Cancer & Larygectomy

Question 1

Tobacco products kill an estimated:

Answer 1

5 million+ people each year

Question 2

Second hand smoke kills an estimated

Answer 2

600,000 people each year

Question 3

Laryngeal cancer occurs in _________ Americans per year and causes _________ deaths

Answer 3

15,000+ occurrences and 4,800 deaths

Question 4

90% of laryngeal cancers are:

Answer 4

Squamous cell carcinomas which are related to smoking

Question 5

Types of laryngeal cancers (3) and percentage by type:

Answer 5

Supraglottic 35% (false VF, arytenoids, etc)
Glottic 65% (true VF)
Subglottic 5%

Question 6

Risk of secondary tumors, especially if patient continues to smoke is

Answer 6

25%

Question 7

Overall 5 year survival rate for glottic cancer:

Answer 7

85%

Question 8

Overall 5 year survival rate for supraglottic cancer:

Answer 8

55%

Question 9

Cancer stages are based on (5):

Answer 9

>Location of primary tumor
>Tumor size (T)
>Lymph node involvement (N)
>Cell type & tumor grade
>Metastasis (M)

Question 10

Primary Tumor (T): TX

Answer 10

Primary tumor cannot be evaluated

Question 11

Primary Tumor (T): T0

Answer 11

No evidence of primary tumor

Question 12

Primary Tumor (T): Tis

Answer 12

Carcinoma in situ (early cancer not spreading to neighboring tissue)

Question 13

Primary Tumor (T): T1-4

Answer 13

Size and/or extent of primary tumor

Question 14

Regional Lymph Nodes (N): NX

Answer 14

Regional lymph nodes cannot be evaluated

Question 15

Regional Lymph Nodes (N): N0

Answer 15

No regional lymph node involvement

Question 16

Regional Lymph Nodes (N): N1-3

Answer 16

Involvement of regional lymph nodes (number and/or extent of spread)

Question 17

Distant Metastasis (M): MX

Answer 17

Distant metastasis cannot be evaluated

Question 18

Distant Metastasis (M): M0

Answer 18

No distant metastasis (cancer hasn’t spread)

Question 19

Distant Metastasis (M): M1

Answer 19

Distant metastasis (cancer has spread)

Question 20

Cancer staging: Stage 0

Answer 20

Tis, N0, M0

Question 21

Cancer staging: Stage I

Answer 21

T1, N0, M0

Question 22

Cancer staging: Stage II

Answer 22

T2, N0, M0

Question 23

Cancer staging: Stage III

Answer 23

> T3, N0, M0

>T1-3, N1, M0

Question 24

Cancer staging: IVA

Answer 24

> T4, N0, M0
T4, N1, M0
Any T, N2, M0

Question 25

Cancer staging: IVB

Answer 25

Any T, N3, M0

Question 26

Cancer staging: IVC

Answer 26

Any T, Any N, M1

Question 27

Oral cancers involve any/or all of these structures (5)

Answer 27

``` >Tongue >Floor of mouth >Mandible >Maxilla >Palate ```

Question 28

Head and neck cancer treatments (3)

Answer 28

>Radiation >Chemotherapy >Surgery

Question 29

Side effects of radiation therapy w/ or w/o chemotherapy

Answer 29

Xerostomia, inflammation, pain, fibrosis, alopecia, reduced taste, anorexia, decreased ROM of tongue/jaw, reduced pharyngeal constriction

Question 30

Types of Partial laryngectomies (5)

Answer 30

``` >Supra glottic laryngectomy >Supracricoid laryngectomy >Hemilaryngectomy >Cordectomy >Subtotal laryngectomy ```

Question 31

Total laryngectomy includes:

Answer 31

>Removing the larynx >Resection hyoid bone, pre-epiglottic space, thyroid, circoid, tracheal rings) >Trachea sutured to incision of the neck >Constrictor muscles are reconstructed to support the reconstruction of the trachea

Question 32

Types of communication post-laryngectomy (3)

Answer 32

>Electrolarynx >Esophageal Speech (ES) >Trachesophageal Puncture Prosthesis (TEP)

Question 33

Electrolarynx Communication

Answer 33

>Very robotic | >Voicing machine place at the neck under the chin while speaking

Question 34

Esophageal Speech

Answer 34

>Inhaling air into the esophagus | >Speaking while burping

Question 35

Trachesophageal Puncture Prosthesis (TEP)

Answer 35

``` >Need respiratory support >Cognition of >>>Occlusion of the stoma >>>Cleansing of the prothesis >Adequate vibratory PE segment ```

Question 36

Reasons for inserting tracheostomy tubes

Answer 36

Obstruction of the airway (post surgery) or provisional respiratory care

Question 37

How is a tracheostomy is done?

Answer 37

Tubes are inserted into the trachea via surgical incision between the 3rd and 4th tracheal rings

Question 38

What comprises a tracheostomy tube (3)?

Answer 38

>Outer cannula (holds site open) >Inner cannula (breathing tube) >Obturator (smooth tip for initial insertion)

Question 39

Types of tracheostomy tubes (3)

Answer 39

>Cuffed (prevents aspiration, used with ventilators) >Cuffles (risk of aspiration, assisted breathing and secretion removal, for long term use) >Fenestrated (smaller, short term, use for wearing and decannulation)

Question 40

Passy Muir and Provox are?

Answer 40

Speaking valves used as voice treatment for ventilator dependent or trached patients