Chapter I
INTRODUCTION
A. Background of the Study Respiration is a vital process in the human body. The intake of oxygen and removal of carbon dioxide are the primary functions of the respiratory system (Microsoft Encarta, 2009). Supporting this complex process is the nasopharynx which functions to remove the dust, microorganisms, and mucus that come with the air through the presence of cilia within its walls. Conditions that may damage or affect the structure of the nasopharynx have detrimental effects to people. Malignancies can also arise from this structure, the most common disease that afflicts the area. Cancer is a disease process that begins when an abnormal cell is transformed by the genetic mutation of the cellular DNA. A phenomenon known as metastasis occurs when these cells infiltrate the surrounding tissues and gain access to other areas of the body. The scope, responsibilities, and goals of cancer nursing are as diverse and complex as those of any nursing specialty (Smeltzer and Bare, 2004). The extensive physical, emotional, social, cultural and spiritual effects defeat the human spirit more than the actual source, more than the disease.
The National Cancer Institute (NCI) of the US National Institutes of Health defines nasopharyngeal carcinoma (NPC) as “a cancer that forms in tissues of the nasopharynx. It is believed that nearly all nasopharyngeal cancers are considered squamous cell carcinomas due to its identified origin in flat cells lining the upper part of the throat behind the nose or nasopharynx. This type of cancer when early detected and treated has a high rate of survival (Ma, 2008).
Being the most common malignant tumor of the nasopharynx, nasopharyngeal cancer is most often diagnosed when a patient goes to a doctor because of symptoms or a lump in the neck. Radiotherapy is the treatment of choice though sometimes chemotherapy may be used in conjunction. The success rates are high with stage I and stage II nasopharyngeal cancer, with 91.7% and 96.9% patients remain cancer-free three years following treatment respectively. The majority of deaths are caused by widespread metastasis, so early diagnosis is an important factor for positive patient outcomes (Hayes, K., 2009).
The exact cause of NPC is unknown. Dietary factors such as salt-cured fish and meats are thought to increase a person’s risk of developing the disease. The Epstein-Barr virus has also been linked to an increased risk of developing. As with other cancers, nasopharyngeal cancer is not infectious and cannot be passed on to other people. It is much more common in parts of the world such as Asia and North Africa; for instance, it is a fairly common cancer in Southeast China (American Cancer Society, 2010). The average annual age-adjusted incidence rate of nasopharyngeal cancer in Chinese men, 10.8 per 100,000, is 1.4 times greater than that of Vietnamese men and nearly 2.8 times greater than that of Filipino men. In fact, the rate among Filipino men, although relatively high, is the same as that for Chinese women. Rates of one per 100,000 and lower occur in black men, Hispanic and non-Hispanic white men and non-Hispanic white women.