Distinguishing Nasopharyngeal Cancer Symptoms from Allergic Rhinitis

Q: Distinguishing Nasopharyngeal Cancer Symptoms from Allergic Rhinitis

Hello Mr. <br>Hsieh： 1. <br>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. <br>

The symptoms of nasopharyngeal carcinoma can be similar to those of 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 difficulty hearing; 5.
Numbness around the cheeks near the nose, or inability to move one eye outward, resulting in double vision; 6.
Headaches.
I have had symptoms of allergic rhinitis since childhood and have seen many doctors, most of whom diagnosed me with allergic rhinitis or chronic rhinitis.
My symptoms include runny nose, nasal congestion, sneezing, and frequent colds.
However, during high school, I visited Chimei Hospital, where they told me I had a deviated septum, and I subsequently underwent surgery.
Initially, my symptoms improved significantly, but over time, as is the case now, I often experience nasal congestion, sometimes severe on both sides, and usually just on one side.
If the air quality is poor or the air is cold, I also have a runny nose and sneezing.
Additionally, I sometimes experience ear fullness and occasional migraines.
Among the six warning signs of nasopharyngeal carcinoma, I have persistent nasal congestion on one side, headaches, and tinnitus.
I have not noticed the other signs, but sometimes when I try too hard to clear my nose, there is blood in the discharge.
I have also noticed that the sensitivity around my nose is indeed lower, which may indicate numbness.
I would like to ask: based on my symptoms, is there a possibility of nasopharyngeal carcinoma? I hope you can take the time to respond.
Wishing you good health.

Mr. Hsieh, 20~29 year old female. Ask Date: 2001/12/20

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 confirm the presence of nasopharyngeal carcinoma, a nasopharyngoscopy can be performed for diagnosis.
3.
I recommend that you go to a hospital for an examination to determine whether or not you have nasopharyngeal carcinoma.

Reply Date: 2001/12/20

More Info

Distinguishing between the symptoms of nasopharyngeal cancer and allergic rhinitis can be challenging, as there is some overlap in the symptoms experienced by patients. However, understanding the key differences can help in identifying the underlying condition and seeking appropriate medical care.

Symptoms of Nasopharyngeal Cancer:
Nasopharyngeal cancer (NPC) is characterized by a range of symptoms that can often be mistaken for other conditions, including allergic rhinitis. The six warning signs you mentioned are critical to recognize:
1. Painless Lump in the Neck: This is often one of the first signs of NPC, indicating swollen lymph nodes due to metastasis.

2. Unilateral Nasal Congestion: Persistent nasal obstruction on one side can be a significant indicator, especially if it does not respond to typical treatments for allergies or sinusitis.

3. Nasal Discharge with Blood: While blood-tinged mucus can occur in various conditions, it is particularly concerning in the context of NPC.

4. Ear Symptoms: These may include hearing loss, ear fullness, or tinnitus (ringing in the ears), often due to Eustachian tube dysfunction.

5. Neurological Symptoms: This can manifest as facial numbness or diplopia (double vision), indicating possible nerve involvement.

6. Headaches: Persistent headaches that are different from typical tension or migraine headaches can be a red flag.

Symptoms of Allergic Rhinitis:
Allergic rhinitis, on the other hand, is primarily characterized by:
- Sneezing and Itchy Nose: These symptoms are often triggered by allergens such as pollen, dust, or pet dander.

- Clear Nasal Discharge: Unlike the bloody discharge associated with NPC, allergic rhinitis typically presents with clear mucus.

- Bilateral Symptoms: Allergic rhinitis usually affects both sides of the nose and may cause bilateral nasal congestion.

- Seasonal Variation: Symptoms often correlate with specific seasons or exposure to allergens.

Key Differences:
The primary distinction lies in the nature and persistence of symptoms. Allergic rhinitis symptoms tend to be episodic and related to allergen exposure, while NPC symptoms are more persistent and progressive. The presence of unilateral symptoms, especially a lump in the neck or blood in nasal discharge, should prompt immediate medical evaluation.

Given your history of allergic rhinitis and the recent symptoms of persistent nasal congestion, headaches, and ear issues, it is essential to consult with an ENT specialist. They may recommend a nasal endoscopy or imaging studies to evaluate for any abnormalities in the nasopharynx. A biopsy may be necessary to confirm or rule out cancer.

In conclusion, while your symptoms could be attributed to allergic rhinitis, the presence of unilateral nasal congestion, headaches, and any blood-tinged discharge warrants further investigation to rule out nasopharyngeal cancer. Early diagnosis is crucial for effective treatment, so do not hesitate to seek medical attention. Your health is paramount, and addressing these concerns with a healthcare professional is the best course of action.

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