Dysplasia and Oral Cancer 2 Flashcards
what are potentially malignant lesions
en route to becoming cancer
much more likely to become cancer
what lesions can be classed as potentially malignant lesions
lichen planus
oral submucous fibrosis
leukoplakia
erythroplakia
what is the rate of oral cancer in white lesions
under 4%
what is low grade cancer
easy to identify origin is squamous epithelium
architectural change in lower third
dysplasia may not be prominent yet
considerable amount of keratin production
stratification
basal layer surrounds tumour islands
well defined tumour islands
invasion pattern
what is high grade cancer
little resemblance to squamous epithelium
architectural change in upper third
considerable dysplasia
non-cohesive invasion pattern
abnormal mitotic figures
what is used to predict cancer diagnosis
degree of differentiation
what is carcinoma in situ
theoretical concept
cytologically malignant but not invading
abnormal architecture
full thickness
severe cytological atypia
mitotic abnormalities
what are the histological prognostic factors of cancer
pattern of invasion
depth of invasion
perineural invasion
invasion of vessels
with regards to pattern of invasion what is considered a better diagnosis
bulbous rete pegs infiltrating at same level better than widely infiltration small islands and single cells
what depth of invasion holds greater risk
> 4mm
what is invasion of vessels associated with
lymph node metastases
what is multi stage promotion
when both genetic and environmental changes are at play and genetic is triggered by environmental
what is field characterisation
high cancer risk in 5cm radius of original primary cancer which may be developing at the same time or later on
what is synchronous cancer
lesions arise at the same time in different places
what is metachronous cancer
lesions develop subsequent to original lesion but are from the same field change
what are the variables for cancer staging
site
size (T)
spread (N&M)
what is treatment of oral cancer based on
choice of patient and health prognosis
tumour location, size and nutritional status
what are the treatment options for oral cancer
surgery, radiotherapy and chemotherapy
what is the aetiology of lip cancers
sunlight
smoking
what is the behaviour of lip cancers
slow growth
local invasion
rarely metastasis to nodes
what does lower lip cancer present like
non-healing ulcer or swelling
what are the methods for oral cancer screening
HPV16 screening
toluidene blue
VELscope
photodynamic diagnosis
clinical judgement
what is the GDPs role in oral cancer in primary care
smoking cessation
alcohol reduction
healthy diet promotion
detection of lesions
referral
