NPC Explanations

NPC stands for nasopharyngeal carcinoma. Nasopharyngeal carcinoma is cancer of the nose and throat. In Europe, unlike in some Asian and African countries, this type of cancer is very rare. The success of treatment depends on the type and stage of the cancer.

What is nasopharyngeal carcinoma?

Nasopharyngeal carcinoma is a malignant tumor in the nose and throat area. This carcinoma is one of the head and neck tumors. Nasopharyngeal carcinoma is also synonymously referred to as epipharyngeal carcinoma or nasopharyngeal cancer. The abbreviation for the disease is NPC, derived from the English term “nasopharyngeal carcinoma”.¬†See AbbreviationFinder for abbreviations related to NPC.

In Central Europe and North America, nasopharyngeal carcinoma is observed very rarely. In Germany, for example, only one to two out of 200,000 people fall ill. 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 among young men.

The reason for the high incidence of the disease there seems to be chewing the betel nut. In North Africa, children are particularly affected. The reason for this is not yet clear. There are three forms of nasopharyngeal carcinoma:

  • WHO type I occurs in about 20 percent, which turns out to be a well-differentiated keratinizing squamous cell carcinoma.
  • WHO type II with a frequency of about 30 to 40 percent represents non-keratinizing squamous cell carcinoma.
  • The most common form is WHO type III, accounting for about 40 to 50 percent of cases. This is a lymphoepithelial carcinoma (Schmincke-Regaud tumor), which is probably triggered or at least promoted by the Epstein-Barr virus.

Causes

There are several causes for nasopharyngeal carcinoma. The so-called Epstein-Barr virus is held responsible for most of the diseases. However, this virus is very common. About 98 percent of all adults are infected. The virus persists in the organism for a lifetime.

But only a few people develop nasopharyngeal carcinoma. Therefore, a genetic component is suspected as the cause of the development process of nasopharyngeal cancer. The Epstein-Barr virus is, among other things, the trigger for glandular fever, which is characterized by massive swelling of the lymph nodes.

A large number of lymphocytes are produced during infection. However, when lymphocyte proliferation gets out of control, lymph node cancer and other lymphocyte-related cancers such as nasopharyngeal carcinoma can develop. The nasopharyngeal carcinomas based on the proliferation of squamous epithelial cells are caused by various environmental factors, improper diet or smoking.

Symptoms, Ailments & Signs

All age groups can be affected by nasopharyngeal carcinoma. However, middle-aged people are usually affected. However, the carcinoma is often not diagnosed until very late because it does not cause any symptoms for a long time. Early symptoms may include nosebleeds, otitis media, or otitis media.

The patient often only breathes through the mouth because of problems with nasal breathing. The disease often only becomes symptomatic after the formation of metastases due to failure of the cranial nerves from III to VI. These metastases are regional lymph node metastases.

This causes the eyeballs to protrude, double vision and, in some cases, other visual and olfactory disorders. In addition, persistent and severe 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 advanced-stage patients develop distant metastases in only about 30 percent of cases.

Diagnosis & course of disease

To diagnose a nasopharyngeal carcinoma, methods of visual diagnostics, palpation, imaging and other medical device procedures, as well as serological laboratory tests are used. During visual diagnostics or inspection, the lack of nasal breathing, cervical lymphoma and cranial nerve failures are noticeable. Painless swelling of the lymph nodes can be detected by palpation.

Functional testing of the various cranial nerves is important. The ENT status is also determined using various methods. The tumor can be detected by endoscopy of the nasopharynx. The size of the tumor is determined using CT and MRI examinations. Antibodies against the Epstein-Barr virus are detected as part of the serology.

Complications

Since nasopharyngeal carcinoma is a type of cancer, it is always associated with various complications. As a rule, success in treating the disease depends very much on the time of diagnosis and how the tumor has spread to other parts of the body. The life expectancy of the patient may also be reduced by the nasopharyngeal carcinoma, resulting in premature death.

Patients often suffer from nosebleeds or inflammation in the ears. Problems with breathing through the nose can also indicate the tumor and should be examined. Rapid spread can occur, especially when the tumor passes into the lymph nodes. Furthermore, nasopharyngeal carcinoma leads to visual problems and thus to double vision or blurred vision.

Severe headaches can also occur that cannot be alleviated with the help of painkillers. The quality of life of those affected is significantly restricted and reduced due to the nasopharyngeal carcinoma. The cancer is completely removed in this condition. However, it cannot be universally predicted whether complete healing will occur. Those affected are usually also dependent on chemotherapy, which is associated with various side effects.

When should you go to the doctor?

Nosebleeds, a feeling of congestion in the nose or sinuses, a general feeling of being unwell and an increasing feeling of illness should be presented to a doctor. Swollen lymph, a decrease in physical and mental performance and an inner weakness should be examined and treated.

