Watch out: A tiny, painless lump on the neck may be a warning sign of nose cancer.
Dr Terence Tan, Senior Consultant, Department of Radiation Oncology, National Cancer Centre Singapore (NCCS), explains: "Nose cancer, or nasopharyngeal cancer, occurs when the cells lining the nasopharynx – the area behind the nose and just above the back of the throat – become cancerous.”
Genes play a part
Generally, nose cancer affects men more than women, and typically occurs between the ages of 35 and 55. If you have a family member with nose cancer, you may be genetically predisposed to it.
Statistics from the Singapore Cancer Registry show that the Chinese, especially those in the Cantonese dialect group, are particularly susceptible to nose cancer. To a lesser extent, Malays are also at risk.
Dr Tan says: “For the Chinese, this might be because of their diet, which often features salted fish, and cured and preserved meats that are high in salt and cancer-causing nitrites.”
In Singapore, nose cancer is the eighth most common cancer in men. But it is actually on the decline here. Dr Tan explains: “Over time, there has been a change in lifestyle and dietary preferences – the younger generation have more food choices and may not always choose salted or cured meats.”
Signs & symptoms of nose cancer
If you exhibit any of the following signs and symptoms, you should consult a doctor.
- One or more lumps in the nose or on the neck
- A sore throat that does not go away
- Hoarse voice, difficulty swallowing
- Hearing problems, such as a change or loss in hearing, ringing in the ear
- Difficulty breathing or speaking
- Ear ache or discharge from the ear
- Frequent headaches
- Nasal obstruction or stuffiness
- Frequent nosebleeds
- Blood-stained sputum
- Weight loss for unknown reason
In 75 per cent of newly diagnosed nose cancer cases, there is a painless lump in the neck.
Your doctor will be able to assess if these signs and symptoms actually mean cancer. A typical consultation includes taking a complete medical history and carrying out a physical examination.
Dr Tan adds: “Further tests may also be needed, such as a nasendoscopy, where a long, narrow, flexible and lighted tube is inserted through the nose to look for abnormal growths, bleeding, or other signs of disease. A biopsy, where a sample of the abnormal tissue is examined under the microscope to look for cancer cells, may also be necessary.”
Once the cancer is confirmed, other tests might be required to check the extent of the cancer. “This includes blood tests, chest X-rays, and scans of the head and neck, bone and liver,” says Dr Tan.
Treating & preventing nose cancer
Treatment for nose cancer may include radiotherapy and/or chemotherapy to destroy cancer cells, or surgery to remove the cancer completely.
Dr Tan explains: “It depends on various factors, such as the location of the cancer, extent of the disease, any presence of cancer spread, how far is the spread, as well as the age and the general health of the patient.”
The treatment options include:
- Radiotherapy: This uses high-energy X-rays or other types of radiation to kill cancer cells via either external means (using a machine to send radiation towards the cancer) or internal means (using a radioactive substance sealed in needles, seeds or catheters and placed near or into the cancer).
- Chemotherapy: This uses drugs which are injected through the veins to stop the growth of cancer cells.
- Surgery: This involves removing the cancerous tumour during an operation.
- A combination of the above treatments
Sometimes, side effects may arise. For instance, patients who undergo radiotherapy or chemotherapy may experience hair loss, a dry and sore mouth, or a loss of taste and smell as the treatment progresses. Dr Tan reassures: “The side effects vary from person to person – the type and severity of any side effects have nothing to do with the success of the treatment.”
The exact causes of nose cancer are not known, so there are no definite ways to prevent it. However, avoiding salt-cured foods and preserved meats might help to reduce the risk. “Also, a diet rich in fresh fruits and green vegetables can lower your cancer risk,” advises Dr Tan.
Did you know?
The NPC (Nasopharyngeal or Nose Cancer) Support Group aims to provide knowledge, psychological and emotional support to nose cancer (NPC) patients and care-givers through organised activities, talks, care and the sharing of experiences and practices related to nasal cancer.
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