Chapter 21: H&N Cancer Flashcards
T/F: H&N cancer is twice as common in men than women
True
What are the 3 parts of the pharynx?
- Nasopharynx - behind nose
- Oropharynx - behind mouth
- Hypopharynx - throat
______ is thought to cause ~70% of oropharyngeal cancers
HPV (specifically HPV-16)
What are 8 presenting symptoms of H&N cancer
- Unintended wt loss
- Pain/difficulty swallowing
- Loose teeth
- Sore that won’t heal in mouth
- Double
- Foul breath
- Earache
- Blood in saliva
Also hoarseness in voice, sore throat that doesn’t improve, persistent nasal congestion, trismus
Nutrition, _______ and ______ evaluations are recommended for all H&N patients
Speech
Swallow
Nutrition impact symptoms are likely to develop around week _________ of H&N radiation
3
Side effects of radiation from H&N cancer that are not typically d/t chemo (5)
Xerostomia, thick secretions/saliva, odynophagia/dysphagia, Anosmia, Thrush
________ + ________ treatment regimen for H&N cancer will increase metabolic needs
Cisplatin concurrent w/ radiation
Difference between proton beam radiation & intensity modulated radiation, especially w/ H&N cancer
Proton beam radiation uses protons instead of x-rays. These typically have fewer side effects and decrease need for radiation
Factors to consider w/ H&N radiation that may increase need for a feeding tube
Bilateral neck radiation
Size of the treatment field
How often to manage pt’s weight & NIS for H&N radiation
Weekly
If not possible get nursing involved to help
When is laser surgery used for H&N cancer?
Early stage, especially of the larynx
What is TORS?
Transoral robotic surgery
Treats oral or throat cancer. Arms of the robot are places inside of the pts mouth
ERAS/immunonutrition supplements for H/N cancer post-op?
Recommend both, typically requiring short-term EN
Kcal needs may be as high as _______ - _______ kcal/kg after completing a course of cistplatin + radiation
35-40 kcal/kg
Weight loss during H&N treatment has been correlated with (4) and may help to determine if they need a feeding tube
- BMI > 25
- pharygeal, orocavity, or supraglottic (above) tongue site
- stage 3 or 4 disease
- Multimodal treatment regimen
Nutrition intervention for patients with HNC cancer should start ___________
Before treatment begins
Foods best tolerated w/ taste changes for H&N
Neutral tasting foods high in kcal & protein
Foods best tolerated w/ mucositis & thrush (3 components)
Low acid, smooth textured, very moist
Some H&N pts may be at risk for aspiration of oral secretions. Critical to receive eval by SLP. 3 signs to monitor for
- Coughing w/ oral intake
- “Froggy” voice
- Fever
T/F: Thrush, dysgesusia, xerostomia are both possible short and long term challenges of H&N survivors
TRUE
