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Nasopharyngeal carcinoma: a tumor unique to the Chinese

Nasopharyngeal cancer is common in Guangdong, Guangxi, Fujian, and other regions of China. It is also a very common cancer in Taiwan, but it is rare in Europe and the United States. Nasopharyngeal carcinoma often occurs in the age of 30 to 40 years old, and it is in the middle of the young and middle age group, which often causes considerable family and social impact.

A lump in the neck is the most common symptom of nasopharyngeal cancer, and about 75-80% of patients have this symptom. The nasopharynx is behind the nasal cavity and must be seen with a special nasopharyngeal mirror or nasopharyngeal endoscope. Because of the anatomical location, patients often have nosebleeds or nasal discharge with bloodshot or stuffy nose. Because there is a small tube in the middle ear called the nasopharyngeal tube that leads to the nasopharynx, if the tumor in the nasopharynx blocks the tube, otitis media will occur. Because the nasopharynx is the brain above the tumor, if the tumor grows up and invades the nerves, there will be some neurological symptoms, such as headache, diplopia, and facial numbness.

Why does nasopharyngeal cancer occur in southern China? Scholars in Hong Kong say that it may be related to the delicious salted fish and lack of vitamin C of Cantonese. I think this is not true at least in Taiwan. Epstein-Barr virus is known to be closely related to nasopharyngeal carcinoma, but it has not yet been proven that it is the cause of nasopharyngeal carcinoma. It may also be related to genes. People from northern China are close to Mongolian genes and are less susceptible to the disease. However, the provinces of Lingnan, which are of "Nanman" ancestry, have genes that are prone to nasopharyngeal cancer. The most effective treatment for nasopharyngeal cancer is currently radiation therapy. Radiation therapy is usually given once a day for a total of about forty times, with a total dose of about 7,000 cGy, which takes about two months before and after. In recent years, there are so-called "three-dimensional spatial cis-radiation therapy" and "intensity-modulated radiation therapy", which are used for nasopharyngeal cancer to make the treatment better.

In addition to radiation exposure, chemotherapy is a commonly used adjuvant therapy, which must be given at the same time as radiotherapy to achieve better results. If the cervical lymph nodes have not completely disappeared after radiotherapy, they are surgically removed.

Cancer is usually divided into one to four stages, the earlier the prognosis is better. Generally, the larger the number of cervical lymph nodes, the worse the prognosis. The overall cure rate of nasopharyngeal cancer is good, and many can be cured.

Inflammation of the oral mucosa, pain during swallowing, altered or complete loss of taste during radiation therapy are common. Fatigue and loss of appetite are also common in treatment. However, the above side effects will recover once the treatment is over. Common side effects after treatment include dry mouth, fibrosis of the skin in the irradiated area, or edema of the skin in the irradiated area. In addition, there are few major side effects. Dry mouth is the most common side effect, which is caused by the destruction of salivary glands by radiation during radiotherapy. In the past few years, Sanchang has done a lot of research on dry mouth in patients with nasopharyngeal carcinoma, and has adopted a new treatment positioning method, which has been able to reduce dry mouth to a less serious degree.

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