Nasal Issues: Allergies, Infections, and Cancer Concerns

Nasal issues

Hello, Dr.
Zheng.
I had a nasopharyngoscopy last July, and there were no issues.
In December, I suspected I had a fishbone stuck in my throat, and I had an endoscopy done through my nose.
Recently, for about a month, I've noticed occasional blood streaks in my nasal mucus.
I also have a history of nasal allergies.
I just traveled abroad, and I'm wondering if the air quality might have triggered my nasal allergies.
For about two weeks, I've frequently been blowing my nose, and the mucus is slightly yellow with occasional blood streaks.
There were two or three instances where there was more blood.
However, today it got worse; the first phlegm I coughed up this morning was green, so I went to see a doctor.
The doctor said my nasal allergies are severe, and the green mucus could indicate nasal inflammation or sinusitis.
I was prescribed medication for two days.

I would like to know if this situation could potentially be early signs of nasal cavity cancer or nasopharyngeal cancer.
Recently, I've also been experiencing a slight ringing in my left ear, which is making me quite anxious about serious issues.
I have a smoking habit, and since I won't be returning home soon, I'm worried about delaying treatment.
Should I consider getting another nasopharyngoscopy at this time? I would appreciate your help in addressing my concerns.
Thank you.

mm, 30~39 year old female. Ask Date: 2016/01/19

Dr. Zheng Jueyi reply Otolaryngology

Hello, if you have had previous examinations, most bleeding is still caused by nasal microvascular bleeding.
It is recommended to first address any nasal allergies or sinusitis.
If bleeding persists, you may need to consult an otolaryngologist for further evaluation.
Wishing you safety and health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2016/01/19

More Info

Dear Patient,
Thank you for reaching out with your concerns regarding your nasal issues. It’s understandable to feel anxious when experiencing symptoms like nasal bleeding, colored mucus, and ear noises, especially with a history of nasal allergies and previous examinations. Let’s break down your situation and address your concerns systematically.

Understanding Your Symptoms
1. Nasal Bleeding and Mucus Color: The presence of blood in your nasal discharge, especially if it’s accompanied by yellow or green mucus, can indicate several conditions. Yellow or green mucus often suggests a bacterial infection, such as sinusitis (inflammation of the sinuses), which can occur after a viral upper respiratory infection or due to allergies. The blood could be due to irritation of the nasal mucosa, which can happen with frequent nose blowing or nasal congestion.

2. Nasal Allergies: Given your history of nasal allergies, it’s possible that changes in air quality during your travels exacerbated your symptoms. Allergic rhinitis can lead to inflammation and swelling of the nasal passages, making them more susceptible to bleeding and infection.

3. Ear Symptoms: The "whirring" sound in your left ear could be related to Eustachian tube dysfunction, which is common in individuals with nasal congestion or sinus issues. This dysfunction can lead to pressure changes in the ear, resulting in sensations of fullness or noise.

Concerns About Cancer
Your concern about the possibility of nasal or nasopharyngeal cancer is valid, especially with symptoms like persistent nasal bleeding and changes in mucus. However, it’s important to note that these symptoms are more commonly associated with infections or allergies rather than cancer. Nasopharyngeal cancer typically presents with more specific symptoms, such as a lump in the neck (due to lymph node involvement), persistent nasal obstruction, or hearing loss.

Recommendations
1. Follow-Up with Your Doctor: Since your doctor has already prescribed medication for your nasal inflammation, it’s crucial to follow their advice and complete the course. If your symptoms persist or worsen, particularly if you experience significant bleeding or new symptoms, you should return for a follow-up.

2. Consider a Nasal Endoscopy: If your symptoms do not improve with treatment or if you continue to have blood in your mucus, it would be prudent to discuss the possibility of a nasal endoscopy with your ENT specialist. This procedure allows for a direct view of the nasal passages and sinuses, helping to identify any abnormalities, including polyps or other lesions.

3. Monitor Your Symptoms: Keep track of your symptoms, including the frequency and amount of blood in your mucus, any changes in your sense of smell, and the nature of your ear symptoms. This information will be valuable for your healthcare provider.

4. Lifestyle Modifications: If you smoke, consider reducing or quitting, as smoking can exacerbate nasal and respiratory issues. Staying hydrated and using saline nasal sprays can help keep your nasal passages moist and reduce irritation.

5. Allergy Management: If allergies are a significant trigger for you, consider discussing long-term management strategies with your doctor, which may include antihistamines or nasal corticosteroids.

Conclusion
While your symptoms warrant attention, they are more likely related to allergies or an infection rather than cancer. However, it’s essential to remain vigilant and proactive about your health. Regular follow-ups with your healthcare provider and open communication about your symptoms will ensure that any potential issues are addressed promptly.

Wishing you a speedy recovery and improved health.

Best regards.

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