Mistaking cancer for a cold, a 95-year-old patient regrets fatal negligence

Recently, a female patient born after 1995 in Shaoxing, Zhejiang, went to the doctor for a checkup because of unilateral nasal congestion that did not ease for two months. She thought it was just a common cold, but the diagnosis was unexpected - the patient was diagnosed with nasopharyngeal cancer. Doctors pointed out that the early symptoms of nasopharyngeal cancer are often similar to those of common rhinitis or colds, and are easily overlooked. In addition, family history, environmental factors, Epstein-Barr virus infection, and bad living habits, such as smoking and drinking, are all important factors in causing nasopharyngeal cancer.

Many people are afraid of cancer, believing that being diagnosed with a malignant tumor is equivalent to being sentenced to death.

In fact, the 5-year survival rate of early nasopharyngeal cancer can be as high as 90%...

The key is early detection and early treatment!

What is nasopharyngeal cancer?

Nasopharyngeal cancer is a malignant disease that develops in the nasopharynx, an area between our nose and mouth that is a key part of our upper respiratory tract. This cancer has a relatively high incidence in southern China, especially in Guangdong, Guangxi and Fujian. It can occur in people from children to the elderly, but is most common in middle-aged people.

The cause of nasopharyngeal carcinoma is not yet fully understood, but some known risk factors include Epstein-Barr virus infection, genetic factors, environmental factors (such as long-term exposure to harmful substances such as formaldehyde), smoking, and eating pickled foods.

The early symptoms of NPC are similar to those of rhinitis or colds, which may lead many patients to initially mistake them for ordinary respiratory infections. However, the key difference lies in the persistence and severity of the symptoms. Rhinitis or colds usually resolve on their own within a few days to two weeks, while the symptoms of NPC persist and may gradually worsen.

Rhinitis is usually accompanied by typical symptoms such as nasal congestion, runny nose, and sneezing, which will improve after treatment with cold medicine or rhinitis medicine.

A cold may be accompanied by symptoms such as cough, sore throat, and fever, which usually resolve on their own after a period of time.

The symptoms of nasopharyngeal carcinoma are more stubborn, such as unilateral nasal congestion, neck mass, hearing loss, nose bleeding, etc. These symptoms will not be relieved by ordinary treatment.

What are the clinical manifestations of nasopharyngeal carcinoma?

1. Unilateral or bilateral nasal congestion: When nasopharyngeal carcinoma occurs, tumor tissue may gradually grow in the nasopharynx, thereby blocking the nasal passage, resulting in poor air flow, and causing unilateral or bilateral nasal congestion. This nasal congestion may be intermittent at first and easily ignored by the patient, but as the tumor develops, the nasal congestion will gradually worsen and may even completely block the nasal cavity, seriously affecting the patient's respiratory function.

2. Nosebleeds or respiration of bloody sputum: Patients are often surprised to see blood when blowing their noses or spitting. The tumor tissue of nasopharyngeal carcinoma is relatively fragile, and its surface blood vessels are rich and easy to rupture and bleed. When the patient blows his nose or coughs forcefully, the pressure change in the nasopharynx may cause the blood vessels on the surface of the tumor to rupture, and the blood will flow out of the nasal cavity, showing as nosebleeds; respiration of bloody sputum is caused by the patient forcefully respiration of secretions from the back of the nasal cavity, bringing a small amount of bleeding from the nasopharynx to the mouth and spitting it out. This situation is often more hidden and easily mistaken for coughing up bloody sputum caused by ordinary respiratory inflammation, but in fact it is an important warning sign of nasopharyngeal carcinoma.

3. Tinnitus or hearing loss: This symptom is mainly caused by the tumor compressing or blocking the Eustachian tube . The Eustachian tube is an important channel connecting the middle ear cavity and the nasopharynx. It plays a key role in maintaining the balance of air pressure in the middle ear and ensuring normal hearing. When the tumor of nasopharyngeal cancer grows to a certain extent, it will compress or block the Eustachian tube, causing an imbalance in the air pressure between the middle ear cavity and the outside world, thereby affecting the conduction of sound, and ultimately causing the patient to experience tinnitus or hearing loss.

