NASOPHARYNGEAL CARCINOMA

OTORHINOLARYNGOLOGY, HEAD & NECK SURGERY SERVICES

MINISTRY OF HEALTH MALAYSIA

Brain:

n Chronic Headache. n Facial paralysis, week eye movement

(opthalmoplegia) or Stroke. n Confuse n Convulsion n Coma

Others: n Spread to bone causing brittle bone and

easily fracture esp. vertebra and pelvis. n Spread to the lungs cause bloody cough and

chest pain. n Spread to the lymph node causing swelling

of lymphatic systems. Investigations:

n Nasoendoscopy and biopsy. n Fine Needle Aspiration and Cytology: taken

sample from the swelling for cytology. n CTScan : to look for extension of the tumour

and staging. n MRI : soft tissue assessment.

Treatment:

¨ Stage I-II: Radiotherapy ¨ Stage III-IV: Concurrent

Chemoradiotherapy ¨ Local recurrence: Brachytherapy /

chemotherapy ¨ Regional recurrence: Surgery to

remove lymphatic chain from the neck

¨ Loco-regional: Surgery / CCRT?

CO N T ACT TH E N EA REA ST CL I N IC /H O SP I TAL

Nasopharynx carcinoma

Epidemiology • NPC is the fourth most common cancer

among Malaysian, and the third most common cancer among males • Most common age at the presentation is

between 40-60 years old • It is predominantly among Chinese (49%)

followed by native of Sabah & Serawak Risk factor Combination from below factor: 1. Life style and environment • Tobacco smoking • Consumption of salted fish • Exposure to occupational solvent and wood

dust 2. Infection • Increased risk of NPC in those tested

positive for Epstein Barr virus infection 3. Family Genetic / Hereditary • Increased risk in those with family history

of cancer

Symptoms: Nose: ■ Blood stained nasal discharge or saliva ■ Nasal blockage ■ Bad breath

Ear: ■ Ear block ■ Buzzing sound in the ear (Tinnitus) ■ Decrease of hearing ■ Ear pain

Neck: ■ Painless neck swelling unilateral or

bilateral Opthalmo-neurologic symptom: ■ Unilateral headache ■ Facial numbness ■ Diplopia ■ Ptosis ■ Trismus ■ dysphagia ■ Hoarseness

What is Nasopharyngeal carcinoma? • Nasopharyngeal Carcinoma (NPC) is a

cancer that arising from back of the nose • It start from fossa of ressenmuller • It can spread locally, laterally to Eustachian

tube, superiorly to the brain, nasal cavity anteriorly, pharynx inferiorly. It also can spread to the lymphatic system, lung, bone and liver.

Normal nasopharynx