4.3 Treatment for Cancer

Question 1

What are the treatments for cancer? (4)

Answer 1

• Surgery
• Radiation
• Surgery + Radiation
• Chemotherapy

Question 2

How many treatments of radiation does a patient typically receive?

Answer 2

4-6 weeks of daily treatments

Question 3

A radiation oncologist prescribes a certain number of ________ to be directed at the tumor site

Answer 3

“rads”

Question 4

In regards to radiation, what are the types of yeast infection? (2)

Answer 4

Thrush

Vaginal infections

Question 5

Why is chemotherapy used?

Answer 5

Used to decrease the size of tumors or to prevent mets after resection

Question 6

What are the big disadvantage of chemotherapy?

Answer 6

Makes people feel sick

Question 7

In regards to surgery, what is the microflap?

Answer 7

elevating flap of epithelium

Question 8

How is a cordectomy done?

Answer 8

Incision through neck

Question 9

What symptoms might justify a cordectomy?

Answer 9

• Breathy, weak, hoarse voice

Question 10

What are the two types of partial laryngectomy?

Answer 10

• Hemilaryngectomy

- Vertical partial laryngectomy

Question 11

What is removed during a partial laryngectomy?

Answer 11

Removal of at least half of thyroid, arytenoids, vocal folds, and the membranous tissues on involved side

Question 12

What would voice sound like after a partial laryngectomy?

Answer 12

Hoarse/breathy vocal quality

Question 13

What might you see with a partial laryngectomy?

Answer 13

May see dysphagia (usually resolves)

Question 14

Why would someone get a supraglottic laryngectomy?

Answer 14

Management of tumors confined to the epiglottis and false vocal folds only

Question 15

What is removed during a supraglottic laryngectomy?

Answer 15

True vocal folds not affected, so vocal quality is also likely not affected

Question 16

What happens during a near total laryngectomy? (3)

Answer 16

Removal of the entire larynx

Only a narrow strip of tissues left on the contralateral side to connect the trachea to the pharynx

A speaking shunt is created for voice production

Question 17

What is created as a result of a patient getting a near total laryngectomy?

Answer 17

• Tracheostoma

Question 18

Someone must _________ tracheostoma for voice production

Answer 18

occlude

Question 19

What is a near total laryngectomy associated with?

Answer 19

associated with dysphagia

Question 20

What happens during a total laryngectomy?

Answer 20

removal of the entire larynx, hyoid bone to upper tracheal rings

Question 21

What is created for breathing after a total laryngectomy?

Answer 21

Tracheostoma for breathing

Question 22

How is speech created after a total laryngectomy? (3)

Answer 22

Speech through tracheal esophageal puncture (TEP), artificial larynx, or esophageal speech (ES)

Question 23

What are the physiological differences of the nose after laryngectomy? (3)

Answer 23

• Alternate breathing channel, no longer filters and warms air
• Can’t smell, sniff, or blow the nose
• Taste is often affected

Question 24

What are the physiological differences of the mouth after laryngectomy? (2)

Answer 24

• Eating and drinking are reestablished orally after the removal of the N-G tube
• Eating and swallowing problems reported in over 50% (important to know)

Question 25

In regards to the physiological differences of the tongue after larynectomy, ________ from the base of the tongue are severed during surgery, with the removal of the _______ ________, and subsequently sutured to the ________.

Answer 25

Fibers

Hyoid bone

Pharynx

Question 26

In regards to the physiological differences of the tongue after laryntectomy, some tongue fibers are ________, resulting in a __________ of the base of the tongue.

Answer 26

Excised

Shortening

Question 27

Surgical damage to the __________ ________ affects the tongue.

Answer 27

Hypoglossal Nerve (XII)

Question 28

What are the physiological differences of the esophagus after laryngectomy?

Answer 28

In surgery, some fibers within the PE segment are cut and some may be removed. Nerve damage may occur.

Question 29

What are the respiratory difficulties after laryngectomy? (7)

Answer 29

• Cough is lost
• Lifting is impaired
• Filtering, humidfying and warming of air is lost
• Mucous plugs
• Crusting
• Stoma sensitivity
• Decreased oxygenation

Question 30

What are the treatment options for improving hydration? (6)

Answer 30

• Increased fluid intake
• Stoma covers
• Air filters
• Humidification regimen
• Saline washes of stoma
• Suctioning

Question 31

What does increased fluid intake?

Answer 31

Decreases thickness of secretions

Question 32

What are the advantages of stoma covers? (2)

Answer 32

Disposable

Washable

Question 33

Where do you place air filters? (2)

Answer 33

• in rooms

- in HVAC system

Question 34

What is the humidification regimen? (2)

Answer 34

Steam

Decrease caffeine, alcohol, and diuretics

Question 35

What does suctioning do to help with improving hydration?

Answer 35

Taking out extra food and liquid in that place

Question 36

How should we handle the social factors that have been affected by the laryngectomy? (5)

Answer 36

• Help pt. conceal the tracheostoma
• Amplification possible
• Telephone particularly difficult
• Don’t let spouse get into habit of speaking for patient
• Hobbies limited or eliminated -water sports, singing, playing wind or brass instruments - encourage patient in related areas

Question 37

What are the emotional fears after a laryngectomy? (4)

Answer 37

• Depression, loss of self-esteem, feeling of inferiority and lack of motivation common
• Fear of return of cancer and/or death
• Patients most at risk for emotional problems
• Laryngectomy clubs and support groups

Question 38

What complications can happen after a laryngectomy?

Answer 38

fistulae develops