H&N cancer Flashcards
what is H&N cancer
SCC lining of the upper air digestive tracts
thyroid cancer
-medullary
salivary galnd cancer
tonsillar cancer ass w HPV
larynx, oral cavity, oropharynx (including tonsil), nasopharynx and hypopharynx.
Mx of H&N cancer
surgery
then radiotherapy
RFs of H&N cancer
chewing or smoking tobacco, alcohol, chewing paan (betel nut) in oral cancers, drinking mate (tea like beverage), certain preserved foods and wood dust in nasopharyngeal cancer.
H&N cancer w viral aetiology
burkitts lymphoma nasopharynx kaposi non hodgkin oropharynx
Burkitt lymphoma and nasopharynx cancer - EBV
nasopharynx - Asian - epithelium lining the nasopharynx RFs - cooking salt cured fish and meat which releases notrosamines
Kaposi HIV - raised patches, which form nodules.
HHV-8
HIV-> non-hodgkins lymphoma, cervical cancer, kaposi
oropharynx - HPV 16
what is absolute risk reduction
(absolute survival benefit) is the difference between the event rate (deaths) in chemoradiotherapy group – event rate in radiotherapy group.
acute SEs of radiotherapy
3-6ms
pain, skin redness, nausea and fatigue accumulate over the 6 weeks of treatment.
what do u do before starting radiotherpay
SEs- pain mucositis
dietician review - nourishment is vital
SALT
Dental review is important as any decayed teeth should be removed before starting radiotherapy. This is because there is a risk of osteoradionecrosis, if teeth are extracted AFTER a course of radiotherapy (as the bone cells in the jaw have been damaged).
Smokers have increased toxicity with radiotherapy and response rates are not as good (due to hypoxia)
He will need an immobilization mask made to keep his head and neck still during radiotherapy so that the treatment can be delivered accurately. He will then have a planning CT scan with the mask on. He will be able to breathe and see through the mask. Occasionally some patients are claustrophobic, in which case lorazepam 1 mg ~ 1/2 an hour before treatment is soothing
