwise, the general risk of developing a malignant tumor is significantly reduced by a healthy lifestyle.
In the case of nasopharyngeal carcinoma, the measures and the possibilities of direct follow-up are in most cases clearly limited. The person concerned should therefore contact a doctor relatively early to prevent the occurrence of further complaints or complications. It usually can not come to an independent healing, so that a treatment by a doctor is always necessary.
In many cases, the nasopharyngeal carcinoma can not be cured completely, if it is detected late and the tumor has already spread in the body of the person concerned. Many patients rely on surgery to alleviate the symptoms. In this case, the person affected should definitely rest after the procedure and protect his body.
It is necessary to foresee efforts and stressful or physical activities so as not to burden the body unnecessarily. The support and help of one's own family is also helpful in nasopharyngeal carcinoma and can prevent the development of mental retardation or depression. Whether it comes through the disease to a reduced life expectancy can not be universally predicted.
The nose and throat cancer is associated with an immense loss of well-being and the usual quality of life. However, in order not to lose the courage and the hope, the affected person should direct his inner attitude and his cognitive processes to positive areas of his life. In daily interactions with other people, technical aids such as smartphones, apps or computers can make everyday life easier. In addition, a sign language such as the German Sign Language or another individual communication technique can help to replace the spoken language.
If it comes to the loss of sight, Braille helps to communicate with each other. Through the different methods, a conversation with the other people is possible and expedient. In self-help groups or in Internet forums, experiences with other stakeholders can be exchanged. Mutual help for self-help is made possible and facilitates coping with everyday life.
Especially important is the mental balance. For this the patient can try mental techniques and strengthen themselves. Meditation, Qi Gong, sound therapy or yoga help to mobilize the inner forces and promote harmony. Through cognitive training, the thoughts can be better focused on the supporting areas of life. By adapting and changing one's own behavior to the circumstances and developments of the current life circumstances the well-being is strengthened.