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Nasopharyngeal Carcinoma
Definition:
Nasopharyngeal carcinoma means cancer of the nasopharynx. The nasopharynx is an area in the back of the nose toward the base of skull. It lies just above the soft palate, just at the back of the entrance into the nasal passages. Cancer of the nasopharynx tends to spread early and widely.
We can classify nasopharyngeal carcinoma by the way the cancer cells appear under the microscope. Those with the appearance of epithelial cells with keratin protein fibres are called keratinizing squamous cell carcinoma (type 1), those appear like epithelial cells but without keratin protein fibres are called nonkeratinizing carcinoma (type 2). Those with cells so immature that we can't tell their origin are called undifferentiated carcinoma (type 3). Treatment is usually the same for all types. The chances of survival depend on how far the disease has spread rather than on the cell type.
Who is at risk?
Nasopharyngeal carcinoma is common in Southern China. It often affects people aged 30 and older, but occasionally can be seen in the young, including children. It is twice as common in women.
Several risk factors have been found with nasopharyngeal cancer:
Diet: In areas where nasopharyngeal carcinomas are common, people typically eat diets very high in salted fish and preserved meat from a young age.
Epstein-Barr virus infection: Epstein-Barr virus is common throughout the world. Almost all nasopharyngeal cancer cells contain genetic material of this virus. How this virus can cause nasopharyngeal carcinoma in certain patients but not in others is still a mystery.
Genetic factors: nasopharyngeal carcinoma can run in families. Studies have found that people with certain inherited tissue types are at increased risk of developing nasopharyngeal carcinoma.
Nasopharyngeal carcinoma is relatively rare in most parts of the world except with immigrants from Southern China. Your chance of having the disease is not increased by moving into this part of the world.
Symptoms:
Enlargement and extension of the tumor in the nasopharynx result in symptoms of nasal obstruction in nearly 80% of patients (e.g., congestion, nasal discharge, bleeding), 73% have ear symptoms including deafness and tinnitus. Headache occurs in 60% of patients and neck swellings are just as common.
These are all common symptoms that one may get with any cough and cold. It is little wonder that nasopharyngeal carcinoma rarely comes to medical attention before it has already spread to regional lymph nodes. In fact some patients may present cranial nerve palsies, when the tumor has extended to the base of the skull.
Treatment:
The options for treatment of nasopharyngeal cancer (nasopharyngeal carcinoma) are radiation therapy, chemotherapy, and occasionally surgery.
Radiation therapy is the main form of treatment for nasopharyngeal carcinoma because, irrespective of the cell type, most cases are responsive to radiation. External radiation beams emitted from a machine are directed towards the cancer cells and regional lymph nodes. The doses of radiation would depend on the extent of disease. Modern irradiation techniques can minimize trauma to normal tissues. For some patients, especially recurrent cases, internal radiation may help.
Although new surgical techniques can completely remove some nasopharyngeal tumors, this strategy is appropriate only for a relatively small number of patients and in special centres. Very often surgery is done to obtain tissues to confirm the diagnosis rather than for treatment purpose.
A number of anti-cancer drugs can be effective in nasopharyngeal carcinoma, but chemotherapy is usually reserved for patients diagnosed late or in patients with recurrences.
Prevention:
Avoid eating a diet high in salted fish and preserved food, especially for younger children. Certain dietary habits such as chewing food for small children and sharing of chopsticks can spread the virus to children at young age, which the virus may interact with some unknown environmental factors to put the child at risk of developing nasopharyngeal carcinoma in adulthood.
If diagnosed early, patients with nasopharyngeal carcinoma have a very high chance of complete cure with external irradiation. Consult your doctor for any unusual nasal symptoms, hearing problems, headaches or neck swellings. A simple blood test for IgA antibodies against the Epstein-Barr virus is a sensitive screening test for nasopharyngeal carcinoma. If you have family members suffering from the disease, the blood test should be performed at regular intervals in order to catch the disease early.
