Stage 4 Nasopharyngeal Cancer: Warning Signs Not to Ignore and Treatment Methods by Ramathibodi Doctors

Loss "Tong Wong Two" The famous 90s singer reminds us of the dangers of 'nasopharyngeal cancer' Check early warning signs and stage 4 treatment approaches

From news of loss to learning about “nasopharyngeal cancer”

The news of the passing of "Tong Wong Two" Suraphan Jamlongkul the famous 90s singer due to nasopharyngeal cancer has deeply saddened fans nationwide and serves as a cautionary reminder for society to raise awareness of this serious disease.

According to data from the National Cancer Institute and leading hospitals in Thailand, nasopharyngeal cancer is common in Southeast Asia, especially in men aged 30–50. Because the nasopharynx is located behind the oral cavity and beneath the base of the skull, early-stage patients often show no symptoms or present signs similar to allergies or chronic colds until the disease is advanced.

Early warning signs of nasopharyngeal cancer that should not be overlooked

The Faculty of Medicine at Ramathibodi Hospital, Mahidol University, states that nasopharyngeal cancer usually has no obvious symptoms initially, but if abnormal signs persist for more than 2–3 weeks, patients should promptly see an ENT specialist for immediate endoscopic examination.

• Chronic one-sided nasal congestion persistent nasal blockage or difficulty breathing on one side without known cause
• Abnormal nosebleeds frequent nosebleeds or chronic blood-tinged mucus
• Unilateral hearing loss a feeling of ear fullness, reduced hearing, or middle ear fluid caused by a tumor pressing on the Eustachian tube
• Palpable neck lump due to cancer cells spreading to lymph nodes in the neck, often the main reason patients seek medical attention
• Neurological symptoms such as facial numbness, double vision, drooping eyelid, or chronic headaches when the tumor invades cranial nerves

What is stage 4 nasopharyngeal cancer?

Medically, stage 4 nasopharyngeal cancer is divided into main subgroups as follows:

1. Locally advanced stage cancer cells have invaded the base of the skull, eye socket, cranial nerves, or large lymph nodes in the neck extending to the clavicle area

2. Metastatic stage cancer cells have spread through blood or lymphatic systems to other organs such as bones, lungs, or liver

Treatment approach for stage 4 nasopharyngeal cancer

Experts from Ramathibodi Hospital explain that although it is stage 4, nasopharyngeal cancer responds better to radiotherapy and chemotherapy than other head and neck cancers. The main treatment methods include:

1. Radiotherapy combined with chemotherapy

• Radiotherapy is the primary treatment for nasopharyngeal cancer. Currently, innovations like three-dimensional conformal radiotherapy or intensity-modulated radiotherapy (IMRT) are used to precisely target cancer cells and reduce damage to the brain, eyes, and nearby salivary glands.
• Chemotherapy is used alongside radiotherapy to enhance cancer cell destruction, including chemotherapy given before or after radiotherapy to control the disease.

2. Targeted therapy and immunotherapy

For patients with metastatic or recurrent disease, doctors may consider targeted drugs that inhibit cancer cell growth or immunotherapy that stimulates the immune system to attack cancer cells, improving survival rates and longer disease control.

3. Surgery

Generally, surgery is not the main treatment due to the tumor’s difficult location. However, it may be considered for residual lymph nodes after radiotherapy or localized recurrent tumors.

Quality of life care for stage 4 patients

Beyond disease control, palliative care and quality of life support are vital. The Ramathibodi medical team emphasizes these key points:

• Managing complications monitoring and relieving side effects such as dry mouth, sore throat, difficulty swallowing, or pain using standard pain medications
• Proper nutrition focus on soft, easily digestible, mild-flavored, high-protein foods. If swallowing is difficult, feeding tubes may be necessary to prevent malnutrition.
• Emotional care emotional support from family combined with care from psychiatrists and social workers to reduce anxiety and boost morale for treatment

Be vigilant for physical abnormalities in yourself and close ones. If you notice persistent one-sided nasal congestion, nosebleeds, or a lump in the neck, promptly see a doctor for early diagnosis, as early detection greatly increases the chance of a cure.