H&N21 - Thyroid Gland and H&N Cancers

Question 1

3 features of H/N cancers

Common Locations x3
Type of Cancer
Risk Factors x6

Answer 1

1. ) Common Locations - oral cavity, larynx and oropharynx
   - rarer in nasopharynx and laryngopharynx
2. ) Type of Cancer - squamous cell carcinoma (>90%)
   - most cancers begin in squamous mucosal surfaces
3. ) Risk Factors
   - main: heavy alcohol and tobacco use
   - infection: EBV (nasopharyngeal), HPV (oropharyngeal)
   - demographic: age (60-70), gender (male)

Question 2

4 clinical manifestations of H/N cancers

Answer 2

1. ) Painful Mucosal Ulceration or Lesion - in oral cavity
   - common initial manifestation
2. ) Recurrent Laryngeal Nerve Lesion
   - leads to hoarseness of voice, dysphagia

3.) Non-Otological Otalgia - ear pain but normal ear examination

4. ) Cervical Lymphadenopathy (Neck Lump)
   - due to cervical lymph node metastases
   - persistent (>6 weeks), fixed, hard, rapidly growing

Question 3

Diagnosis and treatment of H/N cancers

Clinical Examination
Biopsy
Imaging
Endoscopy
Staging
Treatment

Answer 3

1.) Clinical Examination - thorough H/N examination

2. ) Biopsy - of lesion or neck lump
   - fine needle aspiration for cytology or a core biopsy
3. ) Imaging - CT or MRI
   - evaluates extent of the primary cancer and involvement of other structures and lymph nodes
4. ) Endoscopy - cancers involving the nasal cavity, pharynx, and larynx
   - allows direct visualisation and enables biopsy

5.) Staging - TNM staging

6. ) Treatment
   - early stage can be treated by surgery or radiotherapy
   - advanced cancers may require surgery and adjuvant chemotherapy