The lump on the neck is not painful or itchy, and it is a nasopharyngeal cancer

Mr. Li (pseudonym) is 50 years old this year, usually the body is OK, but there is a lump on the neck, and this lump is not painful or itchy to touch, so he did not take this matter to heart.

Unconsciously, a period of time passed, and Mr. Li found that the lump around his neck not only did not shrink, but also became larger, and the whole neck looked thicker. Reminded by his friend, Mr. Li also realized that the situation was not right, so he went to the hospital for treatment.

After arriving at the hospital, the doctor inquired about Mr. Li's situation and gave him a relevant examination, and the results showed that Mr. Li's nasopharynx had a lump, and the pathological examination suggested nasopharyngeal cancer.

Wang Xin introduced that nasopharyngeal carcinoma is one of the most high-incidence malignant tumors in south China.

Dr. Wang Xin, director of the Cancer Center of Qingyuan People's Hospital, explained that the appearance of lumps in the neck is a common symptom of nasopharyngeal cancer patients, because most of the lumps are painless and are often ignored. She reminded that in the clinic, many patients have a large lump in the neck before coming to the doctor, resulting in late detection of nasopharyngeal cancer and easy to miss the best treatment time.

Nasopharyngeal carcinoma is high in South China

Wang Xin introduced that nasopharyngeal carcinoma refers to malignant tumors that occur at the top and side walls of the nasopharyngeal cavity, and the incidence is the first of the otolaryngological malignancies, and it is also one of the high-incidence malignant tumors in South China.

Compared with European and American countries, nasopharyngeal cancer is relatively high in China, according to the data released by the National Cancer Center, the number of cases of nasopharyngeal cancer in mainland China in 2015 was about 51,000, ranking 20th in the cancer incidence spectrum; the number of deaths of nasopharyngeal cancer was about 27,000, ranking 15th in the cancer death spectrum.

The incidence of nasopharyngeal carcinoma is obviously regional, and the incidence of nasopharyngeal carcinoma in South China is significantly higher than that in other regions, about 16 times that of North China. Nasopharyngeal cancer is even called "Guangdong cancer", and the probability of nasopharyngeal cancer in people in Guangdong is 20 times that of other low-incidence areas.

Why is nasopharyngeal cancer high in Guangdong? Wang Xin said that the exact reason is not yet known, which may be related to multiple factors such as genetics, environment and Epstein-Barr virus infection.

People in Guangdong like to eat pickled food, Guangdong's geographical location is near the sea, wax flavor and dried fish, salted fish and other foods are welcomed by many Cantonese, but pickled food contains a large number of nitrosamine precursor substances, easy to transform into nitrosamine compounds with strong carcinogenic effects in the human body.

In addition, people's unhealthy lifestyles can also induce the occurrence of the disease, such as frequent exposure to oil fumes, chemical poisons, smoking, alcohol consumption, etc.

At present, the pathological classification of nasopharyngeal carcinoma mainly includes keratinizing squamous cell carcinoma, differentiated nonkeratotic carcinoma, and undifferentiated nonkeratotic carcinoma. Epidemiological data show that 98% of patients with nasopharyngeal carcinoma in high-incidence areas have pathological types of differentiated and undifferentiated nonkeratotic carcinomas.

Early symptoms are similar to rhinitis

"In the early stages, NASOPHARY MAY HAVE NO OBVIOUS SYMPTOMS OR ONLY SOME RHINOID-LIKE MANIFESTATIONS." Wang Xin said that the symptoms of nasopharyngeal cancer are not typical, there may be nasal congestion, blood in the nasal discharge, tinnitus, headache, etc., of which nasal congestion, tinnitus or nasal discharge with blood can easily be considered as "fire" or "rhinitis" problem. In addition, the nasopharyngeal carcinoma lesion is behind the nasal cavity, and the location is relatively hidden and easy to misdiagnose.

Most patients have lymph node metastases at the time of diagnosis, and cervical lymphadenopathy is most common and mostly painless. As the disease progresses, cervical lymph nodes can progressively enlarge, harden, and have poor mobility, starting with one-sidedness and later developing bilaterally.

"Most of the other cancers are mainly treated by surgery, but the treatment of nasopharyngeal cancer is mainly radiation therapy." Wang Xin explained that because the nasopharyngeal carcinoma site is deep, there are a large number of nerves and blood vessels around, surgical resection is more difficult, and nasopharyngeal cancer is more sensitive to radiation therapy, so radiation therapy is the preferred treatment for nasopharyngeal cancer, and the 5-year survival rate of patients with early nasopharyngeal cancer is more than 90%.

Doctors will formulate individualized treatment plans according to different clinical pathological stages, and for early patients, radiation therapy alone is generally used, and local middle and advanced stages are recommended to use radiotherapy as the mainstay, chemotherapy and targeted drugs as a supplement. Wang Xin said that with the improvement of modern radiotherapy technology and the application of comprehensive means such as chemotherapy and targeted therapy, the local control rate of advanced nasopharyngeal carcinoma has also increased significantly. The overall 5-year survival rate for patients with nasopharyngeal cancer is about 45% to 50%. In addition, in the clinic, many advanced patients can get better control after systematic treatment.

Wang Xin said that with the improvement of modern radiotherapy technology and the application of comprehensive means such as chemotherapy and targeted therapy, the local control rate of advanced nasopharyngeal carcinoma has also increased significantly. In addition, in the clinic, many advanced patients can get better control after systematic treatment.

Attach importance to physical examination and screening, and do a good job in prevention

Early screening and early detection are effective means to deal with various types of tumors, and nasopharyngeal cancer is no exception. Wang Xin introduced that people in South China, especially those with a family history of nasopharyngeal cancer, should be screened for nasopharyngeal cancer.

At present, the more commonly used initial screening method is EBV-related antibody detection, EBV will cause nasopharyngeal carcinoma, the human body will produce antibodies after infection with EBV, and blood samples can be taken for analysis to initially determine the risk of cancer. If the subject has a normal physical examination and the serum test is negative, nasopharyngeal cancer screening is performed after 5 years. If the subject finds nasopharyngeal cancer, abnormal physical examination, or abnormal EBV antibody testing, they should follow the doctor's advice for the next test.

In addition to paying attention to physical examination, it is also necessary to correct daily bad living habits in a timely manner. Quit smoking and alcohol, people who smoke and drink alcohol have a higher chance of nasopharyngeal cancer than normal people, and toxic substances in tobacco and alcohol will directly stimulate the nasal and throat mucosa, which cannot be repaired in the case of continuous stimulation, and cell lesions are easy to cause nasopharyngeal cancer.

Eat less pickled foods and stay away from fried smoked and grilled foods. Foods such as salted fish, bacon and sausages contain high nitrite compounds and are carcinogens of nasopharyngeal cancer, and eating less pickled foods can reduce the risk of nasopharyngeal cancer.

In addition, stay away from the high pollution environment, try not to go out in smog weather, wear a mask when going out, and avoid inhaling polluted air.

[Reporter] Liu Qiuyi

[Media Assistant] Chen Zhiyu

[Correspondent] Peng Keming

【Author】 Liu Qiuyi

【Source】 Southern Press Media Group South + client