Head and Neck CA Flashcards
What is the primary form of cancer seen in the oral cavity, pharynx, and larynx
SCC
What are the major risk factors for oral cancer
Tobacco
Alcohol
HPV
What type of tobacco use increases risk for head and neck cancer
Cigar and pipe smoking
*Chewing tobacco -> mouth cancer
Which types of HPV put people at greater risk of head and neck cancer
16
*Generally not smokers or drinkers
What is the major cause of nasopharyngeal cancer in the US
EBV
Where is nasopharyngeal cancer more commonly seen
southern china
What nut is independently carcinogenic and can cause a major increase in oral SCC
Betel Nut
What is a clinical presentation of cancer in the oral cavity
non-healing mouth or lip ulcer/masses
loosening of teeth
ill fitting dentures
What sign do those with carcinoma of the tongue have
neck mass
When is supraglottic cancer generally diagnosed
once in late stage because of airway obstruction or sever lymphadenopathy
How do you diagnose head and neck cancer
biopsy with immediate referral to EENT
What does an panendoscopy include
laryngoscopy
bronchoscopy
esophagoscopy
What are the different categories of neck masses
congenital
infectious / inflammatory
malignant
What are the types of congenital neck mass
branchial cleft cyst
thyroglossal cleft cyst
vascular abnormalities
What age range has neck masses that are most commonly inflammatory or congenital
0-16 years
After what age are most neck masses malignant
40
What is the first imaging study for neck masses
CT
What type of bx is used for neck mass diagnosis
FNA
Where are occult primaries commonly found
base of tongue
tonsil
hypopharynx
nasopharynx
Where are the most common metastatic sites of head and neck cancer
lung
liver
bone
Where are second primary sites for head and neck cancer
head and neck
lung
esophagus
What is the TNM system
Tumor: Extent of primary tumor
Nodes: Regional nodal involvement
Mets
What causes T staging to increase
as the tumor grows / becomes fixed to other structures or invades other structures
What is the range for tumor staging
TX
T0
TIS
T1-T4
What is the range for nodal staging
NX
N0- N3
What is included with the nodal staging
Number
Location
Size
What is the range for mets staging
M0-M1
How are stage 1 nd 2 head and neck cancer generally treated
surgery / radiation
What is the gold standard for treating locally advanced head and neck cancer
Chemoradiation
What is the overall survival of head and neck cancer
60%
Which type of head and neck cancer has the better prognosis
HPV related
What are premalignant lesions seen with head and neck cancer
leukoplakia
Erythroplakia
What is leukoplakia
White patch on oral mucosa that cannot be scraped off
What is erythroplakia
red patch on the oral mucosa
What type of cancer generally develops from erythroplakia
invasive carcinoma
What is hairy leukoplakia
EBV induced lesion
NOT premalignant
painless white plaque
What is the most common site for nasal/paranasal cancer
maxillary sinus
What are the risk factors for nasal/paranasal cancer
occupational exposure
tobacco
What is the most common pathogen for nasal/paranasal cancer
SCC
How to people commonly present with nasal/paranasal cancer
pain
nasal obstruction
cranial neuropathy
epistaxis
how do you diagnose nasal/paranasal cancer
biopsy
Do nasal/paranasal cancers involve lymph nodes
not usually
*but generally have bony invasion
What is the common cause of death with nasal/paranasal cancer
Local invasion
*Paranasal has better prognosis that nasal
Where are salivary gland tumors most commonly found
parotid gland (mostly bengin)
*If tumors are found in other glands- likely to be malignant
