50-year-old Ms. Wu is engaged in international trade. Last year, she was diagnosed withnasopharyngeal carcinomaAfter examination, it was found that Ms. Wu was suffering from the second stage of nasopharyngeal carcinoma. After receiving 2 months of chemotherapy followed by radiotherapy, the tumor was successfully cured, and she immediately returned to normal life and work.
According to statistics, about 1,500 patients with nasopharyngeal carcinoma are newly diagnosed in Taiwan every year. The causes of the disease include environmental factors, genetics, and Epstein-Barr virus (Epstein-Barr virus) infection. Nasopharyngeal carcinoma often occurs in adults around 40 years old. With current treatment methods, most patients have a good prognosis.
In the treatment of nasopharyngeal carcinoma, the first stage is radiotherapy alone, and the second, third, and non-metastatic stage four nasopharyngeal carcinomas are treated with concurrent chemoradiation therapy or pre-chemotherapy followed by radiotherapy according to risk factor assessment. If the patient has distant organ metastasis at the time of diagnosis, chemotherapy is the main treatment, followed by radiotherapy or surgical resection of metastatic lesions depending on the situation, and disease control can still be achieved.
Kaili Liang, attending otolaryngology head and neck physician at Taichung Veterans General Hospital, said that although nasopharyngeal carcinoma has excellent treatment results, there are still a small number of patients who unfortunately relapsed after the first treatment. Even if the disease relapses, it is not incurable, and long-term control can still be achieved through active treatment.
Endoscopic surgical resection reduces local tissue damage in 2 chemotherapy sessions
In 2010, 40-year-old Mr. Qu was diagnosed with the third stage of nasopharyngeal carcinoma. After chemotherapy and radiotherapy, he was followed up regularly. However, in the 5th year after treatment, he found that the tumor in the nasopharynx had recurred. After joint decision-making between doctors and patients, Mr. Qu He received leading chemotherapy first, followed by endoscopic nasopharyngeal tumor resection, and adjuvant chemotherapy after surgery. It has been more than 10 years since Mr. Qu’s disease treatment has been completed, and he remains in good health and maintains regular follow-up.
Also in 2010, 36-year-old Mr. Ren was found to be stage IV nasopharyngeal carcinoma through imaging examination and pathological section due to a lump in his neck and ear fullness. After 2 years of follow-up, recurrence was found in the right cervical lymph node in 2013. Mr. Ren underwent neck lymph node dissection surgery and subsequent adjuvant chemotherapy. After completing the course of treatment, there has been no tumor recurrence since follow-up.
For local or neck recurrence of nasopharyngeal carcinoma, surgery can be selected as rescue treatment, and chemotherapy or radiotherapy can be supplemented depending on the degree of lesion invasion. In the past, open surgery was required for the recurrence of nasopharyngeal tumors. With the maturity of endoscopic tumor surgery technology, doctors at home and abroad gradually used endoscopic resection of nasopharyngeal recurrent tumors after 2000. The recent statistics of Taichung Veterans General Hospital Surgical experience of endoscopic resection of recurrent nasopharyngeal carcinoma, the 5-year survival analysis of nearly 40 patients was 85%. For patients with local or neck recurrence of nasopharyngeal carcinoma, the treatment team will use surgical rescue treatment as much as possible to reduce the possible local tissue damage caused by two radiotherapy treatments.
Regular tumor follow-up and various teams provide care and consultation services
Liang Kaili reminded that after treatment, patients may have disease and treatment-related quality of life impacts, and patients are more likely to develop nasal andsinusitis、otitis mediahearing loss,Tooth decaymay also be prone to choking, neck stiffness, neuropathy or carotid artery stenosis as the treatment time prolongs.
In addition to regular tumor tracking, the nasopharyngeal cancer treatment team also takes care of the patient’s disease and treatment-related health. Regular team meetings include regular members of ENT, tumor, imaging, pathology, cancer centers and other units, nutritionists, swallowing language Rehabilitation specialists, Neuromedicine Center, Department of Stomatology, Department of Traditional Chinese Medicine and other units are also invited to participate in team meetings to provide care suggestions, consultation and assistance.
Text/ Lai Yiling, Photos/ Lei Siyu
Ask the Experts:Kaili Liang, Attending Physician of Otorhinolaryngology, Head and Neck, Taichung Veterans General Hospital
further reading
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Nasopharyngeal carcinoma was discovered after several months of nasal congestion by “endoscopy” to find out the lesion