Tuesday, 21 August 2018

Nasal polyps are painless soft growths inside your nose

They're not usually serious, but they can keep growing and block your nose if not treated.

Check if you have nasal polyps
Symptoms of nasal polyps include:

blocked nose
runny nose
constant need to swallow (post-nasal drip)
reduced sense of smell or taste
Nasal polyps can sometimes feel like a cold, but colds tend to clear up within a few days, whereas nasal polyps won't get better unless they're treated.

If your polyps block your sinuses (air pockets around your nose), you may also have symptoms of sinusitis.

See a GP if:
you're worried you may have nasal polyps
you have difficulty breathing
your symptoms are getting worse
you notice changes to your sense of smell
Treatment from a GP
A GP should be able to tell if you have nasal polyps by looking inside your nose.

If you have nasal polyps, you'll usually be given steroid nose drops or a spray to shrink the polyps.

You may be given steroid tablets, usually for up to 2 weeks, if:

your polyps are large
nose drops and sprays didn't work
Surgery to remove polyps
If there's no sign of improvement after about 10 weeks, your GP may suggest surgery to remove your polyps.

Most people who have surgery see an improvement, but it's common for polyps to grow back, usually within a few years.

You may need to keep using a steroid nasal spray after surgery to stop the polyps returning quickly.

A pharmacist can help with nasal polyps
After seeing your GP, a pharmacist can recommend:

steroid nasal sprays that don't need a GP prescription
salt water washes – called a saline rinse or nasal douche – to help unblock your nose
Make your own salt water wash
Cause of nasal polyps
It's not clear what causes nasal polyps.

Certain things can increase your risk of nasal polyps, like:

a bad reaction to taking aspirinNasopharyngeal cancer is a rare type of cancer that affects the part of the throat connecting the back of the nose to the back of the mouth (the pharynx).

In the UK, only about 240 people are diagnosed with nasopharyngeal cancer each year.

Nasopharyngeal cancer shouldn't be confused with other types of cancer that also affect the throat, such as laryngeal cancer and oesophageal cancer.

Diagram showing the nasopharynx
Symptoms of nasopharyngeal cancer
It's often difficult to recognise nasopharyngeal cancer because the symptoms are similar to other, less serious conditions. Also, many people with nasopharyngeal cancer don't have any symptoms until the cancer reaches an advanced stage.

Symptoms of nasopharyngeal cancer can include:

a lump in the neck
hearing loss – usually only in one ear
tinnitus – hearing sounds that come from inside the body rather than from an outside source
a blocked or stuffy nose
See your GP if you develop any worrying symptoms, particularly if they don't improve after a few weeks. While they're very unlikely to be caused by nasopharyngeal cancer, it's best to get them checked out.

What causes nasopharyngeal cancer?
The exact cause of nasopharyngeal cancer is unknown, but a number of factors can increase your risk of developing the condition.

These include:

being of south Chinese or north African descent
having a diet very high in salt-cured meats and fish
being exposed to the Epstein-Barr virus (EBV), a common virus that causes glandular fever
having a job where you're regularly exposed to hardwood dust
having a first-degree relative, such as a parent, who's had the condition
Being exposed to the human papilloma virus (HPV) may also increase your risk of developing certain types of nasopharyngeal cancer.

About 3 times as many men as women are affected by nasopharyngeal cancer, and the average age at diagnosis is about 50.

Diagnosing nasopharyngeal cancer
If you see your GP with symptoms that could indicate nasopharyngeal cancer, they'll usually ask about your symptoms and carry out some examinations. This may involve examining your throat using a small mirror and a light.

If your GP thinks further tests are necessary, they'll refer you to hospital. At hospital, a number of different tests may be carried out to check for nasopharyngeal cancer and rule out other conditions.

Some of the tests you may have include:

a nasendoscopy – where a thin, flexible telescope (endoscope) is inserted up your nose and passed down your throat to look for any abnormalities; it's carried out while you're awake, but local anaesthetic can be used to numb your nose and throat
imaging scans – MRI scans or CT scans can be used to check for tumours and determine whether the cancer has spread
a panendoscopy – a more detailed examination of your nose and throat carried out under general anaesthetic (where you're unconscious) using a series of small, rigid telescopes connected together
a biopsy – where a small tissue sample is removed during a panendoscopy so it can be examined in a laboratory
Once these tests are complete, your doctors will be able to confirm whether you have nasopharyngeal cancer. They'll also be able to "stage" the cancer, which means giving it a score to describe how large it is and how far it's spread.