Nasopharyngeal Carcinoma
Definition:
Nasopharyngeal carcinoma means cancer of the nasopharynx. The nasopharynx is an area in the back of the nose toward the base of skull. It lies just above the soft palate, just at the back of the entrance into the nasal passages. Cancer of the nasopharynx tends to spread early and widely.
We can classify nasopharyngeal carcinoma by the way the cancer cells appear under the microscope. Those with the appearance of epithelial cells with keratin protein fibres are called keratinizing squamous cell carcinoma (type 1), those appear like epithelial cells but without keratin protein fibres are called nonkeratinizing carcinoma (type 2). Those with cells so immature that we can't tell their origin are called undifferentiated carcinoma (type 3). Treatment is usually the same for all types. The chances of survival depend on how far the disease has spread rather than on the cell type.
Who is at risk?
Nasopharyngeal carcinoma is common in Southern China. It often affects people aged 30 and older, but occasionally can be seen in the young, including children. It is twice as common in women.
Several risk factors have been found with nasopharyngeal cancer:
Diet: In areas where nasopharyngeal carcinomas are common, people typically eat diets very high in salted fish and preserved meat from a young age.
Epstein-Barr virus infection: Epstein-Barr virus is common throughout the world. Almost all nasopharyngeal cancer cells contain genetic material of this virus. How this virus can cause nasopharyngeal carcinoma in certain patients but not in others is still a mystery.
Genetic factors: nasopharyngeal carcinoma can run in families. Studies have found that people with certain inherited tissue types are at increased risk of developing nasopharyngeal carcinoma.
Nasopharyngeal carcinoma is relatively rare in most parts of the world except with immigrants from Southern China. Your chance of having the disease is not increased by moving into this part of the world.
Symptoms:
Enlargement and extension of the tumor in the nasopharynx result in symptoms of nasal obstruction in nearly 80% of patients (e.g., congestion, nasal discharge, bleeding), 73% have ear symptoms including deafness and tinnitus. Headache occurs in 60% of patients and neck swellings are just as common.
These are all common symptoms that one may get with any cough and cold. It is little wonder that nasopharyngeal carcinoma rarely comes to medical attention before it has already spread to regional lymph nodes. In fact some patients may present cranial nerve palsies, when the tumor has extended to the base of the skull.
Treatment:
The options for treatment of nasopharyngeal cancer (nasopharyngeal carcinoma) are radiation therapy, chemotherapy, and occasionally surgery.
Radiation therapy is the main form of treatment for nasopharyngeal carcinoma because, irrespective of the cell type, most cases are responsive to radiation. External radiation beams emitted from a machine are directed towards the cancer cells and regional lymph nodes. The doses of radiation would depend on the extent of disease. Modern irradiation techniques can minimize trauma to normal tissues. For some patients, especially recurrent cases, internal radiation may help.
Although new surgical techniques can completely remove some nasopharyngeal tumors, this strategy is appropriate only for a relatively small number of patients and in special centres. Very often surgery is done to obtain tissues to confirm the diagnosis rather than for treatment purpose.
A number of anti-cancer drugs can be effective in nasopharyngeal carcinoma, but chemotherapy is usually reserved for patients diagnosed late or in patients with recurrences.
Prevention:
Avoid eating a diet high in salted fish and preserved food, especially for younger children. Certain dietary habits such as chewing food for small children and sharing of chopsticks can spread the virus to children at young age, which the virus may interact with some unknown environmental factors to put the child at risk of developing nasopharyngeal carcinoma in adulthood.
If diagnosed early, patients with nasopharyngeal carcinoma have a very high chance of complete cure with external irradiation. Consult your doctor for any unusual nasal symptoms, hearing problems, headaches or neck swellings. A simple blood test for IgA antibodies against the Epstein-Barr virus is a sensitive screening test for nasopharyngeal carcinoma. If you have family members suffering from the disease, the blood test should be performed at regular intervals in order to catch the disease early.
