Nose cancer a major concern

KUCHING: Malaysian badminton superstar Datuk Lee Chong Wei’s early-stage nose cancer is a rare occurrence in most western countries but in Sarawak, it is a major concern as the state boasts one of the highest rates of Nasopharyngeal Carcinoma (NPC) incidence in the world.

The cancer which affects the area behind the nose and above the mouth has a rate of incidence of less than one per 100,000 in many western countries like the US and most of Europe, but in Sarawak, the rate of incidence is 13.5 and 6.2 per 100,000 for all Sarawakian males and females.

According to Dr Yu Kong Leong, the former head of  Sarawak General Hospital’s (SGH) Radiotherapy and Oncological Unit (RTU) and the current resident oncologist at Borneo Medical Centre, this is largely connected to genetic, viral infections and environmental influences in the state.

“In a study conducted a few years ago, it was found that the Bidayuh community showed the highest rate of NPC in the world, followed by Chinese from Hong Kong and Singapore, and all other Dayak races and Chinese in Sarawak,” he shared during an interview with The Borneo Post on cancer awareness last year.

Published in 2004 and written by a team of researchers at SGH, the study indicated that the risk in the Bidayuh was 2.3 and 1.9 times higher for males and females compared to the Sarawak average.

“This correlates with our department’s own data as we have noted a higher proportion of Bidayuh patients with NPC, and found that our NPC cases are saturated in Serian where there is larger Bidayuh population,” he added.

The frequent consumption of preserved and salted foods such as the traditional Bidayuh ‘kasam’ dish and Cantonese salted fish have also been said to increase the rate of NPC.

“But even if we practise a healthy lifestyle, the risk of developing NPC for Sarawakians is still higher than the general population in the rest of the world, so early detection of the cancer is vital as the disease becomes increasingly difficult to treat in later stages.

“Early symptoms for NCP are reduced hearing and nose bleeds, everything else occurs in the later stages, so it’s imperative that early symptoms are not ignored.

“Nose bleeds caused by NPC will not be a one-time occurrence and will normally be accompanied by other general symptoms of cancer such as reduced appetite, nasal blockages and neck swellings,” Dr Yu said.

While nosebleeds are fairly commonplace and often not a matter of concern, Sarawakian men are recommended to visit their nearest ear, nose and throat (ENT) doctor for a check-up should they experience any of the early symptoms of NPC.

“I think for this region, it’s better to be extra cautious and screen for it earlier rather than waiting a few weeks for another symptom or episode of nose bleeding to occur. That way, we can catch and treat it earlier, allowing a better chance of successful treatment,” Dr Yu explained.

The five-year survival rates of NPC in early Stages 1 and 2 are around 70 to 80 per cent, but in later stages, the survival rates are not nearly as high as it becomes increasingly difficult to treat when it has spread to other parts of the body.

It is reported that Lee’s NPC was detected in its early stages and that he is responding well to his current medical treatment in Taiwan.

In an interview with Bernama yesterday, Ipoh Pantai Hospital Ear, Nose and Throat Consultant and Head and Neck Surgeon, Dr Rekha Balachandran, said: “Heredity, lifestyle and Epstein-Barr virus (EBV) infection are the factors causing the cancer.

“Having a close family member with NPC increases the risk of the disease, and frequent consumption of preserved food such as salted vegetables and dried fish also contributes to it.”

On Sunday, reports on Chong Wei having been diagnosed with an early stage nose cancer left Malaysians shocked, with thousands of positive messages wishing him a speedy recovery.

The Badminton Association of Malaysia (BAM) president Datuk Seri Mohamad Norza Zakaria said that Chong Wei was currently in Taiwan seeking treatment.

In our Sept 25 print edition, we named Dr Yu as current head of Sarawak General Hospital’s radiotherapy and oncological unit. He has since resigned from SGH and is now a resident oncologist at Borneo Medical Centre. We regret the error. – Editor

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