In the case of inflammation of the middle ear, disturbances in hearing or vision, or an irregularity in smelling, a doctor must be consulted to determine the cause. Headaches, sleep disturbances and changes in vocalization are signs of a health impairment that should be evaluated by a doctor. If existing symptoms increase or if new disorders develop, a doctor is needed.

Interruptions or limitations in breathing, a lack of oxygen in the organism or difficult breathing must be examined. There is a risk of an undersupply of the body, which can be life-threatening in severe cases. Changes in weight, loss of appetite and withdrawal from social life are further indications of an existing disease.

Since nasopharyngeal carcinoma leads to premature death if left untreated, a doctor should be consulted as soon as the first symptoms appear. The sooner a diagnosis can be made and therapy initiated, the better the chances of recovery. If you experience sudden nosebleeds, an unusual taste in your mouth, and swelling of your nose, throat, or throat, you need to see a doctor.

Treatment & Therapy

The success of the therapy depends on the stage of the disease. In the case of small and localizable tumors, its complete removal can already lead to healing. However, this does not succeed in most cases. Because the tumor is difficult to access, complete removal is rarely possible. Therefore, an operation is usually not useful.

The main treatment method is radiation therapy. As a result, the tumor can often be treated very effectively. In most cases, however, only the survival time is extended. In favorable cases, however, complete healing is also possible. However, cornified squamous cell carcinomas respond poorly to radiation treatment.

In the case of advanced carcinomas, good results are often still achieved with a combination therapy of radiation therapy and chemotherapy. Oxaliplatin is used as a chemotherapeutic agent. Since the Schmincke-Regaud tumor is particularly sensitive to radiation, the cure rate with radiation in stage I of the disease is as high as 90 percent.

Outlook & Forecast

As is generally the case with all types of malignant cancer, the chances of recovery depend very much on the stage of the tumour. Due to the very high radiation sensitivity of the malignant tumor tissue, there are very good chances of recovery. This also applies if the cancer has already established itself in the regional lymph nodes. In people with first-stage tumors, cure rates range from about 70 to 80%. However, the prognosis is poorer in patients with keratinizing nasopharyngeal carcinoma because this type is significantly more resistant to radiotherapy.

The prognosis for cancer is generally best when it is detected early. These are often tumors that grow further in the front section of the nasal cavity. With such tumors there is a very good prognosis comparable to tumors that are further back in the nasopharynx. The type of cancer also plays a role in the chances of recovery.

In the case of nasopharyngeal carcinoma of the Schmincke-Regaud type, well over 90% of patients can be successfully treated if diagnosed in good time. This is mainly due to the high radiation sensitivity of the tumor tissue. In the fourth stage of cancer, however, the chance of recovery drops to around 20 to 40%. With appropriate therapy, the 5-year survival rate varies between 90% and 58% for early compared to advanced diseases.

Prevention

The best way to prevent nasopharyngeal cancer is to stop smoking and drinking alcohol. In particular, this also applies to chewing tobacco and betel nuts. Otherwise, the general risk of developing a malignant tumor is significantly reduced by a healthy lifestyle.

Aftercare

In the case of a nasopharyngeal carcinoma, the measures and the options for direct follow-up care are in most cases significantly limited. For this reason, the affected person should consult a doctor relatively early on in order to prevent the occurrence of further symptoms or complications. As a rule, self-healing cannot occur, so that treatment by a doctor is always necessary.

In many cases, nasopharyngeal carcinoma cannot be completely cured if it is not recognized until late and the tumor has already spread throughout the affected person’s body. Many of the patients are dependent on a surgical procedure, which can alleviate the symptoms. The person concerned should definitely rest after the procedure and take care of their body.

It is important to refrain from exertion and from stressful or physical activities in order not to unnecessarily burden the body. The support and help of one’s own family is also helpful with nasopharyngeal carcinoma and can prevent the development of mental disorders or depression. It cannot be universally predicted whether the disease will lead to a reduced life expectancy.

You can do that yourself

Nasal and throat cancer is associated with an immense loss of well-being and the usual quality of life. In order not to lose courage and hope, however, the person affected should focus their inner attitude and cognitive processes on positive areas of their life. Technical aids such as smartphones, apps or computers can make everyday life easier in the daily exchange with fellow human beings. In addition, a sign language such as German Sign Language or another individual communication technique can help to replace spoken language.

If there is a loss of sight, Braille helps to communicate with each other. Using the various methods, a conversation with fellow human beings is possible and expedient. Experiences can be exchanged with other affected people in self-help groups or in Internet forums. Other side Help for self-help is made possible and makes it easier to cope with everyday life.

Mental balance is particularly important. For this purpose, the patient can try out mental techniques and strengthen himself. Meditation, Qi Gong, sound therapies or yoga help to mobilize inner strength 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 living conditions, well-being is strengthened.