Could It Be Nasopharyngeal Cancer? Symptoms and Concerns

Could it be nasopharyngeal carcinoma?

I have experienced multiple episodes of nosebleeds and noticed a lump under my left ear.
Initially, I thought it was due to lack of sleep, so I went to bed earlier for a few days, which seemed to help a bit.
However, after staying up late again, I can clearly feel the lump.
Additionally, I feel a sensation in my ear that seems to move with the airflow when I breathe.
I consulted an otolaryngologist who examined me and performed an endoscopy, and found no abnormalities from my nose to my throat (is it possible for cancerous cells related to nasopharyngeal carcinoma to be located beneath the surface cells of the nasopharynx?).
The doctor said it was nothing to worry about and that I didn't need to return for further checks, but I still had another nosebleed recently.
I am currently preparing for the university entrance exam and feel okay about the pressure, but I usually stay up until around 2 AM and often eat takeout, which tends to be fried food.
I'm not sure if this could be the reason for my nosebleeds, but I am quite worried about the possibility of nasopharyngeal carcinoma since I have several similar symptoms.

matt, 10~19 year old female. Ask Date: 2019/11/17

Dr. Zheng Jueyi reply Otolaryngology

Hello, frequent nosebleeds are often related to the rupture of microvessels in the nasal septum.
If an endoscopic examination has already been performed and there are abnormalities in the nasopharynx, it is generally recommended to conduct a nasopharyngeal biopsy.
If nosebleeds continue to recur, it is advisable to maintain follow-up visits to identify the exact source of bleeding.
Wishing you safety and good health.
Sincerely, Dr.
Jue-Yi Cheng, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2019/11/17

More Info

When considering the possibility of nasopharyngeal cancer, it's essential to understand the symptoms and risk factors associated with this condition. Nasopharyngeal cancer (NPC) is a type of head and neck cancer that originates in the nasopharynx, the area located behind the nose and above the back of the throat.
Your symptoms, including recurrent nosebleeds and a noticeable lump under your left ear, warrant careful evaluation. While the initial examination by an ENT specialist did not reveal any abnormalities in the nasal passages or throat, it's important to note that nasopharyngeal cancer can sometimes present with subtle or non-specific symptoms, especially in its early stages.
Common symptoms of nasopharyngeal cancer include:
1. Nasal Obstruction or Congestion: This can lead to difficulty breathing through the nose.

2. Frequent Nosebleeds: While nosebleeds can be caused by various factors, including dry air or nasal trauma, recurrent episodes should not be overlooked.

3. Ear Symptoms: This includes a feeling of fullness or pressure in the ears, hearing loss, or tinnitus (ringing in the ears). The sensation you described, where your ear feels like it responds to airflow, could be related to Eustachian tube dysfunction, which can occur with nasopharyngeal issues.

4. Lumps in the Neck: Swollen lymph nodes in the neck can indicate metastasis or local spread of the cancer.

5. Sore Throat or Difficulty Swallowing: These symptoms may occur if the cancer affects surrounding tissues.

Regarding your concern about whether cancerous cells could be present beneath the surface of the nasopharynx, it is indeed possible. Some cancers can infiltrate deeper layers of tissue without causing visible changes on the surface. This is why imaging studies or biopsies may be necessary for a definitive diagnosis if symptoms persist or worsen.

Your lifestyle factors, such as late-night study habits and a diet high in fried foods, can contribute to various health issues, including nasal problems. Stress and lack of sleep can also weaken the immune system, making one more susceptible to infections or other conditions that could lead to symptoms like nosebleeds.

Given your ongoing symptoms, it would be prudent to seek a second opinion or further evaluation, especially if the nosebleeds continue or if you develop new symptoms. Additional diagnostic tools, such as imaging studies (like an MRI or CT scan) or a biopsy, may be necessary to rule out nasopharyngeal cancer or other serious conditions.

In summary, while your current symptoms do not definitively indicate nasopharyngeal cancer, they should not be ignored. Persistent symptoms, especially those that are unusual for you, warrant further investigation. It is crucial to communicate your concerns with a healthcare provider who can guide you through the appropriate diagnostic process. Early detection is key in managing any potential malignancy effectively.

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