Sinusitis and Nasopharyngeal Cancer: Symptoms and Risks

Sinusitis and Nasopharyngeal Carcinoma

Hello Dr.
Chi, I have been experiencing a persistent cough since early April.
Initially, the clinic diagnosed it as a cold, but after taking medication, there was no improvement until May.
In May, I had a chest X-ray, which showed no abnormalities.
It wasn't until early July that I was diagnosed with sinusitis and prescribed antibiotics (the doctor also performed a nasal endoscopy).
Occasionally, when I blow my nose, there is some bleeding or blood streaks (but it has never been a significant amount like a nosebleed), and I also sometimes notice blood streaks in my sputum.
I would like to ask Dr.
Chi if the presence of blood streaks is a significant concern for nasopharyngeal cancer, and should I request a CT scan at my next appointment with the doctor?

Lin Xiansheng, 20~29 year old female. Ask Date: 2020/07/13

Dr. Ji Zhaoyun reply Otolaryngology

Hello, compared to a CT scan, performing a nasopharyngoscopy can be considered as it has a higher accuracy rate for diagnosing nasopharyngeal masses and can be executed immediately.
Wishing you peace and health.

Reply Date: 2020/07/13

More Info

Hello! Thank you for your question regarding the symptoms you have been experiencing and the potential link to nasopharyngeal cancer (NPC). It’s understandable to be concerned about these symptoms, especially given the complexity of the conditions you mentioned.

First, let’s discuss sinusitis and its symptoms. Sinusitis, or inflammation of the sinuses, can lead to a variety of symptoms including nasal congestion, facial pain or pressure, post-nasal drip, cough, and sometimes fever. In some cases, sinusitis can also cause blood-tinged nasal discharge, which may be due to irritation of the nasal mucosa. This is not uncommon and does not necessarily indicate a serious condition like cancer.

However, the presence of blood in your nasal discharge or phlegm can be concerning, especially if it is persistent or accompanied by other alarming symptoms. In the context of your ongoing cough and the diagnosis of sinusitis, it is essential to consider other potential causes. While NPC is a possibility, it is relatively rare, particularly in individuals without significant risk factors such as a history of Epstein-Barr virus infection, smoking, or exposure to certain environmental factors.

The symptoms of NPC can overlap with those of sinusitis, including nasal obstruction, nasal bleeding, and throat discomfort. Other symptoms may include ear fullness or pain, hearing loss, and swollen lymph nodes in the neck. Given that you have been experiencing these symptoms for several months, it is prudent to have a thorough evaluation.

Regarding your question about whether you should request a CT scan during your next visit, it is advisable to discuss your concerns with your healthcare provider. A CT scan can provide detailed images of the sinuses and nasopharynx, helping to identify any abnormalities that may not be visible through a standard examination or X-ray. If your doctor believes that your symptoms warrant further investigation, they may recommend imaging studies or even a referral to an otolaryngologist (ENT specialist) for a more comprehensive evaluation.

In summary, while the presence of blood in your nasal discharge and phlegm can be concerning, it does not automatically indicate nasopharyngeal cancer. It is essential to consider the broader context of your symptoms and to communicate openly with your healthcare provider about your concerns. They can help determine the most appropriate next steps, which may include further imaging or referrals to specialists. Early diagnosis and intervention are key in managing any potential health issues, so don’t hesitate to seek further evaluation if your symptoms persist or worsen.

Take care, and I hope you find relief from your symptoms soon!

Similar Q&A

Understanding the Link Between Nasopharyngeal Cancer and Sinusitis

Hello Doctor, I started experiencing symptoms like coughing in early April without a fever. Initially, the clinic diagnosed it as a cold, but after taking medication for a month, my cough did not improve, and I also had some headaches. In early May, I had a chest X-ray, which sho...

Dr. Zheng Jueyi reply Otolaryngology
Hello: Please inform the physician that there is a family history of nasopharyngeal carcinoma, although it has not been confirmed by a CT scan. It is recommended that the physician conduct a thorough examination of the nasopharynx, and if necessary, a biopsy of the nasopharyngeal...

Distinguishing Nasopharyngeal Cancer Symptoms from Allergic Rhinitis

Hello Doctor: I often come across reports about nasopharyngeal carcinoma, which mention six major warning signs: 1. A painless hard lump in the upper neck; 2. Persistent nasal congestion on one side; 3. Blood-tinged nasal discharge; 4. Fluid accumulation in one ear, tinnitus, and...

Dr. Chen Junliang reply Otolaryngology
Hello Mr. Hsieh: 1. The symptoms you mentioned regarding nasopharyngeal carcinoma are indeed accurate; however, conditions such as a deviated septum and chronic rhinitis have not shown a statistical correlation with nasopharyngeal carcinoma according to current data. 2. To confir...

Understanding Sinusitis and Nasopharyngeal Cancer: Symptoms and Diagnosis

Dear Dr. Zheng, I am currently in the United States and have been troubled by persistent left-sided nasal congestion and occasional left-sided tinnitus for the past month and a half. I feel as though there is a foreign body between my oral maxilla and the left nasal cavity, and ...

Dr. Zheng Jueyi reply Otolaryngology
Hello: (1) If a CT scan and endoscopy have already been arranged and no significant abnormalities are found, the likelihood of nasopharyngeal carcinoma is low. If there are abnormalities or concerns, physicians will often proceed with a biopsy. (2) Since a CT scan has been arrang...

Is It Nasopharyngeal Cancer or Chronic Sinusitis? Understanding Your Symptoms

I have been experiencing recurrent post-nasal drip for over three months. I have visited five different clinics, and each time the doctor has said it is caused by allergies. I have used nasal sprays and taken antihistamines, but I still experience post-nasal drip and nasal conges...

Dr. Zheng Jueyi reply Otolaryngology
Dear Layla: Hello, this possibility cannot be ruled out. I recommend that you go to the hospital for a more detailed examination. Wishing you safety and good health. Sincerely, Dr. Jue-Yi Cheng, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health an...