Don't Ignore A Persistent Neck Lump !

Don't Ignore A Persistent Neck Lump!

Upper respiratory tract infections, such as tonsillitis or pharyngitis, are often accompanied by swelling of the cervical lymph nodes and tenderness. This swelling will gradually disappear along with the improvement of the infection process. Persistent neck swelling, increasing in size and not painful on pressure, should be investigated further.

Most of the malignancies in the head and neck area are only realized by the sufferer when a lump appears on the neck. It usually a solid mass, varying in sizes, ranging from a few millimeters to centimeters, bumpy surface, and immobile. Several head and neck malignancy is accompanied by lump in the neck, nasopharyngeal cancer is one of them.

Nasopharyngeal cancer is one of the the head and neck malignancy which ranks at the top in Indonesia because of the large number of cases and the high mortality rate. Nasopharyngeal cancer doesn’t only affect adults, but also teenagers. Environmental factors, genetics and Ebstein Barr Virus (EBV) infection play an important role in the occurrence of nasopharyngeal cancer. Exposure to cigarette smoke and consumption of foods containing nitrosamines, a food preservative, increasing the risk factors for nasopharyngeal malignancy.

The structure of the nasopharynx is at the end of the nasal cavity, at the junction of the upper respiratory and digestive tract. This hidden location causes a lump in this area is often not noticed by the sufferer. There are several techniques to inspect nasopharyngeal area, one is a posterior rhinoscopy, a small angled mirror that is inserted through the oral cavity and placed above the tongue walk through its end and reaches the nasopharynx. This conventional examination requires a good cooperation of patient, because the tongue must be protruded and this often stimulates the gag reflex and discomfort. However, this conventional examination has begun to be abandoned, and doctors are turning to endoscopic examination which is more practical, convenient and accurate to evaluate tumors in the nasopharynx. Rigid fiber endoscope is equipped with a camera at the end, the instrument is inserted through the nasal cavity walk through the nasal base to attain the nasopharynx.

In the early stages of nasopharyngeal cancer, mass tumor is only limited to the nasopharynx. The mass looks fragile, bumpy surface and bleeds easily, while at a more advanced stage, the tumor mass extends to surrounding structures, cervical lymph nodes of the neck, distant organs or metastases. Early symptoms of nasopharyngeal cancer are runny nose, stuffy nose, and headaches that resemble influenza symptoms. As increasing size of the mass, it will expand to the surrounding area and symptoms appear more obvious, such as : persistent nasal congestion on one side and accompanied by mucus mixed with blood, decreased hearing on one side, ringing in the ears, tingling in half of the face, double vision, and neck lump.

Biopsy examination, a procedure of taking nasopharyngeal tumor, is performed to determine the type of nasopharyngeal cancer cells. This is needed as a consideration of treatment options. Other examinations include laboratory examinations and head and neck CT scans to assess the extent of the tumor to surrounding organ structures and determine the stage of the disease.

Radiation therapy is the main treatment modality for nasopharyngeal cancer, this is because cancer cells are sensitive to radiation. At an advanced stage, radiotherapy is combined with chemotherapy, a drug treatment that uses powerful chemicals to kill fast-growing cell of cancer. Research revealed that recurrence rate increases with the increase of tumor size.  Therefore, do not ignore if symptoms appear on the neck lump. Investigate and find treatment !