At the back of the nose is a cavity called the 'post-nasal space'.
Very rarely, in adults, a cancer may grow in this space. Cancer of the
this site is very dangerous due it's closeness to the brain.
In the western world it is a very rare place for cancer to develop
and occurs in adults of young to middle age. It is, however, a very
common cancer in people from South China/Hong Kong.
In the western world there is no obvious cause, however in the South
Chinese it is thought to be due to a genetic susceptibility combined
with exposure to a type of virus called 'EBV'. It is not tobacco
The skull at the back of the nose has the drainage channel from the
ear and the nerves from the brain passing through it. This results in
the first signs of the disease being either a blocked ear due to fluid
behind the eardrum or double vision, due to invasion of the nerves
controlling the eye.
This type of cancer often produces big glands high in the neck.
The crucial test is a biopsy of the cancer - either under a local or
general anaesthetic. The next most important investigation is a special
X-ray of the sinuses called a 'CT scan' and possibly a 'MRI'.
Cancer of the post-nasal space is very dangerous due to its ability
to spread into the skull. It is recommend that the cancer is treated
with radiotherapy ('radium or X-ray' treatment) and chemotherapy
(chemical). If it returns, as half of cases do, then further
radiotherapy and chemotherapy is usually recommended. Surgery is only
useful for the rare cancer that has returned and can be cut out without
too much harm to the patient. If neck glands persist despite radiation
treatment then these should be cut out.
The cancer team managing this condition must be experienced and one
way to find this out is to ask how many "new head & neck cancers"
they treat every year. If they see at least 80 patients a year then
they are probably experienced enough. In addition the cancer team
should be composed of an Ear, Nose & Throat Surgeon, an
Oral-Maxillo-Facial Surgeon, a Plastic & Reconstructive surgeon, a
Clinical Oncologist, a Head & Neck Nurse and Head & Neck
Dietician. All members of the team should be present at the meeting
The aim of the treatment is to destroy all of the cancer; this is ultimately possible in about 50% of patients.