The Cancer Research UK website has more information about the stages of nasopharyngeal cancer.

How nasopharyngeal cancer is treated
If you're diagnosed with nasopharyngeal cancer, you'll be cared for by a team of different specialists who work together called a multidisciplinary team (MDT).

If you smoke, it’s important that you give up. Smoking increases your risk of cancer returning, and may cause you to have more side effects from treatment.

Members of your MDT will discuss with you what they think the best treatment option is in your case.

The 2 main treatments for nasopharyngeal cancer are:

radiotherapy – where radiation is used to kill cancer cells
chemotherapy – where medication is used to kill cancer cells
In most cases, a combination of radiotherapy and chemotherapy will be used.

Surgery isn't usually used to treat nasopharyngeal cancer as it's difficult for surgeons to access the affected area.

Radiotherapy is the most commonly used treatment for nasopharyngeal cancer. It can be used on its own to treat very early-stage cancers, or in combination with chemotherapy for more advanced cancers.

In most cases, external radiotherapy is used. This involves using a machine to focus high-energy radiation beams on to the area that requires treatment.

In nasopharyngeal cancer, an advanced form of external radiotherapy called intensity-modulated radiation therapy (IMRT) is used.

It involves aiming radiation beams of different strengths at a tumour from several different angles. This helps maximise the dose delivered to the tumour, while minimising the effect on the surrounding healthy tissue.

Stereotactic radiotherapy is another way of giving radiotherapy externally and may be used to target a specific area where the cancer has returned.

External radiotherapy is often given in short sessions, once a day from Monday to Friday, with a break at weekends.

This is usually carried out for up to 7 weeks. You won't need to stay in hospital overnight between these appointments.

In some cases, internal radiotherapy may be required where nasopharyngeal cancer has returned after initial treatment.

A radioactive source is placed into or near the cancerous area and left in place for anywhere from a few minutes to a few days.

Depending on the type of treatment you have, you may need to stay in hospital for a short period of time.

Radiotherapy itself is painless, but it can have some significant side effects, such as:

red and sore skin in the treatment area
feeling sick
changes to your sense of taste
dry mouth
hair loss
These side effects are usually temporary, but some can be permanent. Let your care team know if you experience these problems as treatment is often available to help.

Read more about how radiotherapy is performed and the side effects of radiotherapy.

Chemotherapy may be used before or alongside radiotherapy for more advanced nasopharyngeal cancers.

It's usually given through a drip into a vein (intravenous chemotherapy), with sessions every 3 to 4 weeks spread over several months.

You won't usually need to stay in hospital overnight during treatment.

Like radiotherapy, chemotherapy can cause a number of significant side effects, such as:

feeling sick
sore mouth
These side effects are usually temporary, but there's also a risk of longer-term problems, such as infertility.

You should discuss any concerns you have about the potential side effects of treatment with your care team before treatment begins.

Read more about how chemotherapy is performed and the side effects of chemotherapy.

After your course of treatment ends, you'll need to have regular follow-up appointments and scans to monitor your recovery and check for any signs of the cancer returning.

To start with, these appointments will be every few weeks or months, but they'll become gradually less frequent over time.

The outlook for nasopharyngeal cancer depends on your age, general health and how advanced the condition is when you're diagnosed.

Radiotherapy alone can cure many very early-stage nasopharyngeal cancers, but many cases are diagnosed at a more advanced stage as the condition doesn't always cause obvious symptoms until later on.

More advanced cancers are treated with a combination of chemotherapy and radiotherapy. They're often curable if the cancer hasn't spread beyond the head and neck region.

Overall, about 50 out of every 100 people (50%) diagnosed with nasopharyngeal cancer will live for 5 years or more after diagnosis.

Survival rates are better for younger people, but worse for older people. Around 70 out of 100 (70%) people under 45 years of age, and 35 out of 100 (35%) people aged 65 to 74, will live for 5 years or more after being diagnosed with nasopharyngeal cancer.

Nasal polyps are rare in children.

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