Briony Alexander – Living with the after-effects

Although Briony Alexander has been in remission for 29 years from nasopharyngeal cancer (NPC), it’s still an ongoing challenge as she lives with the after-effects of the cancer treatment every day.

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What is NPC?

Nasopharyngeal cancer is a rare head and neck cancer. The nasopharynx is the top part of the throat behind the nose. The type of cells from which cancer can develop in this area are surface lining cells causing squamous cell carcinoma. There seems to be a bimodal age distribution for getting nasopharyngeal cancer. The peaks are between 15 – 25 and 40 – 50 years.

Risk factors

• Smoking
• Epstein-Barr virus (EBV)
• Having ancestry in South East Asia, North Africa, or the Arctic
• Having a family member with head and neck cancer
• Following a diet high in salt-cured fish with nitrosamine

Symptoms

• A blocked, painful or ringing ear is usually the earliest sign.
• A blocked nose usually on one side progressing to both sides, sometimes with nose bleeds.
• There may be no symptoms other than a neck lump which indicates that the cancer has already spread to lymph nodes.
• If the disease is particularly advanced, the tumour can invade into the skull base, brain, or eyes with symptoms associated with those structures.

If you have any of these symptoms, please consult an ENT or head and neck surgeon. They are the best specialists to make the diagnosis.

Briony Alexander (46) lives in West Coast, Western Cape.

At age 16, in 1995, Briony was diagnosed with nasopharyngeal cancer. This was once she had consulted a GP due to symptoms of a sore throat, swollen lymph nodes, and not being able to swallow. The 

GP referred her to an oncologist at a provincial hospital where a needle biopsy was performed. She was then sent to a tertiary hospital for another biopsy and CAT scan. 

“I was a case study at this hospital as this was the first time the doctors had experienced this rare head and neck cancer,” Briony explains. 

When asked about being diagnosed as a teenager, she responds, “It was like an outer body experience as I was so young. It was extremely overwhelming, but the support of my family allowed me to deal with the challenges one day at a time. My friends and teachers from school at that time were also so supportive.”

Briony underwent chemotherapy and radiation which proved to be successful despite the nausea, loss of appetite, and lethargy. She was given the all clear but unfortunately there lay a long arduous road of dealing with the after-effects.

The after-effects

At age 22, Briony moved to JHB and four years later had to have a full dental extraction due to the long-term side effects of radiation. She also underwent hyperbaric oxygen therapy in Pretoria to enhance better blood flow, so her jaw could heal properly. Once her mouth healed, she got dentures. 

Then 11 years later, in 2017, she had to have a full thyroidectomy (surgical removal of the thyroid gland) as her thyroid was swelling up and causing many issues. She also had a skin cancer removed from the back of her ear during the same surgery. However, the skin cancer is unrelated to NPC. Due to Briony’s thyroid removal, she will be on levothyroxine (a thyroid medication) for the rest of her life. 

In 2022, Briony moved back home to the Western Cape. A year later she experienced high calcium levels and excessive menstruation bleeding. She was referred to a specialist endocrine surgeon and was treated for the high calcium with a planned parathyroid operation in 2024. Unfortunately, her parathyroid couldn’t be located, however, lymph nodes were removed for testing and the levothyroxine changed due to overactive symptoms. She currently goes for blood tests and monitoring every six months. It’s believed that the radiation played a role in the development of her thyroid and parathyroid pathology.

Live, laugh, love

When asked how she has managed all of these obstacles, Briony responds, “One day at a time. To live, laugh, love has always been my motto for life. The support of family is great and through prayer it all helped my process. I changed my eating plan to softer food and less meat and I always drink water with my food for digestion as I have little saliva.”

She goes on to say, “Difficult roads can lead to beautiful destinations. I’m a survivor of my own ship and God has always been my captain.” 

Header image by Freepik