Saving lives through technology: NP Screen™ Test
Cancer is a killer disease. The dread and fear that comes with a cancer diagnosis is rooted in its lethal nature. Cancer is one of the leading causes of deaths worldwide. While many studies have been carried out to treat the disease, still it remains a de
If recognized and treated early, cancer is almost always curable. The earlier the diagnosis and treatment, the better the chances of survival. But if left to advance to later stages, the cancer can spread to other parts of the body where it becomes hard to treat and thus be fatal. There are many different types and causes of cancer, but all are characterized by abnormal cell growth. And of these, there is one specific type of cancer that seems a bit harder to detect. A SILENT THREAT
Among ethnic Asian groups, Nasopharyngeal Carcinoma (NPC) is one of the leading causes of cancer deaths. NPC is the most common cancer originating in the nasopharynx, the uppermost region of the pharynx (throat), behind the nose where the nasal passages and auditory tubes join the remainder of the upper respiratory tract. Because of the obscure location: far behind the nose, under the skull base, patients having NPC may not have obvious symptoms until it is very late. Routine examination to uncover this cancer is difficult without special equipment such as endoscope, often used by ENT specialist to visualize the area during office visit.
According to Dr. Raymond Ng M.D., Ph.D., F.R.C.S.C — assistant professor in the Department of Otolaryngology Head and Neck Surgery at the University of Toronto — NPC is considered a rare type of cancer in the world but it is very common in a select group of people. “Those who are more at risk are people or the descendants of people from Southern China, Southeast Asia, Mediterranean coast and northern Africa,” he says.
Chinese individuals from Southern China have the highest risk in developing NPC, about 30-250 cases per 100,000 people. Intermediate incidence rates are found in Southeast Asia including the Philippines, where the incidence rate of 8.6 per 100,000 has been reported. This means that in the Philippines alone, there can be as many as 8,800 new NPC cases every year. According to published studies, males in Rizal province and those from northern and central Luzon, have one of the highest rates of NPC in the world.
Statistics have shown that males are affected much more frequently than females — a ratio of 3:1, with a peak incidence in the 50–54 age range, and an incidence rate that starts to climb steadily after 15-20 years of age. First and second degree relatives of patients with NPC have 5-10 times higher risk of developing NPC. Unfortunately, majority (over 70% of the cases) of NPC are discovered late. For this cancer, the annual mortality or death rate globally exceeds 50,000 annually, which is a tragic statistic because NPC can be cured when detected early.
SIGNS AND SYMPTOMS
Because NPC starts from the base of the skull in the centre of the head, during the early stages, NPC usually shows almost no symptoms. “Common early symptoms of nasopharyngeal cancer include nose blockage, hearing loss in one ear due to fluid buildup in the middle ear, and taste of blood in the back of the throat,” Dr. Ng says. Sometimes, patients can first present with a lump in the neck, representing spread of cancer to the lymph nodes. “Since the cancer is in the base of the skull, extension of cancer to the brain may lead to symptoms of headaches, blurry vision and numbness in the face,” Dr. Ng further explains. Treatment for nasopharyngeal cancer using radiation is the primary modality of treatment and is very effective. More advance disease will require additional chemotherapy, which makes it more challenging and complications from treatment is usually higher. Survival is much lower for advance NPC.
EPSTEIN-BARR VIRUS AND NPC
Although NPC is very hard to detect, it leaves enough signs if you know where to look. The Epstein-Barr virus (EBV) is one of the most common viruses in humans and EBV infection normally occurs in early childhood. Majority of people would have been exposed to EBV infection by age 10-12 and fortunately, EBV infection does not always lead to NPC. However, there is a consistent association between presence of EBV genome in virtually all NPC cells. The detection of a single form of viral DNA suggests that the tumors came from of a single cell that was initially infected with EBV and infection of the cells in the nasopharynx is a critical step in the eventual development of NPC.
NEW MEDICAL INNOVATION: THE NP SCREEN™ TEST
Since NPC is not easily visualized during routine clinical examination by family physicians, special equipment and techniques are needed to screen this area. The most common technique is direct nasopharyngoscopy (visual inspection using a endoscope) done by the ENT specialist. However, because this method relies on subjective evaluation and human skills, small or early stage NPC (sometimes called submucosal disease) can also be missed even with the most skilled surgeon.
The NP Screen™ test is a simple, highly sensitive and specific genetic based screening test kit for the detection of early stage NPC. It is non-invasive, painless, highly tolerable and efficient. For this simple procedure, a clinician takes a simple swab of the NP through the patient’s mouth to obtain a cell sample. This sample is then analyzed for the presence of the Epstein-Barr virus DNA, which is an integrated genetic marker inside the NP cells. It screens what cannot be detected visually through endoscopy or MRI. With 99-percent accuracy, the NP Screen™ test is the most accurate and reliable test method available for early detection of NPC. Recent clinical studies also demonstrated the potential of using NP Screen™ test to detect early local cancer recurrence in patients who already had radiation, making it easier for cancer specialists to control the disease better and initiate treatment earlier.
TECHNOLOGY THAT SAVES LIVES
The NP Screen™ test is a leading genetic based technology developed in the US and Canada that allow doctors to detect cancer early. It is an innovative paradigm shift in the effective management of NPC through screening, early detection and treatment with a significant overall improvement of cancer survival.
“If you have a positive NP Screen™ result, your chance of cancer is very high. This is a very good way for a family or ENT doctor to detect signs of cancer early so that investigations and treatment can be started immediately without delay,” Dr. Ng explains. “There is very low false negative rate. Which means If you score a negative result, your chance of cancer is very low. This test takes only about 30 seconds to perform in the office setting and is the most advanced genetic test available for early detection of NPC,” Dr. Ng concludes.
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