Head and Neck Cancer Flashcards
Possible causes of cancer
Tobacco, HPV, poor oral hygiene, consumption of certain processed foods, radiation exposure, mechanical irritation
What is the biggest cause of head and neck cancer?
tobacco
What percentage of individuals with HNC experience some form of malutrition?
30-50%
Why do HNC individuals report weight loss?
difficult (coughing/choking), painful to eat
What is cachexia?
a state of ill health, malnutrition and muscle wasting
What is annorexia?
loss of appetite
Is annorexia always “annorexia nervosa”?
no, the “nervosa” refers to the mental illness
What are possible side effects of HNC?
anorexia, nausea, constipation, fatigue, weight loss
Who is on the MD team for patients with HNC?
head and neck surgeon, radiation oncologist, medical oncologist, dentist, social worker, rehab specialists, dietician
How are HNCs diagnosed?
radiography ,CT and MRI imaging, endoscopy, biopsy, histopathologic confirmation, physical exam
What is a histopathology?
the pathology lab find out what kind of cell and these specialists stage the cancer as well
What is the TNM system?
tumor (size), node (spread to lymph nodes; number), metastasis (spread to other organs)
What is the number scale for tumors?
1-4
What is the number scale for nodes?
1-3
What is the number system for metastasis?
0-1
What is the most common organ to which the HNC metastasizes?
lungs
When do you use a radical neck dissection?
when the lymph nodes are especially affected
What kinds of surgery are there?
resection or removal
When do they use flaps post surgery?
to replace lost tissue
What is the kind of prosthesis used post-surgery in HCN patients?
to construct artificial dental or facial parts
T/F Many ENTs are also board certified in plastics
T
When would they rebuild the mandible?
during surgery
Depending on the HCN involvement, what might a patient have to have?
tracheotomy, gastrostomy, laryngectomy
What is a laryngectomy?
the larynx is taken out and the airway is reconstructed to a stoma site
What is external beam radiation?
aims high energy radiation at the tumor site (older practice)
What is intensity-modulated radiation therapy?
more effective doses of radiation delivered to the tumor while hitting less healthy tissue around the tumor
Why can they get away with lower doses or more confined RT?
surgical robotic surgery and chemo are better now
What is internal radiation or brachytherapy?
implanting small pellets or rods containing radioactive material into the cancer site
What is proton therapy?
beam of protons aimed at tumor site
What are some side effects to RT?
salivary glad changes, redness, skin irritation, mouth sores, sore throat, dental problems, odynophagia (painful swallowing), reduced/altered sense of taste, earaches, fibrosis leading to reduced movement
What is the worst thing about RT?
the latency and they don’t show up until much later
Why do you need to know if a patient has had RT in their lifetime even if it was a long time ago?
the latent effects of RT
How can RT affect salivary glands?
dry them up (xerostomia), cause them to be gummy and stringy/stretchy, chronic thick mucus
How to take care of mouth sores or prevent them after a person has had RT for HNC?
oral care
Why does RT cause earaches?
RT hardens the wax in your ears
What are some side effects of chemo?
nausea, vomiting, fatigue, dry mouth, hair loss, loss of appetite, reduced sense of taste, weakened immune system
What is the big differences between side effects of RT and those of chemo?
the chemo side effects are only when they are getting the treatment, RT side effects are forever
What is mucositis?
painful inflammation and ulceration of the oral mucosa, increased mucus and thicker saliva usually accompany
What is trismus?
reduced mouth opening from radiation; oral masseter more tense
How do you treat trismus?
mouth exercises
What is lymphedema?
the fluid is not draining so there is edema
How do OT treat lymphedema?
massage and move the fluid
How can a HNC patient who is going to receive RT improve swallowing outcomes?
by completing swallow-related exercises before and during RT
What is recommended to maintain nutrition and hydration during RT?
enteral feeding tube
