Nasopharyngeal Cancer: symptoms & prevention, differences from rhinitis

It is springtime, and the increase of pollen, willow floss and germ microorganisms in the air makes many people suffer from nasal congestion, sneezing and utilization of runny nose, which are mostly caused by allergic rhinitis. However, many people cannot distinguish nasopharyngeal cancer from rhinitis, which may lead people to ignore the symptoms and delay the treatment of cancer.

How to distinguish nasopharyngeal cancer from rhinitis?

Nasopharyngeal cancer is a malignant tumor that occurs in the nasopharyngeal cavity and lateral wall, mostly occurs in people around 40 years old. The growth site of nasopharyngeal cancer is hidden and the early symptoms are similar to rhinitis, which is often overlooked by people and delay the disease. So many people have more obvious symptoms before they go to the hospital for examination, most of them are already in the middle and late stage, which makes treatment difficult and the treatment cost will increase. The similar symptoms of nasopharyngeal cancer and rhinitis are mainly nasal congestion and nasal bleeding.

Early symptoms of nasopharyngeal cancer

Nasal congestion and nasal bleeding are two typical symptoms of nasopharyngeal cancer, in addition, some common minor symptoms may also indicate nasopharyngeal cancer. 

1. Blood in the nasal mucus

The main manifestation is blood in the nasal mucus or blood in the sputum after nasal aspiration, which usually occurs in the morning after waking up. In the early stage, it is often overlooked because the amount of blood is not much. Most people suck back bloody nasal mucus and then spit it out from the oropharynx, so it is often mistaken for blood in sputum. 

2. Persistent nasal congestion 

As the mass will block the nostril, the patient will feel nasal congestion and difficulty in breathing, and it will worsen with the gradual increase of tumor, and unilateral nasal congestion is common in the early stage of nasal cancer. 

3. Tinnitus and hearing loss 

Middle ear infection, tinnitus and hearing loss are also early signs of nasopharyngeal cancer. At least half of the patients with nasopharyngeal cancer will have tinnitus and hearing loss, which are caused by the nasopharyngeal tumor blocking the pharyngeal opening of the eustachian tube. However, tinnitus and hearing loss are often thought to be caused by ear diseases, so they are easily overlooked. 

4. Intermittent headache 

Headache is an early symptom of nasopharyngeal cancer, and 69% of patients with nasopharyngeal cancer have headache as the first symptom. The headache caused by nasopharyngeal carcinoma in early-stage mainly belongs to neuroreflex headache, characterized by intermittent and irregular location, but with the passage of time, the headache becomes more and more intensive, the degree becomes more and more aggravated, and the location tends to be fixed. 

5. Swelling of lymph nodes in the neck 

The cancer cells of nasopharyngeal carcinoma will also form swollen lymph nodes in the neck near the back of the earlobe. Many patients clinically seek medical attention because they find a lump on the neck, which has the characteristics of hard texture, poor mobility and painlessness. 

What tests are needed to diagnose nasopharyngeal carcinoma? 

If the above symptoms occur frequently, it is recommended to seek medical attention promptly, and if necessary, nasopharyngoscopy can be done to confirm the diagnosis through pathological biopsy if there is any abnormality. 

1. Nasopharyngoscopy 

Small nodules or granuloma-like elevations in the pharyngeal fossa and the anterior wall of the nasopharynx can be seen, with rough and uneven surfaces and easy bleeding, sometimes showing submucosal elevations. In early stage, the lesion may only show mucosal congestion, anger of blood vessels or one side of the pharyngeal fossa is fuller, which needs attention. 

2. Electronic nasopharyngoscopy 

This is good for detecting early microscopic lesions, especially for patients with strong pharyngeal reflex or difficulty in opening the mouth, and if suspicious lesions are found, biopsy should be performed promptly. 

3. Biopsy 

The biopsy is the basis for confirming the diagnosis of nasopharyngeal carcinoma, and biopsy can be taken through the nasal cavity or mouth under clear view, and for submucosal elevation, submucosal tumor tissue can be taken by puncture needle for pathology. 

4. Palpation and biopsy of cervical lymph nodes

Lymph nodes that are hard, poorly mobile or inactive and painlessly enlarged can be palpated in the deep upper neck. If the patient has swollen cervical lymph nodes and there is no obvious suspicious lesion on nasopharyngeal examination, and if the nasopharyngeal biopsy is negative several times, a biopsy of the cervical mass may be considered to confirm the diagnosis. Usually, cytology is performed by aspiration of the neck mass, and if necessary, excision of the neck mass can be considered for examination. It is best to select a single enlarged lymph node for pathological examination to prevent the spread of the cancer. According to its pathological type, the primary lesion can be identified.

5. Other tests for nasopharyngeal cancer

Including imaging examination, EBV serological examination, exfoliative cell examination, etc.

Can rhinitis cause nasopharyngeal cancer? 

Since the symptoms of rhinitis and nasopharyngeal cancer are similar, many people inevitably worry: Is there any relationship between rhinitis and nasopharyngeal cancer? Will rhinitis develop into nasopharyngeal cancer?

Nasopharyngeal cancer is a malignant tumor that occurs in the top and sidewalls of the nasopharyngeal cavity. It is a polygenic genetic disease, and the more certain causative factors are related to genetic factors, environmental factors and EBV infection.

Rhinitis is an inflammation of the mucous membrane and submucous tissue of the nasal cavity, mostly caused by cold and allergies. The two lesions are different, and there is no direct relationship in terms of pathogenesis.

However, this does not mean that rhinitis can be allowed to develop. If left untreated, rhinitis can slowly develop into chronic rhinitis, sinusitis, etc., and the long-term stimulation of inflammation can easily lead to the recurrence of the process of damage and repair, increasing the chances of cellular carcinogenesis, leading to sinus cancer, etc.

Patients with rhinitis should be actively treated, and the nasal cavity can be cleaned with nasal washes and saline to flush away the germs in the nasal cavity to reduce the attack of rhinitis.

How to prevent nasopharyngeal cancer?

The prevention methods of nasopharyngeal cancer mainly focus on avoiding risk factors and enhancing one’s immunity. In addition to staying away from tobacco and eating less pickled food, you should also do the following in your life.

1. Keep the nasopharynx clean

Using saline to wash the nose can flush out allergic substances in the nostrils and flush away secretions, while keeping the nasal cavity moist and gently soothing the irritated nasal mucosa, which can help reduce the risk of rhinitis, pharyngitis and other diseases and assist in the prevention of nasopharyngeal cancer.

2. Improve immunity

Pay attention to the structure of your diet, don’t be partial, and eat more vegetables, fruits and other foods that contain a lot of vitamins. In the diet, eat less or no foods containing nitrosamines, such as cured salted meat and certain canned foods containing nitrosamines.

Everyone should strengthen physical exercise to enhance physical fitness; at the same time, pay attention to weather changes, prevent colds and prevent viral infections.

3. The susceptible people should have regular checkups

People in areas with high incidence of nasopharyngeal cancer and those with family history of nasopharyngeal cancer should be screened for nasopharyngeal cancer. EBV test can be used as an indicator for the screening, and about 80% of nasopharyngeal cancer patients have positive EBV test. Since more men than women suffer from nasopharyngeal cancer, it is recommended that men should be screened regularly after the age of 40, or earlier than 20 if they have a family history of the disease.