Symptoms and Signs

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Symptoms and signs Cervical lymphadenopathy (disease or swelling of the lymph nodes in the neck) is the initial presentation in many patients, and the diagnosis of NPC is often made by lymph node biopsy. Symptoms related to the primary tumor include trismus, pain, otitis media, nasal regurgitation due to paresis(loss of or impaired movement) of the soft palate, hearing loss and cranial nerve palsies (paralysis). Larger growths may produce nasal obstruction or bleeding and a "nasal twang". Metastatic spread may result in bone pain or organ dysfunction. Rarely, a paraneoplastic syndrome of osteoarthropathy (diseases of joints and bones) may occur with widespread disease. Pathophysiology The detection of the Epstein-Barr virus (EBV) nuclear antigen and viral DNA in nasopharyngeal carcinoma has revealed that EBV can infect epithelial cells and is associated with their malignant transformation.[1] EBV genome has been found in cells of preinvasive lesions, suggesting that it is directly related to the process of transformation. Causes and Symptoms Several factors put people at risk for nasopharyngeal cancer. One is an infection with a type of herpes virus called Epstein-Barr virus (EBV). Another factor is genetic make-up, or inherited DNA. Finally, anything that introduces radioactive elements into the diet or respiratory pathway increases the risk of developing this cancer. In certain parts of China, the soil has a high concentration of uranium and thorium, which break down into radioactive elements such as radium and radon. The elements are taken up by trees, which are burned for wood and become airborne. They also dissolve in water, and fish and plants draw them up. The fish are eaten. Some of the plants are used for tea. The scenario seems to increase the risk of nasopharyngeal cancer, but the exact way in which it does is not known. In all parts of the world, people who work in sawmills or with wood products have a higher likelihood of acquiring nasopharyngeal cancer. Sawdust or chemicals in the wood may contribute to its development. Recently, E. Lopez-Lizarraga demonstrated that human papilloma virus (HPV) is often present in people who contract nasopharyngeal cancer. Neither this link nor the others cited show a precise cause and effect, however. Some of the links may mask true causes. For example, in the HPV study, subjects who had HPV infection also tended to have poor oral hygiene. And in the case of EBV, infection with the virus is so common that some researchers are now investigating whether there is a unique strain of the EBV that puts individuals at greater risk for nasopharyngeal cancer.

Symptoms of nasopharyngeal cancer include:
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lump in the nose or neck headaches ear pain numbness on the side of the face difficulty breathing difficulty speaking

Asymptomatic in early stages
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Nasal obstruction Breathing problems Nasal discharge Bleeding nose Chronic ear infections Impaired sense of smell Impaired hearing Ear pain Tinnitus Chronic nasal congestion Face pain Neck pain Feeling of fullness in throat Feeling of fullness in the sinuses Bulging eyes Impaired eye movement Diplopia

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Impaired vision Difficulty speaking Dysphagia Increased salivation Airway obstruction Enlarged neck lymph nodes Pain - in advanced cases Headache - in advanced cases Nausea - in advanced cases Vomiting - in advanced cases Anorexia - in advanced cases Loss of body weight - in advanced cases Cachexia - in advanced cases

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