Hidden Cancer: Persistent fever leads to early diagnosis

Khadijah ‘Ainaa Raouf Al-Samarraie's life took a significant turn in 2019 when a persistent fever, initially dismissed as a minor ailment, led to the diagnosis of nasopharyngeal cancer. The illness began after a holiday, and what started as a months-long fever, accompanied by a sore throat, prompted a final doctor's visit that revealed the hidden danger.

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Until December, everything disappeared. I remember not wanting to go to the last doctor's appointment because I felt fine. But I went anyway and saw an Ear, Nose, and Throat (ENT) specialist. The ENT specialist inserted a camera and instrument into my nose.

An Ear, Nose, and Throat (ENT) specialist discovered a tumor during an examination using a camera inserted into her nose. Subsequent blood tests and a biopsy confirmed nasopharyngeal cancer, or cancer at the base of the nose. Khadijah was relieved that the cancer was detected at Stage 1, a fact that significantly improved her prognosis. She noted that without the referral to the ENT specialist, the cancer might have progressed undetected due to the absence of significant pain.

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I was shocked when the doctor said there was a tumor. Blood tests and biopsy confirmed I had nasopharyngeal cancer. I cried for months because it was hard to accept. But the good thing is, the cancer was only Stage 1.

The diagnosis was particularly surprising as nasopharyngeal cancer is rare, especially among Malay women, typically affecting Chinese men. Khadijah acknowledged a family history of cancer, with her mother having survived breast cancer in 2000. Despite the diagnosis, she initially postponed radiotherapy to fulfill her teaching duties for a semester, receiving one three-week cycle of chemotherapy instead.

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Many were surprised and disbelieving that I had nasopharyngeal cancer because my nose looked normal. Nasopharyngeal cancer (NPC) is very rare, especially among Malay women, let alone women. It usually affects Chinese men.

Her treatment involved 33 radiotherapy sessions over seven weeks. The side effects were severe, including mouth ulcers, a white tongue, thick saliva making swallowing difficult, and increased sensitivity of gums and teeth. She had to have some teeth removed. The radiotherapy also caused burns, making her skin feel hot and inflamed, and affected her sense of taste, making spicy foods unbearable. She experienced swelling and pain when drinking, consuming less than 400 ml daily, and suffered from constant thirst and hunger.

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The effects of radiotherapy were very severe. My mouth was full of ulcers, and my tongue turned white. Saliva was very thick, making it difficult to swallow, and my gums and teeth became more sensitive.