Indications for testing for oropharyngeal cancer

Vietnam is a country with a high rate of nasopharyngeal cancer compared to the world and has an increasing trend. Screening for oropharyngeal cancer helps to detect the disease early, thereby increasing survival rates and minimizing dangerous complications. So what tests are used to diagnose nasopharyngeal cancer and do blood tests detect nasopharyngeal cancer?

Nasopharyngeal Carcinoma (NPC) is a type of head and neck cancer, cancer that begins in the nasopharynx (the upper part of the throat behind the nose) due to an overgrowth of cells.
According to statistics of the World Health Organization in 2020, nasopharyngeal cancer is on the list of 36 common cancers. In particular, Southeast Asia is the region with the highest rate of nasopharyngeal cancer in the world, the rate of nasopharyngeal cancer in men is three times higher than in women.

Currently, the cause of oropharyngeal cancer is still unknown. Most patients with nasopharyngeal cancer are often detected at a late stage when the tumor has grown, metastasized or spread to lymph nodes and organs in the body. The reason is that nasopharyngeal cancer has no prominent signs and is not specific, so it is easy to confuse with symptoms of other common upper respiratory tract diseases.
The screening test for nasopharyngeal cancer helps to detect the disease early, thereby increasing the survival rate and minimizing dangerous complications. When you have the following symptoms, you should contact your doctor for an examination, especially if the symptoms do not go away after a few weeks:
There is a lump in the neck: this is the most common symptom Nasal congestion or congestion feeling of fullness or pain in the ear due to fluid buildup in the middle ear, especially if it does not go away and occurs in only one ear Pain and ringing in the ears, frequent sore throat that does not go away Difficulty breathing or speaking Frequent nosebleeds Facial pain or numbness Frequent headaches, fatigue Difficulty opening the mouth Blurred vision or double vision (Diplopia - a condition in which the eyes see one object in two). Unexplained weight loss In addition, subjects at risk of oropharyngeal cancer who need periodic intensive otolaryngology can test for nasopharyngeal cancer to detect the disease early. Specifically:
Male patient aged 30-55, Family history of nasopharyngeal cancer. People who have a habit of eating foods such as salted fish, pickles, .... The patient has a history of EBV infection (with EBV antibodies in the blood) Or having risk factors such as smoking, drinking alcohol, working in an environment exposed to a lot of smoke, dust, chemicals, etc.

Does a blood test know nasopharyngeal cancer? Blood tests are not indicated to confirm the diagnosis of oropharyngeal cancer, but may be ordered to determine the extent of the spread of oropharyngeal cancer. In addition, nasopharyngeal cancer blood tests, such as the EBV or SCC test, serve as an indicator of cancer risk.
Routine blood count test: helps to determine the overall health of the patient, diagnose nutritional problems, anemia (low red blood cell count), liver disease and kidney disease. Thereby, predicting the possibility of cancer metastasis to the liver or bones before doing in-depth tests. EBV virus antibody blood test: performed before and after treatment to determine the effectiveness of oropharyngeal cancer treatment. SCC (squamous cell carcinoma antigen) test: determines the level of squamous cell cancer antigen.

Blood test for nasopharyngeal cancer only plays the role of detecting cancer markers, ... to accurately diagnose the disease, the doctor will specify additional paraclinical techniques including:
4.1. The nasopharynx is located deep inside the head and is not easily seen, so an endoscopy should be performed to check for abnormal growths, bleeding, or other signs of disease. There are 2 endoscopic techniques:
Indirect nasopharynoscopy: using special small mirrors and bright lights to examine the nasopharynx and surrounding areas. Direct nasopharynoscopy: a flexible endoscope with a camera and light is passed through the nose to view the lining of the nasopharynx. A local anesthetic can be sprayed into the nose before the exam to make the endoscopy easier. 4.2. Biopsy Different types of biopsies may be done depending on the area of ​​the abnormality. Tumor cells are removed and examined under a microscope.
Endoscopic biopsy: a sample of nasopharyngeal tissue is taken out through the endoscope when the doctor uses the endoscope to look at the inside of the nasopharynx.
Fine needle aspiration (FNA) biopsy: performed when there is a suspicious mass in or near the neck. The needle puncture site may or may not be under local anesthesia. A very thin, hollow needle is attached to the syringe to remove very small amounts of fluid and very small pieces of tissue from the tumor.
4.3. Imaging tests Imaging tests help find a suspected cancer site, check for metastases, or determine the effectiveness of treatment.
Chest X-ray: check if nasopharyngeal cancer has spread to the lungs. Computed tomography (CT): determines the location, size, and shape of the tumor, and looks for enlarged lymph nodes with cancer. CT scan is also valuable in determining whether nasopharyngeal cancer has invaded the bone at the base of the skull. Magnetic resonance imaging (MRI): to determine if nasopharyngeal cancer has invaded the soft tissues near the nasopharynx. Positron emission tomography (PET): determines whether the cancer has spread to the lymph nodes. Combined with chest X-ray images to determine if an abnormal picture on a chest X-ray is cancer or not.

Currently, Vinmec International General Hospital has been and continues to be fully equipped with modern diagnostic facilities such as: PET/CT, SPECT/CT, MRI... biology, immunohistochemistry, genetic testing, molecular biology testing, as well as a full range of targeted drugs, the most advanced immunotherapy drugs in cancer treatment. Multimodal cancer treatment from surgery, radiation therapy, chemotherapy, hematopoietic stem cell transplantation, targeted therapy, immunotherapy in cancer treatment, new treatments such as autoimmunotherapy body, heat therapy...
After having an accurate diagnosis of the disease and stage, the patient will be consulted to choose the most appropriate and effective treatment methods. The treatment process is always closely coordinated with many specialties to bring the highest efficiency and comfort to the patient.
Especially, now to improve the quality of services, Vinmec also deploys many cancer screening packages that can help customers detect cancer early before there are no symptoms, providing a better prognosis for treatment. and a high chance of recovery.

Reference source: cancer.org - gco.iarc.fr