The nasopharynx has a cuboidal shape. The lateral walls are formed by the eustachian tube and the fossa of Rosenmuller. The roof, sloping downward from anterior to posterior, is bordered by the pharyngeal hypophysis, pharyngeal tonsil, and pharyngeal bursa with the base of the skull above. Anteriorly, the nasopharynx abuts the posterior choanae and nasal cavity, and the posterior boundary is formed by the muscles of the posterior pharyngeal wall. Inferiorly, the nasopharynx ends at an imaginary horizontal line formed by the upper surface of the soft palate and the posterior pharyngeal wall.
Caring for a patient with cancer affects the family caregiver's quality of life.
Family caregivers usually begin caregiving without training and are expected to meet many demands without much help. A caregiver often neglects his or her own quality of life by putting the patient's needs first. Today, many health care providers watch for signs of caregiver distress during the course of the patient's cancer treatment. When caregiver strain affects the quality of caregiving, the patient's well-being...
Unlike other squamous cell cancers of the head and neck, nasopharyngeal cancer does not appear to be linked to excess use of tobacco or moderate alcohol intake (up to 15 drinks a week). Factors thought to predispose to this tumor include the following:
In the patient who presents with only cervical adenopathy, the finding of EBV genomic material in the tissue after amplification of DNA with the polymerase chain reaction lends strong evidence for a nasopharyngeal primary tumor, and a concerted search should be conducted in that area.
Diagnosis is made by biopsy of the nasopharyngeal mass. Workup includes the following:
Careful visual examination (by mirror or endoscopic examination).
Documentation of the size and location of the tumor and neck nodes.
Evaluation of cranial nerve function and hearing.
Skull films (especially base-of-skull views) evaluating neural foramina.
Complete computed tomographic (CT) scan.
Magnetic resonance imaging (MRI) with views delineating the upper and lower extent of the lesion.
Any clinical or laboratory suggestion of distant metastasis may prompt further evaluation of other sites. Careful dental and oral hygiene evaluation and therapy is particularly important prior to initiation of radiation treatment. MRI is often more helpful than CT scans in detecting abnormalities and in defining their extent.[5,6,7]
Major prognostic factors adversely influencing outcome of treatment include the following:
Large tumor size.
A higher tumor (T) stage.
The presence of involved neck nodes.
Other factors linked to diminished survival that were present in some, but not all, studies include the following:
Long interval between biopsy and initiation of radiation therapy.