Nasopharyngeal cancer is a rare in children specifically targeting the nasal cavities and pharynx (the upper portion of the throat behind the nose).
This cancer is not as well studied in the literature, so the exact causes are fairly unknown. However, the cancer has been linked to the Epstein-Barr virus (EBV), part of the herpes category, but EBV is not a true precursor to nasopharyngeal cancer. Many patients with a history of EBV are without long-term problems as the patient’s immune system eventually clears the virus. Childhood nasopharyngeal cancer is more common in the teen years than in children who are younger. If no treatment is provided, this cancer may metastasize elsewhere in the body and eventually lead to death. It is common for children to have the undifferentiated type of the disease associated with advanced [local and regional] spread and distant metastases.
Some of the symptoms of nasopharyngeal cancer may include:
- Seeing blurred or doubled images.
- Difficulty speaking.
- Recurrent ear problems.
- A painful face.
- Loss of hearing, a sense of one or both ears ringing, and fullness in one or both ears.
- Neck or nasal lumps.
- Bleeding from the nose.
- Inability to breathe through the nose.
- Throat soreness.
Nasopharyngeal cancer in children is mostly a diagnosis of exclusion. A host of symptoms may or may not be present at the time of examination by a physician and a cancer diagnosis may be the one of the last one to diagnose.
There are four stages of nasopharyngeal cancer. The lower the number, the less the cancer has spread to other parts of the body:
- Stage I is called early stage nasopharyngeal cancer.
- Stage II is called intermediates-stage nasopharyngeal cancer.
Stages II and IV are called advanced or late-stage nasopharyngeal cancer.
The most common treatment for nasopharyngeal cancer in children is radiation therapy with cure rates of only 30% to 60%. This high percent of failure in children may indicate chemotherapy as the first line of treatment for advanced nasopharyngeal cancer. Although combined…treatment has increased 5-year survival to 70% to 90%, early death remains a concern.
As a rare childhood cancer, nasopharyngeal cancer treatment has mirrored those treatments for adults with reported cure rates from 30% to 60% only using radiation. While clinical trials are underway investigating the more promising effects of chemotherapy and its impact on quality of life and longevity, the total dose, volume, and process of radiation along with chemotherapy are thus far unknown. The uncommon existence of nasopharyngeal cancer in children, its epithelial origin, and its presence in children into their teens have led oncologists to provide treatment based on adult research.
Acute reactions to treatment include but are not limited to grade 2-3 skin reactions and mucositis leading to dysphagia (trouble swallowing) and weight loss. Nasopharyngeal cancer in children is the only disease for which radiation is the preferred treatment.