Nose and Throat Cancer: How to Know

Did you know that nose and throat cancer is relatively common in Singapore? Nose and throat cancer may not present until a late stage so there are a few danger signs to watch out for. Nose and throat cancer carries a few risk factors including smoking, alcohol and viral infection. We will discuss this in more detail shortly.

Some patients do not realise that their seemingly innocent ENT symptoms were due to tumours. Many people tend to think it might "just" be a blocked nose, or blocked ear, or "I guess it might go away soon" or "it's just one of these things". But frankly, only benign conditions will usually get better in 1-2 weeks.

If your ENT symptoms don't improve, then you should go see your ENT specialist in Singapore. Here are some interesting anecdotes with anonymous details.

A 40-year-old businessman presented to me with a left-sided blocked nose and blocked ear. He had hoped it would go away by itself. So he had not bothered to seek medical help for a month. When I examined his ear, I could see fluid trapped behind his left eardrum. Although this commonly occurs after a bad cold, we need to examine the back of the nose with an endoscope to screen for nose cancer.

Interestingly, I found a lump growing at the front of his nose with some abnormal tissue changes at the back of his nose. I had expected to find a mass at the back of his nose but this seemed unusual. There was no actual mass at the back of his nose! We arranged urgent biopsies for him under general anaesthesia. To my surprise, the results turned out to be throat cancer. I had originally suspected nose or nasopharyngeal cancer.

Subsequent scans showed the throat cancer to be originating from the soft palate, the area at the back of his throat. This was involving the tissues of his ear and nose. Although smoking and alcohol are risk factors for throat cancer, he had never smoked or drunk alcohol before in his entire life. So the other risk factor to consider was HPV infection (Human Papilloma Virus), which is often sexually transmitted.

Those under the age of 45 should have Gardasil-9 vaccination to protect against infection from high-risk HPV strains to reduce the risk of both head and neck cancers, as well as cervical cancer. Learn more in our article on HPV and throat cancers.

Early diagnosis means early treatment so an urgent referral to an oncologist (cancer specialist) was made. He had to undergo chemotherapy (special medication) and radiation treatment as soon as possible.

Another patient, a 35-year-old journalist, was complaining of a persistently blocked nose with yellow discharge and recurrent nosebleeds. He came to see me, thinking it might "just" be allergy problems with his nose. During nasoendoscopy, we found a large mass growing at the back of his nose. We performed urgent biopsies of the mass in the clinic. The patient underwent scans that very same day.

The biopsy results showed nasopharyngeal cancer (NPC), a nose cancer which occurs in the Chinese population. NPC occurs in 1 out of every 8 people in Singapore. Epstein-Barr Virus (EBV), which many people carry and often are unaware, may cause NPC. Again, we referred this patient urgently to the oncologist for chemoradiation treatment. Early stage NPC carries a relatively good prognosis and survival rate.

1. Recurrent nosebleeds
2. Persistently blocked nose, even more important if it only affects one side.
3. Blocked ear
4. Persistent sore throat or feeling of throat discomfort
5. Neck lump
6. A persistent hoarse, croaky voice, especially if not better after 2 weeks.
7. Persistent ear ache, especially if only in one ear and not better with antibiotics