Nasopharyngeal carcinoma with headaches as the main symptom: A potential diagnostic pitfall (2024)

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“…Cephalgia is not a pathognomonic sign of NPC, with high rate of misdiagnosis up to 84%, leading to delay in treatment. 22 Cephalgia indicates skull base lesions or intracranial invasion. 23 Most RSCM patients with complaints of cephalgia already had multiple symptoms preceding or coinciding with the cephalgia complaints.…”

confidence: 99%

et al. 2021

Background Studies suggest that the most common type of nasopharyngeal carcinoma (NPC) is WHO-3, which is strongly associated with Epstein-Barr virus (EBV).Objective To assess NPC patient characteristics in a national general referral hospital in Indonesia, with regards to EBV DNA load and treatment response.Methods Twenty-three pediatric patients diagnosed with NPC were included in the study. Data collected were history, physical examination, tissue biopsy, CT scan, staging and EBV DNA load from nasopharyngeal (NP) brushing as well as blood specimens. The NP brushing, blood specimens and CT scan evaluations were done two months post-treatment.Results Pediatric patients with symptoms such as blood tinged secretion, lymph node enlargement, and nasal congestion were more likely to have higher EBV DNA loads in their NP brushings (P<0.05) (including T3 and higher). Despite significant reduction of EBV DNA load in NP brushing post-treatment, it was not associated with treatment response, as evaluated by CT scan.Conclusion Higher DNA load from NP brushings is associated with a higher tumor stage. Larger sample size and follow-up data are needed to assess the usefulness of EBV DNA load assessment in pediatric patients.

The study investigates an average direct and indirect costs incurred by Nasopharyngeal Cancer (NPC) patients who received diagnosis, treatment and follow up in the Sarawak General Hospital, Kuching, Malaysia. A total of 299 NPC patients were randomly selected using a primary data collection approach from the Sarawak General Hospital between November 2018-March 2019. Information related to the average direct and indirect costs incurred by NPC patients at various stages and the sources of their financial assistance throughout the treatment periods were assorted. The study reveals that the total average cost of 169 or 56.52% of the NPC patients who received various treatment services in the public hospital is RM13,165 against RM78,860 on 130 or 43.48% of the patients received the same services in both public and private healthcare. Major sources of funding come from patients’ savings, family members, medical insurances, non-profit organization or charity, company healthcare benefits, employees’ provident fund (EPF) as well as subsidy from the government: This study suggests that the treatment cost for cancer patient is high and hence, there is a need to establish a mechanism that can provide a free screening test for NPC as a forward step to cancer prevention, while for policy makers to develop a more supportive initiative to address the needs of the poor patients.

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