H/N Oncology Flashcards
What are the risk factors for H/N cancer
- cigarettes & alcohol use (synergistic)
- betal/pan
- OH
- diet
- HIV
- EBV
- HPV
- previous SCC
Where are oropharynx cancers
base of tongue
tonsil
soft palate
Where are oral cavity cancers
buccal mucosa
retromolar trigone
alveolus
hard palate
anterior 2/3 of the tongue
floor of mouth
lip mucosa
Clinically what are the red flags
- ulcer persisting more than 2 weeks despite removal of causation
- rolled margins, central necrosis
- speckled (erythroleukoplakia)
- cervical lymphadenopathy
- worsening pain
- referred pain
- weight loss
What features of cervical lymphadenopathy are red flags
- enlarged (>1cm)
- firm
- fixed
- tethered
- non tender
What sort of pain is a red flag
neuropathic
dysaesthesia
paraesthesia
Where may a patient get referred pain
ear
throat
mandible
What are the lymph nodes of the neck
What is the imaging used for suspected HN cancer
ct
How is staging done
TNM
t = tumour
n = nodes
m = metastases
What are the tx options for HN cancer
nil
surgery
radiotherapy
chemo radiotherapy
dual or triple modality
What is osteoradionecrosis
necrotic bone in previously radiotherapised field
What causes ORN
hypxoxia
hypocellular
hypovascularity
What is the threshold of radiation dose that is high risk
> 70 Gy
