50-year-old Ms. Wu is engaged in international trade. Last year, she was diagnosed with nasopharyngeal carcinoma in a foreign hospital due to left ear congestion. After examination, it was found that Ms. Wu was suffering from the second stage of nasopharyngeal cancer. After receiving 2 months of pre-treatment chemotherapy And following radiotherapy, the tumor was successfully cured, and he returned to normal life and work immediately.
According to statistics, regarding 1,500 patients with nasopharyngeal carcinoma are newly diagnosed in Taiwan every year. The causes of the disease include environmental factors, genetics, and Epstein-Barr virus (Epstein-Barr virus) infection. Nasopharyngeal carcinoma often occurs in adults around 40 years old. With current treatment methods, most patients have a good prognosis.
In the treatment of nasopharyngeal carcinoma, the first stage is radiotherapy alone, and the second, third, and non-metastatic stage four nasopharyngeal carcinomas are treated with concurrent chemoradiation therapy or pre-chemotherapy followed by radiotherapy according to risk factor assessment. If the patient has distant organ metastasis at the time of diagnosis, chemotherapy is the main treatment, followed by radiotherapy or surgical resection of metastatic lesions depending on the situation, and disease control can still be achieved.
Kaili Liang, attending otolaryngology head and neck physician at Taichung Veterans General Hospital, said that although nasopharyngeal carcinoma has excellent treatment results, there are still a small number of patients who unfortunately relapsed following the first treatment. Even if the disease relapses, it is not incurable, and long-term control can still be achieved through active treatment.
Endoscopic surgical resection reduces local tissue damage in 2 chemotherapy sessions
In 2010, 40-year-old Mr. Qu was diagnosed with the third stage of nasopharyngeal carcinoma. After chemotherapy and radiotherapy, he was followed up regularly. However, in the 5th year following treatment, he found that the tumor in the nasopharynx had recurred. After joint decision-making between doctors and patients, Mr. Qu He received leading chemotherapy first, followed by endoscopic nasopharyngeal tumor resection, and adjuvant chemotherapy following surgery. It has been more than 10 years since Mr. Qu’s disease treatment has been completed, and he remains in good health and maintains regular follow-up.
Also in 2010, 36-year-old Mr. Ren was found to be stage IV nasopharyngeal carcinoma through imaging examination and pathological section due to a lump in his neck and ear fullness. After 2 years of follow-up, recurrence was found in the right cervical lymph node in 2013. Mr. Ren underwent neck lymph node dissection surgery and subsequent adjuvant chemotherapy. After completing the course of treatment, there has been no tumor recurrence since follow-up.
For local or neck recurrence of nasopharyngeal carcinoma, surgery can be selected as rescue treatment, and chemotherapy or radiotherapy can be supplemented depending on the degree of lesion invasion. In the past, open surgery was required for the recurrence of nasopharyngeal tumors. With the maturity of endoscopic tumor surgery technology, doctors at home and abroad gradually used endoscopic resection of nasopharyngeal recurrent tumors following 2000. The recent statistics of Taichung Veterans General Hospital Surgical experience of endoscopic resection of recurrent nasopharyngeal carcinoma, the 5-year survival analysis of nearly 40 patients was 85%. For patients with local or neck recurrence of nasopharyngeal carcinoma, the treatment team will use surgical rescue treatment as much as possible to reduce the possible local tissue damage caused by two radiotherapy treatments.
Regular tumor follow-up and various teams provide care and consultation services
Liang Kaili reminded that following treatment, patients may have disease and treatment-related quality of life impacts. Patients are more likely to suffer from nasal and sinusitis, otitis media, hearing loss, and tooth decay. Stiffness, neuropathy, or narrowing of the carotid artery.
In addition to regular tumor tracking, the nasopharyngeal cancer treatment team also takes care of the patient’s disease and treatment-related health. Regular team meetings include regular members of ENT, tumor, imaging, pathology, cancer centers and other units, nutritionists, swallowing language Rehabilitation specialists, Neuromedicine Center, Department of Stomatology, Department of Traditional Chinese Medicine and other units are also invited to participate in team meetings to provide care suggestions, consultation and assistance.
Text/ Lai Yiling, Photos/ Lei Siyu
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