H + N Flashcards
1
Q
Features of head and neck cancers
A
Begin in mucosal surfaces lining the cavities of the head/neck
- mostly SCC
- also salivary glands
2
Q
Risk factors for H+N cancers
A
Lifestyle - smoking - alcohol - betel nut Viruses - HPV - EBV Occupational - wood dust - asbestos - formaldehyde
3
Q
Symptoms of head and neck cancer
A
Depends on location of tumour
Often involved lymph nodes are first noticed by patients
Advanced cancers cause difficulty breathing, eating and speaking
4
Q
Ix for H+N cancers
A
Refer for 2WW USS and FNA CT/MRI Panendoscopy and biopsy PET scan P16 staining
5
Q
Spread of H+N cancers
A
Local invasion Lymph nodes Other organs - primarily lung - bone, liver and brain
6
Q
Mx of H+N cancers
A
MDT - ENT, maxillofacial, dental, dietician, salt, CNS
Radical or palliative
- depends on tumour features and patient fitness
Surgery
- early tumours - laser/robotic surgery, may need flap reconstruction, laryngectomy
- neck dissection
- depends on histology
- may need adjuvant radiotherapy
7
Q
Surgical mx of H+N cancers
A
Oropharynx - early tumours - T1/T2 transoral resection + neck dissection Larynx - T1/T2 - microlaryngeal laser surgery - T4a - laryngectomy - recurrent cancer - salvage laryngectomy Hypopharynx - laser resection for very small tumours - laryngopharyngectomy Salivary glands - excision - parotid - partial vs total parotidectomy - submandibular - excision of gland - neck dissection in N+ disease - N0 - selective neck dissection Thyroid - hemi-thyroidectomy or total thyroidectomy - neck dissection for N+ disease
8
Q
Radiotherapy side effects
A
Skin reaction Mucositis Dry mouth Difficulty swallowing Osteonecrosis Secondary cancers
