New Mechanisms Leading to Treatment of Nasopharyngeal Carcinoma Identified

What is Nasopharyngeal Carcinoma?

Nasopharyngeal carcinoma is quite an uncommon type of cancer arising from the epithelium of the nasopharynx. About half of these cancers occur in children. It is said that this type of cancer is brought about by Epstein-Barr virus (EBV) infection, because this type of virus can infect epithelial cells and transform them into malignant cells.

The symptoms of this cancer are vague and do not reveal themselves early in the course of the disease. These signs and symptoms may only come about once the disease has spread to the regional lymph nodes. This may further bring about enlargement and extension of the tumor in the nasopharynx and may cause nasal obstruction in the form of congestion, nasal discharge and bleeding. There may also be changes in hearing due to blockage of the eustachian tube or direct extension into the ear; cranial nerve palsies may also result due to the extension of the tumor into the base of the skull. Other symptoms include headaches and neck swelling. This neck mass may consist of painless firm lymph node enlargement and may be bilateral. The most common nodes involved are the jugulodigastric, and upper and middle jugular nodes in the anterior cervical chain.

Epstein-Barr virus (EBV) can infect epithelial cells in the nasopharynx and can transform them into cancerous cells. Genetic and environmental factors have been implicated in the development of this disease. Nasopharyngeal cancer may have a genetic etiology because it is often shared within specific ethnic groups, within first degree relatives, within those with A2 HLA haplotypes and within those with cytogenetic abnormalities identified within tumor samples. The environment may also play a role because of the distribution of the disease, bimodal age distribution, and association seen in patients who consume a large amount of preserved foods and/or salted fish.

Nasopharyngeal carcinoma is often treated with radiation therapy. Chemotherapy may also be given in advanced cases and may improve survival of patients. However, radiotherapy may bring about some side effects in the later stages such as xerostomia, hypothyroidism, fibrosis of the neck with complete loss of range of motion, trismus, dental abnormalities, and hypoplasia of irradiated muscular and bony structures. Other complications include abnormalities of the endocrine system and growth retardation, which may be due to radiotherapy. There may also be sensorineural hearing loss whoch may occur after chemotherapy. Renal toxicity can occur in patients receiving cisplatin. Other complications include dental caries as a result of poor dental hygiene, osteonecrosis of the mandible (rare), secondary malignancies and radiation myelitis (uncommon). The survival rates after both radiation therapy and chemotherapy are said to be 50-80%.

New Mechanisms Leading to Treatment of Nasopharyngeal Carcinoma Identified

A recent study done by researchers from the Cancer Science Institute of Singapore (CSI Singapore) at the National University of Singapore, National University Cancer Institute Singapore (NCIS) and National University Hospital Singapore (NUH) have discovered a distinct mutational signature and nine significantly mutated genes associated with nasopharyngeal cancer. The results of this study are said to pave the way for future novel therapies for this disease. This is said to be the first successful comprehensive genomic study of nasopharyngeal carcinoma. This new study has published online in the journal Nature Genetics on 23 June 2014.

In this study data were obtained from genomic DNA and proteins of over 100 nasopharyngeal cancer patients in Singapore through advanced biological technologies. The research revealed that many genes are mutated and dysfunctional in the nasopharyngeal tumour cells, and some of them cause and exacerbate the disease. The analysis also showed enrichment of genetic lesions which affect several important cellular processes and pathways. Furthermore, a number of novel druggable candidates, which are proteins that have the ability to bind with drugs with a high affinity, were uncovered through this comprehensive study.

More medical breakthroughs are discussed in our other articles on this site.