Nasopharyngeal Carcinoma (NPC) Cancer Screening

Cancer Screening for Nasopharyngeal Carcinoma (NPC) in Singapore

NPC Cancer Screening in Singapore

Nasopharyngeal Carcinoma (NPC), or nasopharyngeal cancer, is the most common head and neck cancer and sixth most common type of cancer in Singapore. Although rare — there are about 300 new cases recorded every year, and about 1,000 cases between 2013 to 2017 — this form of cancer is known to be deadly. This is likely due to late detection as the symptoms of NPC are easily mistaken for other less serious illnesses.

What causes Nasopharyngeal Cancer (NPC)? 

NPC is a form of cancer that affects the nasopharynx that is the junction at the back of the nose and on top of the throat. There is little known about what causes NPC, but it is believed to be a combination of environmental and genetic factors. For example, it has been observed that patients with NPC often have first-degree relatives who suffer from the same disease.

The cancer has been strongly associated with Epstein Barr virus (EBV). EBV is a member of the herpes virus family and it is the most common human virus. It spreads via body fluids, primarily saliva. Although 80% to 90% of the global population harbour the EBV, most of them do not experience symptoms or recover from the infection with no long-term problems.

While more conclusive research is still required, it is suspected that the genetic material from EBV affects the DNA cells of the nasopharynx, resulting in NPC. It is also thought that a diet rich in salt-cured fish and meat and lifestyle involving tobacco and alcohol may increase the chances of contracting NPC, although the link to NPC is unclear.

What are the common symptoms of Nasopharyngeal Cancer (NPC) in Singapore? 

As the symptoms of NPC are very similar to that of many other common diseases that are less severe, only a qualified professional can accurately diagnose and rule out NPC. The most common symptom of NPC is a lump in the neck. Other symptoms include:

  • Sore throat
  • Stuffy nose, nosebleeds
  • Facial pressure or numbness
  • Double or unclear vision
  • Recurrent ear infections
  • Hearing loss, ringing in the ear, or feeling like your ears are blocked
  • Headache

It is advisable to take these symptoms more seriously and seek medical advice if you notice anything unusual. 

Is Nasopharyngeal Cancer painful? 

Most people who suffer from NPC experience symptoms that are similar to less serious illnesses. Hence, the symptoms do not cause much pain including the lumps that may appear on the sides of the neck.

Who is at risk of developing Nasopharyngeal Cancer? 

At home, 80% of patients with NPC are Chinese. While NPC can occur to anyone at any age, male individuals are more likely to contact NPC and it is most commonly found in patients between 30 to 50 years of age.

Your chances of contracting NPC is also likely to be higher if you have a close relative who suffers from the disease. In Singapore, you are advised to go for screening if you have two or more family members with NPC. 

How is Nasopharyngeal Cancer diagnosed?

Diagnosing NPC is based on a biopsy of the tumour in the nasopharynx. This procedure is done under local anaesthesia and involves visualising getting the tumour with a naso-endoscope. A small piece of tissue from the tumour is removed and sent to the laboratory to be tested for cancer.

If the biopsy confirms the presence of cancer, staging investigations will be ordered to determine how aggressive the cancer is and whether it has spread to other parts of the body.

It is advisable to get screened for cancer regularly as early detection would make treatment easier and less costly, while safeguarding your health for the long term.

What are the treatment options for Nasopharyngeal Cancer (NPC) in Singapore? 

The treatment of NPC usually involves radiotherapy and chemotherapy, with surgery reserved for cancer recurrence.

Radiotherapy is typically applied to treat early stage NPC. Radiotherapy uses radiation to eliminate cancer cells, slow down the growth of the cancerous tumour and reduce the spread of cancer. Advanced radiation techniques are able to deliver radiation more targeted to the intended area. In NPC, the treated areas include the posterior nasal space and both sides of the neck where lumps may be identified.

For patients with more advanced NPC, chemotherapy is administered with radiation to improve the treatment outcome.

For small, recurrent tumours, minimally invasive surgery can be performed. Surgery, however, is limited to the management of NPC and not the treatment of NPC. It is an option for patients who experience recurrent localised tumours. A neck dissection may be considered for patients who suffer from persistent neck nodes post-therapy. 

The chances of patients with NPC living five years after diagnosis range from around 90% for early stage cancer to around 60% for advanced stage cancer. This figure is more positive than in the case of other cancers like lung cancer, where the survival rate drops to under 10% for advanced stage.

Allergy & Sinus ENT Specialist Centre
Head & Neck Surgery Singapore

Dr Soma Subramaniam
Consultant ENT Specialist and Surgeon

    * Please note that the requested appointment date and time is subject to availability. The respective clinic will contact you for confirmation.

    Copyright © 2022 Allergy & Sinus ENT Specialist Centre
    linkedin facebook pinterest youtube rss twitter instagram facebook-blank rss-blank linkedin-blank pinterest youtube twitter instagram