H&N Cancer

Question 0

Laryngeal cancer is ….. of all H&N cancers

Answer 0

1/5

Question 1

Laryngeal cancer is largely a …… disease

Answer 1

locoregional disease

Question 2

Laryngeal cancer is usually cancer of the…

Answer 2

squamous cell Carcinoma (SCC)

• squamous cels form part of the epithelium
• presents as thickening of epithelial surface

Question 3

‘differentiated’ means?

Answer 3

how well you can see the cancer
poorly, moderately or well differentiated

cancers that are more differentiated usually associated with better prognosis

Question 4

TNM classification

Answer 4

used to define extent and severity of cancer and used to assist treatment planning

Question 5

T

Answer 5

location of primary tumour
T0- no evidence of tumour
T4- massive tumour in structure examined

Question 6

N

Answer 6

lymph nodes - involvement in immediate region
N0 - no nodal involvement
N3 - nodal metastes

Question 7

M

Answer 7

metastasis - tumour spread (secondary site)
M0- no metastates
M1 - distant metastasis present

Question 8

What is the typical head and neck cancer population?

Answer 8

• middle aged (30-70)
• male:female - 8:1
• heavy smoker and moderate to heavy drinker

Question 9

associated issues for head and neck cancer population

Answer 9

• education levels
• literacy skills
• visual and hearing impairments
• personal care

Question 10

presenting sign and symptoms (H&N)

Answer 10

• vocal changes - hoarseness (most common symptom)
• cough sore throat
• pain on swallow
• dysphagia
• chest infection
• wieght loss
• sore in the mouth that wont heal
• blackened nose
• Trismus
• Halitosis (bad breath)
• Dysneoa and stridor
• Otalgia (pain in ear)
• Visible tissue changes

Question 11

H&N Cancer Tx choices

Answer 11

Non-surgical

• radiotherapy
• chemotherapy
• chemoradiotherapy

Surgical

• laser surgery
• surgery +/- reconstruction

Question 12

factors that influence the H&N Tx choices…

Answer 12

• tumour site, size and type
• Pt suitability, health and social factors
• Radical/curative tx or pallitation
• Is the Tx worse than the disease?
• Historical trends: Surgery (US) radiation (UK)
• research evidence
• personal preference/ skills of surgeon/ equipment/ support teams available

Question 13

Radical Tx

Answer 13

• aim is to achieve cure, therefore complex. time consuming and unpleasant tx are considered to be justified

Question 14

Palliative Tx

Answer 14

• aim is to alleviate symtoms, so intervention should not produce side effects worse than the cancer is causing

Question 15

Radiotherapy (XRT)

Answer 15

• XRT causes damage to DNA in both normal and tumour cells
• cancer cells divide more frequently and less efficiently - therefore the chances of radiation killing a malignant cell are greater than for a normal cell

Question 16

Most common form of XRT

Answer 16

External Beam radiotherapy (also referred to as teletherapy)

- beam of radiation dorected at part of body with tumour