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Nose Troubles
March 15, 2016
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DR DIPAK BANARSI DASS
By: Dr Dipak Banarsi Dass Discusses Nasal Cancer
Family was the main influence that led Dr Dipak to pursue a career in the medical field. He explains that many of his relatives were doctors and that the profession was looked at as a noble one. After graduating medical school, deciding on a specialization came about easy enough, as he had always been fascinated by the impact a nose has on a person’s face. The fact that there were only a dozen otorhinolaryngologists in the country also led him to eventually choose rhinology as his calling, as he wanted to differentiate himself from the many others in the field. When the cells in the back of the nasopharynx become cancerous, it is a condition called nasopharyngeal cancer, more commonly known as nose cancer. If caught early, the prognosis is good and surgery is minimally invasive. Care for Life speaks to Dr Dipak Banarsi Dass, a Consultant Otorhinolaryngologist from KPJ Rawang Specialist Hospital to find out more about this condition, and ways to spot the symptoms early.
Dr Dipak advises to be aware of the signs of nose cancer and to come in for a check-up even if symptoms seem minor. An endoscope (pictured) is used to perform a quick diagnosis. Early detection leads to a better chance of recovery. Catching it Early
For such a small structure as the nose, the impact of having nose cancer is enormous, possibly affecting other areas if the disease progresses, in the later stages. Unfortunately, early detection is quite difficult as patients usually are not aware that something is wrong. Only when the cancer has progressed significantly do they visit a healthcare professional.
Some of the early symptoms include a blocked nose, bleeding through your nostrils, a foul-smelling discharge and a persistent cough. As the cancer progresses and spreads to other parts of the body, symptoms include bulging eyeballs, decreased movement of the eyeballs,
headaches, dizziness, hearing loss, mouth ulcers, and neck swellings.
Treatment by Stages
In order to treat the cancer, determining the stage of the growth must first be conducted. A biopsy of the infected area is taken for examination to determine whether it is benign or malignant. Imaging After spending twenty years in a crowded government hospital in
Kuala Lumpur, joining the privately owned KPJ was a gratifying change, and working in the more outlying location of Rawang as the only ENT (ears, nose and throat) doctor offered
its own unique attraction. As he says, “helping people who don’t have as much access to medical care is more fulfilling.â€
Constant Aggravation
Nose cancer can be classified according to the area affected. The major types affect parts which include blood vessels, underlining mucosa, epithelial cells, fibrous or connective tissue, and the surrounding vascular structures or the neural tissues. Tumours can arise from any of these. In Malaysia, the most common type of nose cancer is Nasopharyngeal carcinoma, which is also the second most common cancer in the country for the respiratory system, after lung cancer, according to Dr Dipak. More predominant in Chinese, especially in older males aged 50-60 years, the prevalence of the illness is about 25 cases for every 10,000 patients.
“Chronic irritation is the reason nose cancer occurs, as the cells start becoming malignant and turn cancerous,†says Dr Dipak. Those who work in the timber industry or in leather or shoe factories, are more at risk of having it, due to increased exposure to harmful chemicals in the environment. But he warns that though they are not direct causes, habits such as “smoking and drinking alcohol can increase the likelihood threefold.†(consisting of a CT scan or MRI) is then used to establish the size and location of the tumour. In the early stages, treatment is quite straightforward and painless. During stages one and two, the cancer is confined to the nose area, and surgery can be immediately executed, utilizing endoscopic methods. “This is followed by radiotherapy to sterilize the area,†explains Dr Dipak.
Thegeneral prognosis is also very positive, with 90% success rate being reported for nasopharyngeal carcinoma cases. For stage three or four, a combined treatment is used involving both radiotherapy and chemotherapy. Sometimes the tumour cannot be completely removed, but with the application of chemo before the therapy, much of the tumour can be debulked. “Of course, at this point, prognosis for a patient will drop to somewhere around 60% and then to 35% if the tumour has spread to other parts of the body,†says Dr Dipak. “That’s why it’s so important to be aware of the signs and to catch it early, before it
