Esophageal, Head and Neck, Thyroid

Question 1

Head and neck squamous cell carcinoma (HNSCC)

Answer 1

aggressive cancer with low survival rates in advanced stages

Question 2

Oral cavity site causes

Answer 2

sun exposure, HPV, paan (used by southeast Asians), intake of mate

Question 3

Oral cavity ages and risk

Answer 3

Rare in persons younger than age 40, risk of metastasis is great, only about 50% live longer than 5 years

Question 4

Nasopharynx causes

Answer 4

Epstein-Barr virus infection
occupational exposure to wood dust
consumption of certain preservatives or slated foods

Question 5

Nasopharynx most common in

Answer 5

Chinese ancestry

Question 6

Oropharynx causes

Answer 6

Poor oral hygiene
HPV infection
use of mouthwash with high alcohol content

Question 7

Paranasal sinuess and nasal cavity

Answer 7

Industrial exposures, such as wood or nickel dust inhalation

Question 8

Hypopharynx causes

Answer 8

Plummer-Vinson syndrome = rare disorder that results from iron and other nutritional deficiencies with severe anemia

Question 9

Larynx causes

Answer 9

Exposure to airborne particles of asbestos

Question 10

Parotid and salivary glands causes

Answer 10

Radiation to head and neck. Diagnositc X-rays or RT for noncancerous conditions or cancer. Cancer is rare. Surgery is curative.

Question 11

Esopahgeal cancer develops in -

Answer 11

middle or lower third of esophagus. most common types.

Question 12

Esophageal ages

Answer 12

More common in > 50 years old and males

Question 13

Barrett’s esophagus (BE)

Answer 13

premalignant condition associate with esophageal cancer - COX-2 is overexpressed

Question 14

Thyroid cancer

Answer 14

TSH from pituitary causes thyroid gland to produced thyroid hormones and to realse thyroglobulin. Papillary tumors are most common type

Question 15

Thyroid cancer distant metastasis

Answer 15

uncommon, but lung and bone are the most common sites

Question 16

Thyroid meds

Answer 16

Synthroid, Levoxyl, Unithroid needed to keep TSH levels low

Question 17

Thyroid surgery and RDI

Answer 17

Thyroidectomy may be used or RDI to destroy cancerous cells that remain after surgery. Low iodine diet needed about 2 weeks before RDI treatment

Question 18

Head and Neck vitamins

Answer 18

increase intake of Vitamin D3, A and C, zinc
EGCG in green tea beneficial

Question 19

Cisplatin side effects

Answer 19

N/V, altered taste, changes in renal fxn, diarrhea

Question 20

Bleomycin and methotrexate side effects

Answer 20

nausea, vomiting, anorexia, stomattitis

Question 21

Pilocarpine

Answer 21

may be used as a saliva substitute for xerostomia

Question 22

Herbs

Answer 22

Avoid echinacea and St John’s wort with cyclosporine or methotrexate
Curcumin = powerful inhibitor of COX-2 expression
L-carinite somtimes used to decrease toxicity from agents such as bleomycin
Zinc supplementation helps in managing mucositis after radiation