Can Nasopharyngeal Cancer Spread To Lungs?

Nasopharyngeal cancer is cancer that is seen in the neck and head area. It originates in the nasopharynx. The nasopharynx is the part of the pharynx that is located behind the nose. Cancer is a condition in which the cells of a certain part of the body start dividing uncontrollably. The cells of any part of the body can start dividing in this manner and it can also spread to other areas of the body that is called metastasis. This cancer belongs to squamous cell carcinoma. The exact cause of this cancer is not yet known but different factors act together in the causation of cancer. A virus named Epstein-Barr virus has been linked to the causation of nasopharyngeal cancer. Other factors like diet and genetic susceptibility also play an important in causing nasopharyngeal cancer. ⁽¹⁾

The incidence rate of nasopharyngeal cancer is one or fewer cases per 1,00,000 people per year. This is a very rare type of cancer. The main symptom of the patient who might have nasopharyngeal cancer is that the patient might notice or feel a lump in his/her neck. The lump may be either one or both sides of the neck. The lumps may be multiple as they are the enlarged lymph nodes. These lumps are always painless in touch. The lymph nodes are the glands in the body that are full of cells that provide immunity to our body to fight against infections. When the cancer cells spread to the lymph nodes, they swell. Usually, these lymph nodes are small in size and are not visible or palpable normally.

The patient might experience hearing loss or pain or ringing in either one of the ears. Other symptoms are- nosebleeds, headaches, blockage of nose, double vision or blurry vision, trouble while breathing, trouble while speaking, etc.

The majority of patients who are diagnosed with nasopharyngeal cancer die due to metastasis of nasopharyngeal cancer. The treatment failure also results due to metastasis. Almost 125 patients out of 629 patients diagnosed with nasopharyngeal cancer were found to have distant metastasis found between the years 1987 and 1992. The region of metastasis was analyzed in these patients. The frequency of metastasis in different parts of the body was as follows:

Bones- 75%
Lungs-46%
Liver-38%
Retroperitoneal lymph nodes- 10%

So, the commonest site of metastasis for nasopharyngeal cancer is bone and then next is the lung. So, yes, nasopharyngeal cancer can spread to the lungs and it is the second most common site for metastasis. The survival period of the patient reduces when there is the presence of metastasis in the body.^{(2) (3)}

Chemotherapy In Nasopharyngeal Cancer

Under chemotherapy, certain anti-cancer drugs are administered in the patient in order to treat cancer. These drugs can either be given orally or intravenously.

Chemotherapy is usually used along with radiotherapy. In radiotherapy, radiations are used to reduce the growth of cancer cell production. Chemotherapy and radiotherapy are used together when cancer has reached an advanced stage. The drugs used in chemotherapy make the cancer cells more sensitive to the radiation. This is also known as chemoradiation.

The commonly used drugs for chemotherapy in nasopharyngeal cancer are:

Methotrexate
Cisplatin- is the most commonly used drug in nasopharyngeal cancer
Carboplatin
5-fluorouracil
Paclitaxel
Doxorubicin
Epirubicin
Docetaxel
Gemcitabine

When these drugs are administered into the patient’s body, they attack the cancerous cells and stop them from multiplying faster. Along with the cancer cells, the normal cells of the body are also exposed to these drugs and this leads to certain side effects.

The commonest side effects of chemotherapy are:

Diarrhea
Oral ulcers
Hair loss
Easy bruising
Easy bleeding (because of lowered platelet counts)
Loss of appetite
Fatigue (because of lowered red blood cells)
Nausea
Vomiting
Chances of getting infections increases (because of lowered white blood cells)

These side effects are not long-lasting; they disappear as the treatment is discontinued. The side effects can be treated or controlled with the help of other medications. ⁽⁴⁾

Conclusion

Yes, nasopharyngeal cancer can spread or metastasize to the lungs. Lungs are found to be the second most common site for nasopharyngeal cancer to spread, first being the bones. About 46% of patients were found to have lung metastasis from nasopharyngeal cancer. The common reason of mortality amongst patients with nasopharyngeal cancer is due to metastasis.

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Can Nasopharyngeal Cancer Spread To Lungs?