Nasopharyngeal cancer

For a lay person:

Nasopharyngeal cancer starts in the space behind the nose, at the top of the throat. It is much more common in southern China and South-East Asia and is linked to Epstein-Barr virus, salted fish in the diet and family history. It often first shows as a painless lump in the neck or a blocked ear on one side.

For a trained medical person:

Usually a non-keratinising undifferentiated carcinoma strongly associated with Epstein-Barr virus. Diagnosis is by nasoendoscopy and biopsy, with MRI and PET-CT staging, and plasma EBV DNA is used for prognosis and monitoring. Radiotherapy is the main treatment, with concurrent and induction chemotherapy for locoregionally advanced disease.

In Chinese medicine:

Liu and Tseng's textbook differentiates this condition into these patterns: Knotted Phlegm Stasis; Accumulation of Fire Toxins; Excess Evil Pathogens and Deficient Zheng Qi. Treatment follows the pattern a patient presents with, not the Western diagnosis alone.

When to get help: This needs specialist head and neck oncology care; Chinese medicine is adjunctive at most. See a doctor for a neck lump, one-sided blocked ear or repeated nosebleeds lasting more than a few weeks, and check herbs with your team during chemoradiotherapy.