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Writer's pictureDr. Malwinder Singh Sandhu

Two generations of nasopharyngeal carcinoma (NPC) and family screening.

Updated: Nov 29, 2023


Nasopharyngeal carcinoma


Today I had my first case of a middle-aged man whose mother I treated a few years ago for stage 3 nasopharyngeal carcinoma (NPC) and he is diagnosed with the same cancer now but unfortunately stage 4A. I am still pursuing radical treatment and trying to cure him as even stage 4 head and neck cancer has a chance of being cured.


He is only over 40 years old and suffers from headaches, nasal congestion, blurred vision, and reduced hearing. All these signs indicate that the tumor has infiltrated the cranial nerve in the brain. My suspicions were confirmed after a CT scan was performed.


I am planning for chemotherapy to shrink the tumor and later concomitant chemo-radiation therapy. This will be his best chance at cure. As a routine, I sent him to the dietitian for nutritional support and referred him for a dental exam prior to radiotherapy.


Another issue I had to deal with was his other two siblings who were concerned and keen to get tested for nasopharyngeal cancer (NPC). So far, no guideline recommends a screening for the early detection of nasopharyngeal carcinoma (NPC) in Malaysia. However, there is a simple blood test called EBV DNA that can help detect nasopharyngeal cancer early.


What is this EBV DNA? Ninety percent of all nasopharyngeal carcinoma (NPC) are caused by the EBV virus and because of their Chinese ancestry, they are at higher risk of developing nasopharyngeal carcinoma (NPC). The blood test checks the level of EBV in the body. If the value is high, then they need to undergo nasendoscopy, and if it is low, it can be repeated every 3 to 5 years.


So, if you have a strong family history of nasopharyngeal carcinoma (NPC), an EBV DNA blood test can be done as a screening tool. Remember early detection saves lives.

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