Doctor Exam 2 Flashcards
Epidemiology of carcinoma of the nasopharynx
- Uncommon in US, more common in China and Chinese ethnicities
- Can happen in young people
- M:F 3:1
Etiology of carcinoma of the nasopharynx
- Carcinogens
- Genetics
- EBV
Defn of Nasopharynx
Transition zone between the nasal cavity and the oropharynx
Patterns of spread for carcinoma of the nasopharynx
Up to base of skull, down along the pharyngeal walls, nasal cavity
carcinoma of the nasopharynx travels through
directly of through involvement of the retropharyngeal LN
Carcinoma of the nasopharynx distant mets?
LN, Lung, bone and liver
Symptoms of carcinoma of the nasopharynx
Painless neck mass, nasal obstruction, ear infection, sore throat, neurological deficits,
Work up for carcinoma of the nasopharynx
Fibroptic exam, CT and MR, Chest scan, PET scan
Histology of carcinoma of the nasopharynx
Most common is squamous cell carcinoma
Standard treatment for carcinoma of the nasopharynx?
Radiation therapy w/wo chemotherapy
Treat LN level 2-5
Prescription dose for carcinoma of the nasopharynx
Initial volume to 40 Gy, Off-cord to 54, Boost to ~70
Carcinoma of the nasopharynx 5 yr survival?
60-70%
Epidemiology of Carcinoma of the Oropharynx
- 8000 cases/year
- M:F 4:1
- Usually seen in older patients but increase incidence in young people with HPV
Etiology of Carcinoma of the Oropharynx
Tobacco, alcohol, p53 mutation
Symptoms of Carcinoma of the Oropharynx
Otalgia, painless neck mass*, dysphagia, trismus, face numbness
Patterns of spread of Carcinoma of the Oropharynx
Typically a neck mass w/unknown origin, LYMPH NODES
work-up of Carcinoma of the Oropharynx
Direct laryngoscopy, CT, MR, PET, Dental eval
Histology of Carcinoma of the Oropharynx
Most common is squamous cell carcinoma
Treatment of Carcinoma of the Oropharynx
Early stage: Surgery and RT*
Late Stage: organ preservation with RT and maybe chemo
margin for tumor of Carcinoma of the Oropharynx
2 cm
Earl stage 5 yr survival of Carcinoma of the Oropharynx
70-80%
Epidemiology of carcinoma of the hypopharynx
Male, 60s or older, common recurrence, poor prognosis,
Etiology carcinoma of the hypopharynx
Tobacco, alcohol, iron deficiency
Most common tumor loc for carcinoma of the hypopharynx
pyriform sinus
symptoms of the carcinoma of the hypopharynx
Dysphagia, otalgia, painless neck mass, airway obstruction, hoarseness,
work up for the carcinoma of the hypopharynx
Direct laryngoscopy, CT, MR, PET
Treatment for carcinoma of the hypopharynx
Early stage: surgery plus or minus radiation
Late stage: Organ preservation w/ RT
radiation treatment for carcinoma of the hypopharynx
2 cm margin of primary tumor, bilateral cervical nodes, retropharyngeal nodes, supraclav nodes
Epidemiology of carcinoma of the larynx
9500 cases, 70 years old, more males, good prognosis
Etiology of carcinoma of the larynx
Smoking*, alcohol, occupational, prior radiation
Patterns of spread
Not as common to go to LN, Most glottis cancers arise from the free margin of the true vocal cord. Spreads to supraglottic and subglottic regions. Mets is uncommon but if it does, goes to lung and liver
Symptoms for carcinoma of the larynx
Hoarseness, vocal change
work-up for carcinoma of the larynx
Direct laryngoscopy, CT, chest x-ray, PET, fiberoptic, pulmonary function test
histology of carcinoma of the larynx
squamous cell carcinoma
early treatment of carcinoma of the larynx
early stage: tripping (remove w/o damaging the vocal cords) + RT
late stage: total laryngectomy, maybe RT
**Typically 3D planning
radiation prescription for carcinoma of the larynx
40 to all, 50-54 off cord, boost to 70
Epidemiology of breast cancer
more white women diagnosed, black women present with more advanced stages, 1/8 women will have, 1% of breast cancer patients are male
Estimated new breast cancer statistics?
about 250,000
Estimated deaths from breast cancer
about 40,000
Risk factors for breast cancer?
age, over weight, 1st degree relative, genetic mutations, Estrogen exposure, dense breast tissue,
Most common s/sx for breast cancer?
95% present with a non palpable, asymptomatic mass seen on a screening exam
Detection and diagnosis for average risk women for breast cancer?
40+ annual mammogram, self exam
20-39 clinical breast exam every 3 years, monthly self breast exam
detection and diagnosis for high risk
mammogram beginning at 30, annual breast MRI, genetic counseling, clinical exam yearly
Histology of breast cancer
20% non invasive
75-80% invasive
1-3% inflammatory
DCIS
WBI b/c it can move along the ducts
without treatment, about 30% will progress to invasive cancer
