Can Nasopharyngeal Cancer Be Cured?

The types of nasopharyngeal cancer include:

• Keratinizing squamous cell carcinoma: In countries with a low incidence of nasopharyngeal cancer, this is the most common type.
• Non-keratinized differentiated squamous cell carcinoma: The less common type and is associated with the Epstein-Barr virus in countries with high rates of nasopharyngeal cancer.
• Non-keratinized undifferentiated squamous cell carcinoma: The most common type seen in countries with high rates of nasopharyngeal cancer and is associated with the Epstein-Barr virus.
• Basaloid squamous cell carcinoma: A rare and aggressive form of nasopharyngeal cancer.

The exact cause of nasopharyngeal cancer is unknown, but scientists have found a strong connection between nasopharyngeal cancer and the Epstein-Barr virus. Not everyone who has the Epstein-Barr virus infection will get nasopharyngeal cancer, however.

The Epstein-Barr virus infection affects the DNA, causing a mutation. Change in genetic mutation results in abnormal cell growth, leading to cancer.

Other factors that may increase the risk of nasopharyngeal cancer

• Men are at three times higher risk than women.
• Excess use of alcohol and tobacco can increase the risk of nasopharyngeal cancer.
• Commonly diagnosed at ages between 30 and 50 years but can occur at any age.

The symptoms of nasopharyngeal cancer include:

• A lump in the throat (most common symptom)
• Vision problems, such as blurred or double vision
• Hearing problems or fullness in the ear or ringing in the ears
• Recurrent ear infections
• Trismus (restricted mouth opening)
• Facial pain or numbness
• Headache
• Nosebleed
• Stuffy nose

1. Stage I
   • Cancer is in the nasopharynx only (or)
   • Cancer has spread from the nasopharynx to the oropharynx or nasal cavity.
2. Stage II
   • Cancer has spread to one or more lymph nodes on one side of the neck or one or both sides of the back of the throat. The lymph nodes are 6 cm but not larger.
     • Cancer is in the nasopharynx only or has spread from the nasopharynx to the oropharynx or nasal cavity (or)
     • The cancer has spread only to the lymph nodes in the neck and cancer cells in the lymph nodes are infected with the Epstein-Barr virus.
3. Stage III
   • Cancer has spread to lymph nodes on both sides. The affected lymph nodes are smaller than 6 cm. Cancer has spread to the nasopharynx only or the oropharynx or nasal cavity (or)
   • Cancer has spread to lymph nodes in the neck. Lymph nodes are infected with the Epstein-Barr virus.
4. Stage IV
   • Stage IVA:
     • Cancer has spread to the cranial nerves, brain, hypopharynx, salivary glands in front of the ear bone, around the eye, and soft tissues of the jaw (or) 
     • Cancer has spread to lymph nodes on both sides; the affected lymph nodes are smaller than 6 cm (or)
     • Cancer has spread beyond the lymph nodes in the neck to distant lymph nodes, such as between the lung, below the collar bone or armpit or groin, or other parts of the body, such as the lung, liver, and bone.
   • Stage IVB: The lymph nodes between the collarbone and the top of the shoulder have been affected by cancer, and/or the affected lymph nodes are significantly bigger than 6 cm.
   • Stage IVC: Cancer has spread to distant body organs from the local lymph nodes.

To diagnose nasopharyngeal cancer, you might be referred to an otolaryngologist. The doctor will do a physical examination.

A neurological examination is done to check the mental status.

A few other tests are recommended, such as:

• Biopsy: Cells are removed and viewed under a microscope to check for malignancy. To remove the sample tissue, the following methods are used:
  • Nasoscopy: The healthcare provider uses a nasoscope (a thin tube-like instrument with a lens and light) and inserts it into the nose to identify and remove abnormal tissues.
  • Endoscopy: A nonsurgical medical procedure that helps look inside the internal organs, such as the throat, esophagus, and trachea, to check for abnormal tissue growth. The endoscope is a flexible tube with a light and a camera attached to it. It is inserted into the body to view the internal organs on a screen.
• Ultrasound: Sound waves produce clear images of the tissues inside the body.
• CT: Takes pictures of internal organs using X-rays from different angles.
• MRI: Uses a magnet and radio waves to take pictures.

The treatment includes the following:

• Immunotherapy: Loqtorzi (toripalimab-tpzi) with cisplatin and gemcitabine is the only approved first-line treatment of adults with metastatic or recurrent, locally advanced nasopharyngeal carcinoma (NPC). It was also approved as a single agent for adults with recurrent unresectable or metastatic NPC with disease progression on or after a platinum-containing chemotherapy.
• Radiotherapy: Uses powerful rays to kill cancer cells. Radiotherapy is done after the surgery.
• Chemotherapy: Uses medications to kill fast-growing cancer cells and stop their spread. The chemotherapy drugs can be administered orally or intravenously.
• Surgery: Resects cancerous cells. Sometimes, some healthy tissues around the cancerous cells and adjacent lymph nodes are also removed.

Additional treatments could be used to slow its progression or relieve symptoms. For example, if cancer has spread to the spine, the area could be treated with radiation to relieve pain and reduce the likelihood of further complications.

Even if a cure is not possible, there are several options to treat and manage symptoms of advanced cancer.