I received an unexpected present a week before Christmas in 2008 - the gift of thanks.

A middle-aged Chinese woman walked into my consulting room, beaming.

My lack of recognition prompted her to remind me of our first meeting more than 20 years ago.

"I would not be alive today if not for you. Thank you for saving my life." I then recalled that first consultation she had with me.

Jane (not her real name) had lost part of her hearing in her left ear when she came to see me. She also revealed that her neck was swollen, apparently for the past three months.

I proceeded with the physical examination and took a tissue sample from a growth in the back part of her nose to test for Naso-Pharyngeal Carcinoma (NPC), a form of nose cancer.

The results were positive. Jane was devastated. No one in her family had contracted cancer of any kind before, and she was a healthy woman in her late 20s.

After she recovered from her shock, she decided to proceed with radiotherapy.

Within a few sessions, the mass in the back of her nose was completely destroyed.

We continued with follow-up sessions to prevent the cancer from recurring. Today, she remains free of the cancer.

NPC is a relatively common cancer, with over 400 new cases diagnosed in Singapore every year.

It occurs most commonly among Chinese, particularly those living in the southern region of China. Malays are the next most frequent patients while it is rare among Indians.

Besides race, family history also affects an individual's chance of contracting this type of cancer. People with siblings or cousins who have confirmed NPC, and people who have a family history of cancer, should be aware that they are at higher risk of contracting it.

A few years ago, I diagnosed it in a pleasant young man. A year later, he sent his younger brother to see me and I had the difficult task of telling him that he too had NPC.

Fortunately, both responded well to treatment.

NPC is a cancer that not only affects people in the middle and later years but also those in their mid-20s and early 30s who are in the prime of their lives.

In this regard, it differs from most other types of cancer which typically affect people in their 50s and 60s.

The youngest person I have diagnosed with this cancer was a nine-year-old boy. This was unusual as, like most other cancer, it rarely affects children.

Its symptoms include a worsening deafness, a swollen neck or throat, and nose bleeds. Tasting blood in your mouth is often an early symptom. Double vision, migraines and difficulty in swallowing can also develop as the cancer progresses.

Like any cancer, it can metastasize and affect the lungs, liver and bones. Of course, not all is bleak. This cancer is treatable, like so many others. Many individuals have responded well to treatment.

People like Jane can now live happy, healthy lives because they saw the warning signs and acted early.

You should never ignore the symptoms listed here, particularly if more than one symptom occurs.

Often, lives are lost because people ignore the warning symptoms, believing their prolonged ailments to be simply caused by diseases like the cold or the flu. There are also those who inexplicably think that they are immune to the cancer.

Sometimes, it may even be a fear of finding out the truth that prevents them from taking the first step.

NPC will only get worse and possibly become untreatable if symptoms are ignored. Never be arrogant or fearful to the point of not being able to take action.

Always check with your doctor if you think your hearing is failing or if you taste blood. You may save a life - your own.

stslee@rafflesmedical.com

Dr Stephen Lee is an ear, nose and throat surgeon and senior partner and consultant at the ENT department at Raffles Hospital. He has published more than 20 articles locally and internationally and authored three textbooks.

This article was first published in Mind Your Body, The Straits Times.