17. Head And Neck Cancers

Question 1

Give 4 risk factors associated with head and neck cancers.

Answer 1

Smoking.
Alcohol.
Beta nut chewing.
Dental hygiene.
Viruses eg HPV.
Premalignant eg leucoplakia, erythroplakia.

Question 2

Give 2 risk factors associated specifically with thyroid cancers.

Answer 2

Irradiation exposure including radioactive iodine and radiation leaks.
Family history and certain inherited conditions eg FAP.
Lumps in young (<20 years) or old (>70 years) people in the thyroid glands are more likely to be malignant.

Question 3

What is the most common type of malignancy seen in head and neck cancers?

Answer 3

Squamous cell carcinomas.

Question 4

How do cancers of the oral cavity present?

Answer 4

Lump.
Pain including referred pain to the ear.
Fixation of the tongue.
Dysphagia.
Odynophagia.

Question 5

How do cancers of the pharynx present?

Answer 5

Lump.
Pain including pain referred to the ear.
Dysphagia.
Odynophagia.
Weight loss.

Question 6

How do cancers of the larynx present?

Answer 6

Dyphonia.
Dysphagia.
Referred pain to the ears.
Globus.
Neck lump.
Weight loss.
Cacexia.

Question 7

How do thyroid cancers present?

Answer 7

Lump in the thyroid or neck nodal metastases.
Compressive symptoms eg problems swallowing, feeling like they are being strangled.
Voice change.

Question 8

Give 3 typical investigation used to diagnose and determine the severity of a head or neck cancer.

Answer 8

Imagining with a CT with or without MRI, including chest.
PET scan.
Biopsy.

Question 9

Give 3 typical investigation used to diagnose and determine the severity of a thyroid cancer

Answer 9

Triple assessment:
Full history and examination.
Imaging USS.
Needle testing of any suspicious limps via cytology in the form of fine needle aspiration.
May need advanced investigation.

Question 10

Give 3 common causes of neck lumps?

Answer 10

Lymphadenopathy.
Sebaceous cysts.
Hypopharyngeal carcinoma.
Laryngeal carcinoma.

Question 11

What are the general principles for management of head and neck cancers?

Answer 11

Medical - chemotherapy and radiotherapy.
Surgical - assessment of the tumour, sample, remove, reconstruct.
Supportive - swallowing, feeding, voice rehab, pain, supportive care.
Requires an MDT approach.