NPC Symptoms Q&A

So I have been asked multiple times by many friends on how I found out I had cancer, more specially, nasopharyngeal carcinoma. As with any cancer, early detection is key to your prognosis.

Like Lance Armstrong, I ignored all the early symptoms and warnings that would have helped catch my cancer at an earlier stage. Unfortunately, detecting nasopharyngeal carcinoma (NPC) at an early stage is difficult as the symptoms are usually presented and masked as symptoms of a common cold or allergy.

For me, I had:

• nosebleeds (I've had nosebleeds since I moved from humid Taiwan to not-so-humid USA at an early age)
  
• headaches, especially during hot weather (who doesn't have a headache now and then)
  
• post-nasal drip that lead to a persistent cough, more so during the day than at night (I went to multiple doctors who thought it was just allergies due possibly to the smog and pollen)
• popping sensation in my right ear and, not so frequently, ear pain (perhaps I should have pushed my doctors harder on this one as I'm not sure this is all that common for colds and allergies)

My cancer was not discovered until it was locally advanced with metastasis to my lymph nodes on the right side of my neck.

The World Health Organization (WHO) classifies NPC into three subtypes:

• Type 1: squamous cell carcinoma
• Type 2: non-keratinizing carcinoma
• Type 3: undifferentiated or poorly differentiated carcinoma

Unfortunately and fortunately, I was diagnosed with type 3. Type 3 is most aggressive, but out of the three types, it responds best to radiation treatment.

Your body is an amazing system with each and every organ serving a distinct and useful purpose. Please do not ignore the early warning signs.

Anticlimactic Taxol (paclitaxel) infusion

Today was my first induction chemotherapy session, which turned out to be quite uneventful. You sit in these large recliners in a not-so-big room with many other people, who are all getting different types of chemo drugs and most are asleep, a few listening to music, and others reading like me. They allow you to talk on the cell phone as long as you are not too loud, you can bring in your laptop computer, and even eat if you like. If you need to go to the restroom, no problem, just unplug your IV stand and take it with you. I think the IV monitoring machine has battery backup since that keeps running. I noticed I was the only person in the room with a port. Everyone else got their chemo drugs through an IV line in their hand. My nurse said my port is needed for the 5-FU chemo drug, which I get to take home with me in a portable pump after tomorrow's cisplatin session. Since I'm going back again tomorrow for another session, I get to keep my IV line on my chest.

The Taxol (Paclitaxel 315 mg / 552.5 cc) drug does not kick in right away. I don't feel anything except for the tenderness on my right chest from the port surgery yesterday. The surgeon at the hospital made two incisions to place the PowerPort. During the surgery, I spoke to my surgeon the whole time, asking him what he was doing, where he is from, has he done this before (joking!), and the advantages of a port versus a PICC line. He said the PICC line is used for shorter term purposes. For me, I need to get chemo for a longer period so the port is preferred.

I feel like a walking drug store. After leaving the infusion center, we stopped by the pharmacy to pick up the following:

• Dexamethasone
  
• Zantac (ranitidine)
• Ondansetron
• Lorazepam
• Prochlorperazine
• Neupogen; used to boost white blood cells
  
• BMT mouthwash; used for sores in my mouth and throat; you can swallow the liquid
  

In addition, once a week, I need blood work done to check my blood count. If the counts get too low, chemo sessions will be delayed and my risk of infection increases dramatically. I need to avoid contact with too many people, if possible.