Nasopharyngeal carcinoma (NPC), or nasopharynx cancer, is the most common cancer originating in the nasopharynx, most commonly in the postero-lateral nasopharynx or pharyngeal recess (fossa of Rosenmüller), accounting for 50% of cases. NPC occurs in children and adults. NPC differs significantly from other cancers of the head and neck in its occurrence, causes, clinical behavior, and treatment. It is vastly more common in certain regions of East Asia and Africa than elsewhere, with viral, dietary and genetic factors implicated in its causation. It is most common in males. It is a squamous cell carcinoma of an undifferentiated type. Squamous epithelial cells are a flat type of cell found in the skin and the membranes that line some body cavities. Undifferentiated cells are cells that do not have their mature features or functions.
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👉 Nasopharyngeal carcinoma in the context of Epstein–Barr virus
The Epstein–Barr virus (EBV), also known as human herpesvirus 4 (HHV-4), is one of the nine known human herpesvirus types in the herpes family, and is one of the most common viruses in humans. EBV is a double-stranded DNA virus. EBV is the first identified oncogenic virus, a virus that can cause cancer. EBV establishes a permanent infection in human B cells. It uncommonly causes infectious mononucleosis and is also tightly linked to many malignant diseases (cancers and autoimmune diseases). Various vaccine formulations have been tested in humans and other animals; however, none of them were able to prevent EBV infection, thus, no vaccine has been approved to date.
Infectious mononucleosis ("mono" or "glandular fever"), is characterized by extreme fatigue, fever, sore throat, and swollen lymph nodes. EBV is also associated with various non-malignant, premalignant, and malignant EBV-associated lymphoproliferative diseases such as Burkitt lymphoma, hemophagocytic lymphohistiocytosis, and Hodgkin's lymphoma; non-lymphoid malignancies such as gastric cancer and nasopharyngeal carcinoma; and conditions associated with human immunodeficiency virus such as hairy leukoplakia and central nervous system lymphomas. The virus is also associated with the childhood disorders of Alice in Wonderland syndrome and acute cerebellar ataxia and, by some evidence, higher risks of developing certain autoimmune diseases, especially dermatomyositis, systemic lupus erythematosus, rheumatoid arthritis, and Sjögren's syndrome. About 200,000 cancer cases globally per year are thought to be attributable to EBV. In 2022, a large study following 10 million active US military over 20 years suggested EBV as the leading cause of multiple sclerosis (MS), with a recent EBV infection causing a 32-fold increase in MS risk development.
Nasopharyngeal carcinoma in the context of Infectious causes of cancer
Estimates place the worldwide risk of cancers from infectious causes at 16.1%. Viral infections are risk factors for cervical cancer, 80% of liver cancers, and 15–20% of the other cancers. This proportion varies in different regions of the world from a high of 32.7% in Sub-Saharan Africa to 3.3% in Australia and New Zealand.
A virus that can cause cancer is called an oncovirus or tumor virus. These include the human papillomavirus, which is associated with cervical carcinoma and nasopharyngeal carcinoma; Epstein-Barr virus, which is associated with a variety of Epstein-Barr virus-associated lymphoproliferative lymphomas; Kaposi's sarcoma herpesvirus, which is associated with Kaposi's sarcoma and primary effusion lymphoma; hepatitis B and hepatitis C viruses which are associated with hepatocellular carcinoma; and human T-cell leukemia virus-1 which is associated with adult T-cell leukemia/lymphoma. Bacterial infection may also increase the risk of cancer, as seen in Helicobacter pylori-induced stomach cancer. Parasitic infections strongly associated with cancer include Schistosoma haematobium (squamous cell carcinoma of the bladder) and the liver flukes, Opisthorchis viverrini and Clonorchis sinensis (cholangiocarcinoma).
Nasopharyngeal carcinoma in the context of Head and neck cancer
Head and neck cancer is a general term encompassing multiple cancers that can develop in the head and neck region. These include cancers of the mouth, tongue, gums and lips (oral cancer), voice box (laryngeal), throat (nasopharyngeal, oropharyngeal, hypopharyngeal), salivary glands, nose and sinuses.
Head and neck cancer can present a wide range of symptoms depending on where the cancer developed. These can include an ulcer in the mouth that does not heal, changes in the voice, difficulty swallowing, red or white patches in the mouth, and a neck lump.