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CMS2 > Cancer Symposium > Flashcards

Cancer Symposium Flashcards

1
Q

What are some of the risk factors for oral cancer?

A
  • Smoking
  • Alcohol
  • HPV (affects oropharyngeal/tonsil)
  • Immune suppression
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2
Q

How is dysplasia developed?

A

damage to the normal mucosa repeatedly

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3
Q

What is low grade /mild dysplasia limited to?

A

basal 1/3 of the mucosa

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4
Q

What is high grade / severe dysplasia limited to?

A

top 2/3 of the mucosa

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5
Q

What stages of cancer is no longer reversible?

A

Carcinoma In-situ and Invasive carcinoma

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6
Q

What does TNM stand for in the classification?

A

Tumour
Nodes
Metastases

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7
Q

What does symptom mean?

A

What the patient experiences

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8
Q

What does sign mean?

A

What we can see clinically

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9
Q

What are common signs of oral cancer?

A

White patches (leukoplaplakia)
Red patches (erythroplakia)
Speckled patches (spelled leukoplakia)
Ulcer
Lumps
Unexplained bleeding
Unexplained pain
Osteolytic lesion
Trismus (if cannot open more than 15mm)

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10
Q

What is known to be a high risk area for oral cancer and why?

A

Floor of the mouth
(toxins from tobacco/alcohol - gravity hold them in the floor of the mouth)

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11
Q

What is a common site for oral cancer?

A

Lateral border of the tongue

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12
Q

What appearance would a cancerous ulcer have?

A

big ulcer with raised rolled edge

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13
Q

After how long should persistent ulcers be treated with suspicion?

A

3 weeks

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14
Q

What does MDT stand for? What do they do?

A

Multi-disciplinary team - This is a team of health professionals who work together to decide on the best treatment and care for you. It can include: specialist head and neck surgeons. doctors who specialise in cancer drug treatments (medical oncologist)

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15
Q

What appearance does frictional keratosis have in the mouth?

A

Long occlusal line from cheek biting on buccal mucosa

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16
Q

What increased risk does a patinet with high grade/severe dysplasia have of developing oral cancer if untreated?

A

50%

17
Q

If an individual has been referred to oral surgery, how long should they expect a diagnosis/tx plan and 1st tx?

A

within 31 days and first tx within 62 days

18
Q

What assessment would you undertake for the primary site of cancer?

A
  • clinical assessment
  • radiographic
  • scans (MRI/CT)
19
Q

What scan would you take if you suspect bone involvement?

A

CT

20
Q

What assessment would you undertake for the regional lymph nodes of cancer?

A
  • clinical assessment
  • scans (MRI)
  • CT scan
21
Q

What assessment is routine to undertake for the distant metastases of cancer?

A

CT scan of the chest

22
Q

What is the measurement of limited mouth opening (trismus) that would be concerning and a red flag for oral cancer?

A

cannot open >15mm

23
Q

which lymph nodes tend to metastasis first in cancer?

A

submandibular lymph nodes

24
Q

How is lymph involvement treated?

A

Neck dissection

25
Q

How might a white patch with some ulceration on the side of the tongue be treated?

A

Wide local excision

26
Q

Why is it important to cut out the cancer and get 1cm around it (if possible?)

A

Due to microscopic disease spreading from the primary tumour into tissues that you cant see - it is done to reduce the risk of recurrent disease

27
Q

What is the treatment for regional metastases?

A

Surgery/neck dissection/reconstruction/radiotherapy/chemotherapy

28
Q

As radiotherapy affects the salivary glands, what effects can this have on the oral cavity?

A

Dry mouth

29
Q

What is osteoradionecrosis?

A

Occurs when radiotherapy affects the fibroblasts and endothelial cells in blood vessels (they tend to get thicker) and you get a condition called endarteritis obliterans (very small arteries in the tissue get blocked and so the bone cannot heal)

30
Q

What is the role of GDP in oral cancer?

A

promote oral health and oral cancer awareness
screening

31
Q

What are the effects of radio treatment?

A

Loss of teeth
Changes in soft tissues/hard tissues
Dry mouth
Caries risk increased
ORN

32
Q

What is the roll of a dentist in the long term follow up of Oral cancer pts?

A

Recurrent disease
Managing tooth loss (dentrure)
Managing changes in soft and hard tissues
Managing pt caries risk
Managing risk of developing osteoradionecrosis

33
Q

What is the period of follow up?

A

5 years
Every month for 1st year
Every 2months for 2nd year
Every 3 months for 3rd year
Every 4-6months for the 5th year

34
Q

How do we reduce patient delay?

A

Patient awareness
Public awareness
Populated screening
Targeted screening (high risk groups)
Opportunistic screening (dental appt)

35
Q

How do we reduce referral delay?

A

Clinician awareness
Guidelines

36
Q

What is populartion screening?

A

Whole of the at risk popilation

37
Q

What is opportunistic screening?

A

Dental check up

38
Q

What is targeted screening?

A

Those at the highest risk

CMS2 (24 decks)

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