21: ENT

Question 1

what areas of the body fall under Head and Neck Cancer types?

Answer 1

Paranasal sinuses
Nasal Cavity
Oral Cavity
Tongue
Salivary Glands
Larynx
Pharynx (nasopharynx, oropharynx, hypopharynx)

Question 2

What are the common risk factors for H&N Ca? Top 3 and then in addition

Answer 2

Tobacco and Alcohol (particularly together)
Oral HPV infections — 10% of men and 3.6% of women in US have oral HPV. 70% of oropharyngeal Ca is HPV

environmental and occupational inhalants
GERD
Laryngopharyngeal reflux disease

Question 3

Aside from what would be common symptoms (swallowing issues, blood in saliva, loosing teeth), where are some other symptoms to know for H&N Ca?

Answer 3

sore throat that doesn’t improve
foul mouth odor without hygiene as explanation
jaw pain
persistent nasal congestion
hoarseness or a change in voice that doesn’t go away

Question 4

What are the common nutrition impact symptoms for H&N Ca from: Radiation

Answer 4

Dysgeusia/ageusia
xerosomia
mucositis
odynophagia
dysphagia
thrush
increased/thick secretions
nausea
anorexia
anosmia

Question 5

What are the common nutrition impact symptoms for H&N Ca from: Chemo

Answer 5

dysgeusia/ageusia
mucositis
N/V
Diarrhea
Constipation
hyper/hypoglycemia
anorexia

Question 6

What are the common nutrition impact symptoms for H&N Ca from: CCRT

Answer 6

Dysgeusia/ageusia
xerosomia
mucositis
odynophagia
dysphagia
thrush
increased/thick secretions
anorexia
anosmia
N/V
Diarrhea
Constipation
hyper/hypoglycemia

plus increased needs, particularly if cisplatin is chemo agent

Question 7

What are the common nutrition impact symptoms for H&N Ca from: Immunotherapy

Answer 7

diarrhea
nausea
mucositis
anorexia
hyperglycemia

Question 8

What are the common nutrition impact symptoms for H&N Ca from: Surgery

Answer 8

dysphagia
odynophagia
xerostomia
dysgeusia/ageusia
increased/thick secretions
trismus
anosmia
nasal regurgitation
jaw pain/ pain when chewing

Question 9

how common is wt loss in H&N Ca?

Answer 9

75-80% of HNC have significant wt loss with 35-60% being malnourished at time of diagnosis

Question 10

how high are needs in N&N Ca patients?

Answer 10

often quite high due to inflammation and it can change often during treatment. Can go up to 35-40 kcal/kg, particularly with CCRT(cisplatin)

Question 11

how long can taste changes linger for patients?

Answer 11

although varied, it often takes 3 weeks to 2 months to resolve after treatment completion. It slightly depends on how big the treatment field is.

Question 12

what are some chronic challenges for H&N Ca patients?

Answer 12

xerostomia
dysphagia
oral thrush
dysgeusia
ageusia
strictures
dental issues
anorexia