Cancers Flashcards
How may thyroid cancers present?
Hypo/ hyperthyroidism is rare. Usually in middle aged women.
Often asymptomatic lumps (node mets) or goitre
Sometimes dysphagia, voice change, strangling feeling
What is the most common cancer of the pharynx and larynx?
Squamous cell carcinoma
Where do most squamous cell carcinomas occur
oral cavity, larynx and oropharynx (few in hypopharynx or nasopharynx
What are the risk factors for squamous cell carcinomas of the pharynx/ larynx
- alcohol
- smoking
- chewing betel quid (paan)
- older age
- men more than woman
- EBV infections
- certain inhalants (hardwood)
- sunlight or sunbed increase lip cancer risk
- HPV
What is leukoplakia and erythroplakia
Leuko= white lesions in moth and tongue
eyrthro= red, inflammed areas, often ulcerated
They indicate mouth cancer
How may pharyngeal cancers present?
- dysphagia
- odynophagia (painful swallowing)
- lump (nodal mets)
- weight loss
- otlagia (painful ear) in otherwise normal ear
How may laryngal cancers present?
dysphonia cachexia globus (lump in throat) cervical lymphadenopathy dysphagia
How are head and neck cancers investigated?
CT or MRI
Biopsy with endoscope- usually core biopsy for histology and sometimes aspirates
TNM staging
How are early and late stage tumours managed?
If early: chemo and radio therapy
If late: surgery and neoadjuvant chemo
Who from the MDT may be involved in head and neck cancer care
Radiologist, ENT surgeon, cancer support nurses, pathologists, plastic surgeons, dieticians, speech and lang therapists
What structures and layers around found in the neck (and so can be an origin of a lump)?
- skin
- fat
- fasica
- submanibular gland
- platysma
- muscles
- thyroid
- lymph nodes
- arteries and veins
- nerves
- cartilage
What infections may cause lymphadenopathy?
- staph
- TB
- EBV
- HIV
- cytomegalovirus
- herpes
- strep
What non- infective diseases may cause lymph adenopathy?
sarcoidosis, leukaemia, lymphoma, metastasis
What are the red flags for neck lumps?
- night sweats
- weight loss
- fatigue
- itching
- fever
- breathlessness
- bruising
what is the most common type of thyroid cancer?
Papillary adenocarcinoma (70-80%) and then follicular adenocarcinoma