4. Neck lumps: Neck lumps may be caused by swollen lymph nodes and are often located above the neck. Nasopharyngeal carcinoma is prone to metastasis to the cervical lymph nodes. Cancer cells can spread to the cervical lymph nodes through the lymphatic system, causing swollen lymph nodes. These swollen lymph nodes may be hard and painless at first, but as the disease progresses, the lumps may gradually increase in size, increase in number, or even fuse together, which will have a significant impact on the patient's neck appearance and movement, and also indicate that the disease is worsening.

5. Facial pain or numbness: If the tumor invades the facial nerves, it will cause pain or abnormal sensation. Facial nerves are widely distributed. When nasopharyngeal cancer tumors invade these nerves, they will interfere with the normal conduction function of the nerves, causing pain in the patient's face. This pain may be tingling, dull pain, or swelling, and the pain site is not fixed, and may involve multiple areas of the face; patients may also feel facial numbness, as if there are ants crawling on the skin, and the perception of touch becomes dull, seriously affecting facial expressions and normal facial sensory functions.

6. Hoarseness: If the tumor compresses or invades the recurrent laryngeal nerve, it may cause changes in voice. The recurrent laryngeal nerve is mainly responsible for controlling the muscle movement of the larynx. When it is compressed or invaded by nasopharyngeal cancer tumors, the movement of the laryngeal muscles will be affected, and the normal closure and vibration function of the vocal cords will also be impaired, resulting in hoarseness of the patient. The patient's originally clear and loud voice will become low and hoarse, or even completely unable to make a sound, seriously affecting normal language communication and social activities.

Prevention and lifestyle adjustments

1. Reduce the risk of EB virus infection: EB virus is mainly transmitted through saliva. Behaviors such as kissing and sharing tableware may lead to virus transmission. In daily life, we should develop good personal hygiene habits, wash hands frequently, and avoid sharing personal items such as toothbrushes and towels with others. For areas or populations with a high incidence of EB virus infection, EB virus testing can be considered for early detection and intervention.

2. Avoid smoking and drinking: Smoking and drinking are risk factors for many cancers, including nasopharyngeal cancer. Tobacco contains a large amount of carcinogens, such as nicotine and tar. After entering the human body, these substances will irritate and damage the nasopharyngeal mucosa. Long-term smoking will cause the mucosal epithelial cells to mutate, increasing the risk of nasopharyngeal cancer. Alcohol will also damage the nasopharyngeal mucosa and affect the liver's detoxification function, making it easier for carcinogens in the body to accumulate.

3. Healthy diet: Reducing the intake of pickled foods and increasing the intake of fresh vegetables and fruits are essential for preventing nasopharyngeal cancer. Pickled foods such as pickles and salted fish contain a large amount of nitrite, which can be converted into nitrosamines in the body, a strong carcinogen. Long-term consumption of pickled foods will expose the nasopharyngeal mucosa to carcinogens for a long time, thereby increasing the possibility of cancer. Fresh vegetables and fruits are rich in vitamins, minerals and antioxidants, such as vitamin C, vitamin E, β-carotene, etc. These nutrients have antioxidant, anti-inflammatory and immune-enhancing effects, which can help the body resist the invasion of cancer cells and protect the health of the nasopharyngeal mucosa.

4. Environmental factors: Avoid long-term exposure to harmful substances such as formaldehyde. Formaldehyde is a common indoor pollutant, which mainly comes from decoration materials, furniture, carpets, etc. Long-term exposure to excessive formaldehyde will irritate the respiratory mucosa, cause respiratory inflammation, and may induce nasopharyngeal cancer. When decorating a house, you should choose environmentally friendly materials, and after decoration, you should fully ventilate the house to allow harmful substances such as formaldehyde to evaporate as much as possible.

References:

ChenYP,ChanATC,LeQT,etal.Nasopharyngealcarcinoma.[J].Lancet,2019,10192:64-80.