A NEW Screening Tool for Nose Cancer

Nose cancer or nasopharyngeal cancer (NPC) is common in Southeast Asia. It is more common amongst the Chinese – particularly the Cantonese – due to a genetic predisposition. The consumption of salted fish which contains high levels of nitrosamines and an infection early in life with a common virus (Epstein-Barr Virus or EBV) contribute to the development of nose cancer.

Nose cancer develops in the back of the nose in a ‘crevice’ beside the opening of the auditory or eustachian tube. The eustachian tube connects the back of the nose to the middle ear. This crevice is called the Fossa of Rosenmuller. Due to its location close to the eustachian tube, nose cancer often causes problems with hearing. The diagram below shows the location of the Fossa of Rosenmuller.

Diagram showing the location where nose cancer arises

In the video below, I undertake a biopsy of a recurrent tumour in the nasopharynx

The outcome of early stage NPC following treatment is good. It is therefore imperative to make an early diagnosis when patients may have no symptoms. Screening for nose cancer is now offered to those who have an increased susceptibility. The current screening method is based on blood tests. However these blood tests are notoriously inaccurate. Many patients with cancer have negative blood tests (what we call a false negative) and many more normal healthy individuals have positive blood tests but have no cancer (false positives).

There now exists a new screening method which offers greater accuracy. This method utilises molecular genetics to identify genetic material from cancerous cells.

The video below is a simple description on how this screening tool works

The following scenarios would benefit from the use of NP Screen™ as a routine adjunctive screening and detection protocol:

• General screening for individuals from high risk endemic areas
• Individuals with an ethnic background that are considered at risk and screening is desired
• Individuals who have strong family history of NPC
• Individuals who are at risk and present with clinical symptoms suspicious of NPC (with or without endoscopic findings)
• Individuals who have rising EBV serology and a family history of NPC
• Individuals who are at risk and present with rising EBV serology of unknown etiology
• Individuals who present with asymmetry in the nasopharynx on endoscopy need further screening to rule out the possibility of sub-mucosal NPC prior to further invasive biopsy
• Individuals that present suspicious lesions in the nasopharynx on endoscopy need further screening to support the clinical diagnosis prior to a definitive biopsy
• Monitoring of post radiated NPC patients with or without clinical findings in the nasopharynx

If you think you may benefit from NP Screen™ please do contact our clinic on +65 67107522 or email enquiry@entclinic.sg and schedule an appointment.

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