Incidence of Anemia in Patient With Nasopharyngeal Carcinoma at Ent-HNS Department West Nusa Tenggara

Abstract

Article InfoIntroduction: Nasopharyngeal carcinoma is common in China and Southeast Asia, including Indonesia. The cases are often diagnosed in an advanced stage with a poor prognosis. Objective: The purpose of this study was to determine the incidence of anemia in nasopharyngeal carcinoma patients in the ENT-HNS Department West Nusa Tenggara Hospital. Methods: the methods of this research are a descriptive study that used data from the medical record of West Nusa Tenggara Hospital. The data were obtained between April 2017 to September 2017. Result: During the study periods, we obtained 32 cases. 75% of patients were male and 25% female, with ratio 3:1. According to the age, patients were distributed from 28 to 69 years old with peak incidence at 41-60 years old. Most patients were stage IV (68.75%). There was 87.51% patient with anemia in this research. However,the highest number was found mild anemia 59.38% and the most types of anemia were hypochromic microcytic. Discussion: In this study, patients with advanced stages were 93.75%, consist of stage IV (68.75%) and stage III (25%), followed by stage II 6.25%, while stage I was not found. This shows that patients usually come at an advanced stage because of the low awareness of the NPC in medical personnel in Indonesia. Conclusion: The incidence of anemia in a patient with nasopharyngeal cancer in West Nusa Tenggara Hospital is 87.51%. Most of them were mild grade and hypochromic microcytic type.

Laboratory Profiles of Nasopharyngeal Carcinoma Patients

“…Hemoglobin of less than 14 mg/dL was found in 86.61% of the participants. This result was consistent with a prior study conducted by Susilawati that 87.5% of patients with NPC had anemia [16]. A study in China reported that hemoglobin level less than 11g/dL significantly lowers the Overall Survival (OS) in NPC (70% vs. 78%).…”

“…Malignancy anemia is caused by several factors such as malnutrition, malabsorption, acute/chronic bleeding, inflammation, metastatic infiltration to bone marrow, and myelosuppression due to cancer therapy [18]. Susilawati also reported that hypochromic microcytic anemia is the most common type in NPC patients, associated with iron deficiency anemia [16]. In patients with malignancy, tumor cells induce the secretion of serotonin and bombesin, resulting in appetite suppression.…”

“…Inflammation of oral and digestive tract mucosa in NPC patients results in pain and psychological distress during food ingestion is associated with malnutrition [17]. Blood loss due to epistaxis may also exacerbate anemia [16]. While polycythemia may be related to dehydration in NPC cases resulting in volume depletion rather than the actual increase of RBC mass [19].…”

Knowledge, Attitude, and Behavior of Tanjungpura University Undergraduate Students towards Nasopharyngeal Carcinoma

“…However, environmental substances such as Epstein-Barr Virus, alcohol, cigarettes, salted foods, canned foods, traditional medicines, formaldehyde, wood dust, and non-environmental risk factors such as gender and ethnicity have been determined as risk factors for nasopharyngeal carcinoma. [8][9][10][11] Being an Asian is a risk factor for nasopharyngeal carcinoma due to the narrower structure of the nasopharynx compared to other ethnicities. Therefore, repeated infections can occur and lead to malignancy.…”

“…According to epidemiological studies, the average latent period of cancer is 15 years or more. 3,11,14 Thus, when calculated with the latent period, it can be assumed that exposure begins from adolescence to young adulthood. Undergraduate students are one of the groups belonging to adolescence and young adulthood.…”