Core principles Flashcards

1
Q

what is the main pathology

A

SCC (tough mucosal layer = protection)

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2
Q

what is the only site to have a different staging system

A

nasopharynx

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3
Q

what is the histological types

A

SCC
benign
lymphomas

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4
Q

aetiological factors

A

excessive alcohol
smoking

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5
Q

when is prophylactic irradiation common

A

when the tumour is midline, bilateral spread is common due to the lymphatic channel cross over
- larger fields are needed

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6
Q

what is the prophylactic dose

A

54Gy in 30

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7
Q

what happens if the patient has a poor nutritional status

A

low QOL
malnutrition = deteriation

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8
Q

what is the pre-treatment for dental

A

identify mandible invasion/obstruction
orthopantomogram
look at healthy teeth
unhealthy teeth need to be removed, dentures may be needed

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9
Q

what is the nutrition pre-treatment

A

PEG

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10
Q

what is the SLT role before treatment

A

understanding prior surgery
regain speech or re-train breathing for trachestomy
swallowing exercises, PEGs weaken these muscles

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11
Q

what are the considerations for multi-modality

A

functional outcomes
cosmetic outcomes
survival rates
patient choice
late stages might need all options

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12
Q

what is the early stage treatment

A

surgery and RT

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13
Q

what is the late stage treatment

A

multimodality

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14
Q

what are the SE from surgery

A

face disfiguration
speech changes
trismus
aspiration
nasal regurgitation
oral regurgitation
poor wound healing
loss of taste, smell
difficulty chewing
drooling, pocketing of food and fluid

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15
Q

why is IV contrast given

A

to visualise LN, and tumour delineation

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16
Q

describe patient position

A

neck needs to be in a straight neutral position, which is straight at the C-vertebrae
bear claws + hand supports
indexed = reproducibility
shoulders dropped, greater length from the neck
knee support relieves back pressure

17
Q

what is mucositis and how can it be managed

A

inflammation of the OC, cells become damaged at a greater rate than can be replenished
ulcerated, deep and persistent pain

mouthwash with opoid for T3/T4
baby toothbrush
high fluoride toothpaste and mouthwash
saline: keep oral cavity clean
gargle paracetamol 30 min before treatment and food

18
Q

how to manage loss of taste

A

swap metal cutlery for other forms
bitter and saltier foods tend to go first
metallic taste
eat small meals regularly
keep trying foods

19
Q

how to manage dysphagia

A

avoid sharp and spicy foods
blander foods
high calorific foods

20
Q

what is xerostomia and how is it managed

A

dry mouth
sticky thick saliva
parotid = dose constraint
regular sips of water to keep mouth moist
artificial saliva
nebuliser

21
Q

how to manage skin reaction

A

moisturise regularly
stay out of the sun
electric razor, more favourable
avoid makeup in that area
MDS = non absorbent, hydrocolloid gels

22
Q

cisplatin infusion

A

weekly or 3 weekly infusion
if platinum intolerant then cetuximab is used
can be neoadjuvant

chemo heightens reactions