Which are the symptoms?
An initial laryngeal tumor most often manifests as a change in the voice (dysphonia), but if the tumor is more extensive, it may also manifest as difficulty and pain when swallowing, which may extend all the way up to the ear. Tumors are less common with shortness of breath: shortness of breath can occur at night, when stressed, or in the case of a large tumor, difficulty breathing can also occur even when resting.
· hearing loss
· nasal obstruction
· nasal bleeding
· ear pain
· enlarged cervical lymph nodes
How is it diagnosed?
A prompt specialized otolaryngologic examination is needed, supported by an endoscopic examination called fibroscopy and associated, if suspected, with radiologic studies such as: magnetic resonance imaging (MRI) of the face and neck with and without contrast media (mdc) and, if necessary, positron emission tomography (PET).
The diagnosis of cancer must be confirmed by a nasopharyngeal biopsy or, if that is not possible, a biopsy of a suspicious lymph node with additional search for EBV DNA in the tumor and in the blood.
How is it treated?
Treatment of early stages is with radiotherapy alone, while locally advanced disease requires a combined approach involving simultaneous chemotherapy and radiotherapy.
In more advanced forms, chemotherapy or salvage surgery is currently used in selected cases.
The combination of immunotherapy and radiotherapy for locally advanced nasopharyngeal tumors is currently under study (link to studies), so there is no evidence to suggest that it will be used in the near future.
These treatments may be combined with radiotherapy for symptomatic or bleeding/fracture risk areas and surgical treatment of individual metastases.