Feel strongly about these letters, or any other aspects of the news? Share your views by emailing us your Letter to the Editor at [email protected] or filling in this Google form. Submissions should not exceed 400 words.

The end of April marked the end of Head and Neck Cancer Awareness Month, offering a reminder that one disease deserves greater attention in Asia: nasopharyngeal carcinoma (NPC), a type of head and neck cancer. NPC has a strikingly uneven geography. It remains endemic in East and Southeast Asia, where the majority of cases occur.

The regional burden is easy to see. In Hong Kong, the Centre for Health Protection recorded 700 new NPC cases in 2023, 549 in men and 151 in women. According to the International Agency for Research on Cancer’s recent estimates, Indonesia recorded 18,835 new nasopharyngeal cancer cases in 2022, also with a particularly heavy male burden: NPC was the fourth most common cancer in men, accounting for 14,497 new cases or 7.7 per cent of all new male cancers. These numbers reflect a cancer burden that merits wider awareness and discussion.

That is why lifestyle medicine belongs in the NPC conversation, as evidence-based support for prevention, treatment tolerance and survivorship. In NPC, three pillars of lifestyle medicine stand out most clearly.

First, avoiding risky exposure: smoking and prolonged and high intake of Chinese-style salted fish are established risk factors for NPC. Hong Kong’s own NPC-specific recommendations, thus, explicitly emphasise avoiding smoking and Chinese-style salted fish. Indonesia, meanwhile, continues to face a heavy tobacco burden: according to the 2023 Indonesian Health Survey, an estimated 70 million Indonesians are actively smoking, which is often perceived as a cultural practice.

Second, nutrition matters. In NPC specifically, recent clinical data suggests that individualised nutritional interventions during radiotherapy can improve quality of life and nutritional status, while other investigations likewise show the value of evidence-based nutritional support during treatment.