H&N Cancers Flashcards
What type of cancer are head and neck cancers
Squamous cell carcinomas
What are the risk factors for HNC
Heavy alcohol
Tobacco use
EBV infection - nasopharyngeal cancers
Chewing betel quid/Paan - common in Asian populations
Long term exposure to sunlight or sunbeds
HPV infection - oropharyngeal cancers
Irradiation exposure - thyroid cancers
Men affected more than women
What are common manifestations of HNC
Asymptomatic neck lump
Unexplained painful and/or mucosal ulceration of lesion within oral cavity, e.g. leukoplakia, erythroplakia
Unexplained hoarseness of voice, dysphagia or odynophagia
Otalgia in otherwise normal ear
Cervical lymphadenopathy due to cerivcal lymph node metastasis
How are H&N lumps examined
Imaging to show extent of primary cancer, involvement of other structures and lymph nodes
Endoscopy to visualise cancer and for biopsy
Neck lump biopsy under USS guidance
How are HNC treated
Early stage cancers treated using surgery or radiotherapy
Advanced cancers require surgery and adjuvant chemotherapy
Surgical techniques depend on cancer type and extent of disease spread
Name some clinical features of oral cavity cancers
Usually SCC seen as non-healing ulcer or lesion on lip/tongue/other structure in oral cavity
Risk factors: smoking, alcohol, HPV, long term sunlight exposure
Presentation: lump, pain, fixation of the tongue, dysphagia, odynophagia
Name some clinical features of pharyngeal cancers
Presentation: lump, pain (possibly referred), dysphagia, odynophagia, weight loss
Often require feeding assistance with gastronomy tubes
How do laryngeal cancers present
Dysphonia
Dysphagia
Referred otalgia
Globus
Neck lump
Weight loss
Cachexia
Name some clinical features of thyroid cancers
Found in midline below thyroid cartilage
Presentation - lump, compressive symptoms, voice change
Unlikely to have changes in thyroid levels
Treatment: thyroidectomy, radioactive iodine, radiotherapy, chemotherapy
