Nasopharyngeal Cancer Screening Guidelines

Nasopharyngeal Cancer
Screening Guidelines

The nasopharynx is the upper part of the throat that lie behind the nose and under the skull. Nasopharyngeal cancer results from the abnormal growth of cells in the nasopharynx.

In Malaysia, nasopharyngeal carcinoma (NPC) is the fourth most common cancer.

What is The Epstein-Barr Virus (EBV)?

The Epstein Barr Virus (EBV)

is a very common virus that can increase one’s risk of nasopharyngeal cancer.

EBV is a very common viral infection

that spreads through saliva and other bodily fluids.

Most people carry EBV,

and it does them no harm.

Nasopharyngeal Cancer Risk Factors

Epstein-Barr virus (EBV) infection

Family history of nasopharyngeal cancer

High intake of preserved, salted or
fermented food or fruit

Smoking

Occupational exposure to wood dust,
chemicals, dust, exhaust or smoke

Individuals of Southern
Chinese descent

Nasopharyngeal Cancer Signs and Symptoms

Painless neck lump(s)

Blocked nose

Double vision

Headache

Nose bleed or bloodstained phlegm, especially upon waking up in the mornings

Facial numbness

Sore throat

Unilateral ear pressure or ringing sound in the ear

Screening & Diagnosis Options

EBV DNA

The EBV DNA test is a diagnostic test used to detect the presence of EBV genetic material (DNA) in a person’s blood.

PURPOSE

To determine if a person is currently infected with EBV.

PROCEDURE

A blood sample will be taken, and the DNA from the virus will be analysed.

INTERPRETATION

Positive Result:
Indicates an active EBV infection.

Negative Result:
Suggests no current EBV infection.

EBV VCA-IGA
Antibody Blood Test

The EBV VCA-IgA antibody test detects specific antibodies produced by the immune system in response to the EBV viral capsid antigen (VCA).

PURPOSE

To diagnose acute EBV infection.
To aid in the diagnosis of type 2 or type 3 nasopharyngeal carcinoma (NPC).

PROCEDURE

A blood sample will be collected.

INTERPRETATION

IgA Antibodies Present:
Indicates a current or recent EBV infection.

IgA Antibodies Absent:
Suggests no recent EBV infection.

NASAL Endoscopy

A nasal endoscopy is a diagnostic procedure that allows a doctor to examine the inside of the nasal passages and sinuses using
a thin, flexible tube called an endoscope.

PURPOSE

To evaluate nasal and sinus conditions (e.g., nasal polyps, tumours).

PROCEDURE

A local anaesthetic or numbing spray is applied to the nasal passages.
The endoscope is inserted through the nostril and advanced into the nasal cavity.
The doctor can visualise the nasal structures, take biopsies, and assess any abnormalities

NASAL Endoscopy

A nasal endoscopy is a diagnostic procedure that allows a doctor to examine the inside of the nasal passages and sinuses using
a thin, flexible tube called an endoscope.

PURPOSE

To evaluate nasal and sinus conditions (e.g., nasal polyps, tumours).

PROCEDURE

A local anaesthetic or numbing spray is applied to the nasal passages.
The endoscope is inserted through the nostril and advanced into the nasal cavity.
The doctor can visualise the nasal structures, take biopsies, and assess any abnormalities

Nasopharyngeal Cancer Treatment Options

Radiotherapy

Mechanism:
Uses high-energy beams to kill cancer cells or slow their growth.

Target:
Nasopharynx and neck lymph nodes

Effectiveness:
Commonly used for early-stage NPC and in combination with chemotherapy for more advanced stages.

Chemotherapy

Mechanism:
Anti-cancer drugs destroy cancer cells.

Administration:
Intravenous

Effectiveness:
Often combined with radiation therapy to potentiate the action of radiation.

Surgery

Indication:
Used if cancer recurs or persists after initial treatment.

Procedure:
Removal of the main tumour and affected lymph nodes.