Know yourself, know your enemy, and you will never be defeated
What is Nasopharyngeal Cancer? How to Identify and Treat It? South Korean actor Kim Woo-bin, who rose to fame through the drama The Heirs, was diagnosed with nasopharyngeal cancer two years ago and suspended all his acting work. After about a year of treatment, his condition gradually improved, and earlier this year, netizens spotted him vacationing in Australia with his girlfriend. In a public letter, he revealed that he underwent 35 radiation therapy sessions in just seven months.
Higher Incidence Among Males
Nasopharyngeal cancer is more commonly found in Southern China. In 2022, nasopharyngeal cancer ranked as the 10th most common cancer in Hong Kong, accounting for 2.0% of all new cancer cases. Additionally, it was the 10th most common cancer among males.
In 2022, there were a total of 705 new cases of nasopharyngeal cancer, with 522 cases in males and 183 cases in females, resulting in a male-to-female ratio of approximately 2.9 to 1. By gender, the crude incidence rates per 100,000 population were 15.6 for males and 4.6 for females. The age-standardized incidence rates per 100,000 standard population were 10.1 for males and 2.9 for females.The age-standardized incidence rates for nasopharyngeal cancer for both sexes combined, as well as for males and females separately, have shown a declining trend over the past 40 years and the past 10 years.
In 2023, nasopharyngeal cancer caused 254 deaths, accounting for 1.7% of all cancer deaths. It ranked as the 13th most fatal cancer in Hong Kong. By gender, the crude mortality rates per 100,000 population were 6.0 for males and 1.2 for females, while the age-standardized mortality rates per 100,000 standard population were 3.2 for males and 0.6 for females.
Early Symptoms of Nasopharyngeal Cancer
Suppose you experience tinnitus, hearing loss, recurrent middle ear infections, persistent nasal congestion, bloody nasal or throat discharge, or painless neck lumps. In that case, you may have nasopharyngeal cancer and should get examined promptly. Should the tumour extend to the skull base and brain, it may cause headaches, facial numbness, double vision, or lockjaw.
In more severe cases of nasopharyngeal cancer, complications may occur. Cancer cells can invade nearby structures such as the throat, brain, and bones when they grow to a specific size. Additionally, cancer cells may spread to other parts of the body, with nearby metastasis to neck lymph nodes or distant spread to lungs and liver. If symptoms suggestive of nasopharyngeal cancer are noticed, early examination is recommended.
Understanding Cancer Causes
Family History and Physical Examination
To diagnose nasopharyngeal cancer, doctors will first inquire about symptoms, medical history, and family history. They will thoroughly examine the ears, nose, and throat, and check for neck tumours. An endoscope will then be used to inspect the nasopharynx for tumours. If a tumor is found, a small tissue sample (biopsy) will be removed for microscopic analysis to determine malignancy and identify the cause.
Following this, doctors will perform a detailed evaluation, including imaging tests, to assess whether the tumour has spread to the skull, brain, or nerves, helping to determine the cancer’s stage. Diagnostic approaches generally fall into three categories:
Based on tumour size and extent of involvement, nasopharyngeal cancer is generally classified into 5 stages:
| Stage | Scope of Impact |
| Stage I | The tumour is localised to the nasopharynx and has not invaded surrounding tissues. |
| Stage II | The tumour has invaded the tissues on the side of the pharynx, or has spread to lymph tissues on one side outside the nasopharynx, but has not yet spread to more distant locations. |
| Stage III | Cancer cells have spread to lymph nodes on both sides of the neck, but have not yet spread to more distant locations, or the tumour has extended to the skull or sinuses. |
| Stage IVA | The tumour has extended to the brain, or has invaded cranial nerves, or has spread to supraclavicular lymph nodes, or the lymph nodes have exceeded 6 centimetres. |
| Stage IVB | The tumour has spread to distant locations, such as bones, liver, or lungs. |
Staging nasopharyngeal cancer helps doctors plan treatment, determine radiation doses, and choose appropriate therapies.
Primary Treatment Approaches
This treatment uses high-energy X-rays to target and destroy cancer cells in patients without distant spread. For metastatic cases, it can alleviate symptoms like bone pain. The painless outpatient procedure involves no anaesthesia or hospitalisation, typically administered 5 times weekly for 7 weeks using large equipment. Patients don’t become radioactive and require no isolation.
Before treatment, radiation therapists create custom plastic masks moulded to each patient’s facial and cranial contours to ensure precise positioning during radiation targeting. After mask fitting, patients undergo CT scanning to enable physicians to delineate tumour boundaries and identify critical avoidance structures, including spinal cord nerves and brainstem. Radiation physicists then develop personalised treatment plans to optimise beam angles and intensity.
This treatment delivers drugs intravenously or orally, typically over several days. IV administration occurs in day treatment centres, though some regimens require hospitalisation. Unlike radiation therapy, chemotherapy isn’t localised – drugs travel through the bloodstream to disrupt cancer cell growth/division systemwide, ultimately causing cell death.
Three primary treatment approaches exist:
Administered after completing radiation therapy, this approach similarly aims to reduce the risk of tumour spread to other organs. However, some patients may become too physically weakened from radiation treatment to tolerate additional chemotherapy.
Healthy Living
Dry mouth is a common side effect after treatment, causing significant discomfort and potentially leading to difficulty swallowing or bacterial infections. If experiencing dry mouth, patients should brush their teeth several times a day with a soft-bristled toothbrush and rinse with warm salt water after meals. Dietary habits should also be adjusted, such as drinking water regularly, chewing sugar-free gum to stimulate saliva production, avoiding fried or spicy foods, and reducing caffeine and alcohol intake.
Keeping Records
To prepare for a doctor’s appointment, patients should note any unusual physical symptoms, whether they are common signs of nasopharyngeal cancer. Additionally, they should record any medications and vitamin supplements they regularly take. On the day of the appointment, patients should be accompanied by a family member or friend and bring a notebook to jot down the extensive information provided by the doctor.
*Sources:
Cancer Online Resource Hub
▣ The information on this website has been reviewed by the HEAL Medical Team and is regularly updated according to the most recent clinical evidence. All content is provided for general informational purposes only and should not replace professional medical advice. Please consult your doctor or another qualified healthcare professional for personalized medical guidance.
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