High rate of nose cancer

KUALA LUMPUR: Malaysia has among the highest incidence of nasopharyngeal cancer (NPC) in the world but early detection is hampered by poor awareness of its symptoms.

Malaysian Society of Otorhinolaryngology and Head & Neck Surgeons president Dr Yap Yoke Yeow said NPC was one of the most treatable cancers.

“If they come to us at the early stages of the cancer, most patients respond well to radiotherapy and chemotherapy and have good outcomes,” he told The Star.

Dr Yap said 70% of NPC patients were diagnosed only six months after the first symptom was noticed and treatment was delayed due to lack of awareness of its early symptoms.

For this reason, the society and the Health Ministry recently started a nationwide campaign to increase the awareness level on NPC and other head and neck cancers such as oral, laryngeal and pharyngeal.

The 2006 National Cancer Registry showed NPC was the fifth most common cancer in Malaysia, but grouped under head and neck cancer, and 2,884 cases were reported in the peninsula the highest number after female breast cancer (3,525) and higher than colorectal (2,866) and lung (2,048) cancer cases.

Dr Yap said people with immediate family members suffering from NPC and middle-aged Chinese, Malay or those from indigenous groups in Sabah and Sarawak should go for screenings while general practitioners should refer patients with neck lumps to ear, nose and throat (ENT) specialists for further investigation.

A neck lump is the most common NPC symptom, followed by hearing loss or ringing or buzzing in the ear, blood-stained saliva or nasal discharge and double vision.

Dr Yap said a study in Sarawak revealed that the Bidayuhs had 26 NPC cases per 100,000 people compared with one per 100,000 worldwide.

There were 5.4 cases per 100,000 in the peninsula and 13.5 per 100,000 in Sarawak.

NPC is caused by many factors and is linked to genes, preserved food such as salted fish and vegetables which contain carcinogenic nitrosamines and the Epstein-Barr viral infection.

The cancer was common in the Guangdong province in China, Hong Kong, Taiwan and the South-East Asia region, indicating a possible genetic link, he said.

The Malaysian 2008 Nasopharyngeal Carcinoma Database showed that carpenters were a high risk group and pesticides and formaldehyde used in the timber industry were possible causes.

Another ENT surgeon, Dr Yeo Sek Wee said the lower income group tended to seek treatment at a late stage of cancer.

He said he was also seeing more cases of tongue cancer.

He urged those with prolonged mouth ulcers to seek treatment and people should visit dentists on a regular basis.

Dr Yeo said the prognosis for all head and neck cancers were good if treated at the early stages.