Stuffy nose is not a cold or rhinitis?
Watch out for nasopharyngeal cancer "knocking on the door"
On September 2, the announcement of the Center for Drug Evaluation of the National Food and Drug Administration of China showed that the drug carrelizumab had submitted a new indication marketing application and was planned to be included in the priority review process.
According to the previous announcement, this new indication of the drug is to treat local recurrence or distant metastasis of nasopharyngeal carcinoma.
In fact, compared with common malignant tumors such as lung cancer and breast cancer, nasopharyngeal cancer does not seem to be mentioned often.
However, according to statistics from the International Agency for Research on Cancer (IARC), about 80% of nasopharyngeal cancers worldwide occur in China.
Nowadays, tumor screening has made great progress. So, is there any way for high-risk groups to conduct early screening?
In this regard, Wang Peiguo, member of the Standing Committee of the Chinese Anti-Cancer Association Nasopharyngeal Carcinoma Professional Committee and deputy director of the Radiotherapy Department of Tianjin Cancer Hospital, said that nasopharyngeal cancer is easily misdiagnosed or missed because of its hidden location and variable or inconspicuous early symptoms.
Nasopharyngeal cancers in our country are basically concentrated in coastal areas such as Guangdong, Guangxi, and Fujian. As a high-risk group, regular screening is very helpful for early detection of nasopharyngeal cancer.
Don't miss the clues of early symptoms
Nasopharyngeal carcinoma is a malignant tumor that occurs on the top and side walls of the nasopharyngeal cavity.
"Nasopharyngeal cancer is not a common malignant tumor worldwide, and for early nasopharyngeal cancer, through standardized treatment, the 5-year survival rate can reach more than 90%." Wang Peiguo introduced, but in clinical practice, many early symptoms are easily confused. Or be ignored.
"The symptoms of nasopharyngeal cancer can be summarized as seven main symptoms, such as blocked nose, tinnitus, deafness, bloody nose, headache, facial numbness, and diplopia." Wang Peiguo pointed out that bloody nose and tinnitus are relatively early symptoms. When neurological symptoms such as vision, headache, and facial numbness appear, tumor classification will be relatively late.
Colds, rhinitis, etc. can cause nasal congestion and bloodshot eyes in the nasal mucus. How to find the "clues" of nasopharyngeal cancer?
Wang Peiguo reminded that if the nose is not ventilated for two weeks, it is not a cold to make trouble, then you must pay attention to other details.
When the nose is inhaled hard, it is found that there is blood in the aspirated sputum, or it is accompanied by tinnitus, deafness, headache, painless lumps on the upper neck, etc., which may indicate nasopharyngeal cancer.
The location of the nasopharynx is special. Once cancer cells erode the skull and enter the brain, neurological symptoms such as severe headaches, double vision, and difficulty swallowing will occur.
The more the country goes to the south, the higher the incidence rate
"At present, there is no specific cause of nasopharyngeal carcinoma, but three factors have been determined to be related to nasopharyngeal carcinoma: Epstein-Barr virus infection, geographic region and genetics." Wang Peiguo explained that Epstein-Barr virus belongs to the gamma herpesvirus subfamily and was the first to be identified with humans. In addition to nasopharyngeal carcinoma, the viruses related to tumor biology are also the culprit of many tumors, such as Burkitt’s lymphoma in children, as well as lesions in the nasal cavity and throat, many of which are also related to Epstein-Barr virus infection.
"But not all people infected with Epstein-Barr virus will get nasopharyngeal cancer." Wang Peiguo explained that the infection rate of adult Epstein-Barr virus is very high. It can be transmitted through oral saliva and droplets, but only a small number of infected people eventually develop nasopharyngeal cancer. cancer.
"Region is also an important factor. From the perspective of incidence, in my country, the incidence of nasopharyngeal cancer is higher in the south, and the incidence in coastal areas such as Guangdong, Guangxi, and Fujian can reach 30 per 10,000, which is a low risk. Dozens of times the area." Wang Peiguo said, this has no direct relationship with eating habits and living habits. Scientists have put forward various conjectures, but there has been a lack of strong evidence.
In 2019, a paper published by a team of scientists from China and Singapore in Nature Genetics proposed that 80% of nasopharyngeal cancer patients in Guangdong have a unique high-risk virus subtype, called the BALF2_CCT subtype.
Studies have found that if a person is infected with this high-risk EB virus subtype, the risk of nasopharyngeal cancer will be 11 times higher than that of people infected with the low-risk subtype.
The influence of genetic factors on nasopharyngeal cancer was also discovered in 2002 and 2010. The research team of Zeng Yixin, an academician of the Chinese Academy of Sciences, published two research results in Nature and Heredity, revealing the genetic susceptibility of nasopharyngeal cancer patients. Point, it shows that nasopharyngeal cancer does have a certain heredity, and some people are born with a higher risk than others.
"In addition, there are some patients with nasopharyngeal cancer who have long-term exposure to chemical coatings and inhalation of toxic and harmful substances in clinical practice." Wang Peiguo said, but these factors have not been specifically confirmed, and may just be high-risk factors.
Radiotherapy can make the survival rate reach 60 to 90%
"Although the etiology of nasopharyngeal carcinoma is not clear and primary prevention cannot be used to prevent it from occurring, there are currently many good methods for the treatment and early screening of nasopharyngeal carcinoma." Wang Peiguo said, nasopharyngeal carcinoma is a poorly differentiated squamous cell carcinoma However, the lower the degree of differentiation of cancer cells, the more sensitive they are to radiation. Therefore, “radiotherapy is also the core treatment for nasopharyngeal cancer”.
"Through radiotherapy, the 5-year survival rate of early nasopharyngeal carcinoma can reach more than 90%, and the middle-advanced patients can also reach about 60% through a combination of radiotherapy and chemotherapy and targeted therapy." Wang Peiguo said, but many patients with advanced stages are easy Recurrence and metastasis occur, leading to treatment failure.
Therefore, screening for early detection of nasopharyngeal cancer is very important for the treatment effect.
For people living in areas with a high incidence of nasopharyngeal cancer and those with a family history, Wang Peiguo recommends multiple combined tests for Epstein-Barr virus antibodies. The more common combinations are: Epstein-Barr virus Rta protein antibody IgG (Rta-IgG), Epstein-Barr virus coat Capsular antigen IgA antibody (VCA-IgA) and Epstein-Barr virus early antigen IgA antibody (EA-IgA), the results have very high clinical diagnostic value in the screening and early diagnosis of nasopharyngeal carcinoma.
Based on the results, the doctor will assess the subject's risk level of nasopharyngeal cancer, and conduct the corresponding level of health management.
For people who are suspected of having nasopharyngeal cancer with some symptoms, nasopharyngoscope, CT, MRI and other imaging examinations can be performed.
"In addition, in daily life, pay attention to maintaining nasal cavity hygiene, washing hands frequently, not picking your nose, to reduce the chance of EB virus infection." Wang Peiguo suggested that you should also pay attention to the toxic and harmful gases released by chemical coatings, pesticides, etc. Protection to reduce the chance of inhalation.