Nephritis
Definition:
Nephritis, or glomerulonephritis, is an inflammatory disease of the structural units in the kidneys that filter the blood. This condition is most often caused by abnormal immune response or toxins. Most cases of acute nephritis settle completely. Occasionally, the disease can progress to chronic inflammation of the kidneys and can result in renal failure after 10 to 20 years.
Who is at risk?
- Children from 2 to 12
- Patients after recent throat or skin infection caused by streptococcus, a bacterium that can trigger abnormal immune response in susceptible individuals
- Family history of nephritis
- Patients suffering from immune disorders such as SLE (Systemic Lupus Erythematosus)
- Patients with diabetes
- Chronic carriers of the Hepatitis B virus
Symptoms:
- Blood in the urine, or dark color urine
- Foamy urine
- Decreased urine production
- Swelling in face, limbs and abdomen caused by fluid retention
- Hypertension
- Tiredness and fatigue
Treatment:
For acute nephritis related to streptococcal infections, antibiotics are given to get rid of any residual bacteria. Medication may be needed to control the blood pressure. Fluid retention and poor urine output may be treated with diuretics. Dietary restriction is often necessary in the acute stage when the kidney function works poorly in regulating fluid and electrolyte imbalance.
Other causes of nephritis may require special treatment, for example, nephritis caused by SLE may respond to treatment with corticosteroids and immune-suppressing drugs. Since treatment depends on the underlying cause, the specialist may need to take out a sample of the kidney tissue to examine under the microscope (renal biopsy) before definitive treatment can be recommended.
Prevention:
- Prompt treatment of throat and skin infections would reduce the risk of nephritis related to streptococcal infections.
- Immunization against hepatitis B would eliminate another common cause of nephritis.
Neurosis
Definition:
Neurosis refers to any mental imbalance that causes distress in the patient but does not interfere with rational thought or an individual's ability to function in daily life. Modern classification of psychiatric diseases tends to replace the term with specific disease entities, such as anxiety disorders, mood disorders and so on.
Who is at risk?
Most psychiatric disorders result from the interaction of genetic and constitutional factors with social and environmental factors. Those with a family history of neurosis and those with have traumatic childhood experiences are more vulnerable. Any personal crisis and stressful events can precipitate the disease in susceptible individuals. Neurosis tend to be concurrent with major changes in life, such as divorce, change of jobs, retirement and grief. It is more common in the socially isolated and in recent immigrants. Depression, one of the most common types of neurosis, is particularly common in the elderly and in those suffering from chronic diseases.
Symptoms:
Symptoms experienced would depend on the type of neurosis. For example in anxiety disorders, patients would be tense and anxious, have difficulty in relaxing and cannot sleep. In mood disorders such as depression, patients would feel sad for no reason, constantly accusing themselves for things they are not responsible. They have sleep problems and frequently wake up in early morning. They have little interest in sex and food, and are no longing taking part in activities their previously enjoyed.
Treatment:
Neurosis can be treated with a combination of drugs and psychotherapy.
- Pharmacological treatment:
Symptoms such as anxiety, depressed mood and sleep difficulties usually respond favorably. Medicine may need several weeks or more to achieve an optimal effect, and treatment may last for months, or years. - Psychotherapy:
This can vary from psychoanalysis to an extended counseling with your entrusted doctor, and may be arranged in groups or involve family members. Cognitive therapy emphasizes on providing patients with understanding and guidance to cope with stressful events. Behavioural therapy emphasizes on identifying and discouraging maladaptive behaviours and replacing them with positive ones.
Prevention:
- Exercise regularly.
- Try to be with other people and to confide in someone.
- Participate in religious and/or community work, and take part in any social activities that make you feel better.
- Break large tasks into small ones, set priorities.
- Share with others. Do not assume all responsibilities to yourself.
- Take a short break. Listen to music, or go to a movie.
- Let your family and friends help you.
- Talk to your doctor if you're still not feeling better
