Head And Neck Cancer

Question 1

What are risk factors for head and neck cancers?

Answer 1

Smoking 
Alcohol 
Sun exposure 
Poor nutrition/weakened immune system 
Viruses- HPV, EBV 
Occupational exposure- nickel, chromate, hardwood/softwood dusts

Question 2

What are some common symptoms of head and neck cancers?

Answer 2

Hoarseness 
Unresolved head and neck masses 
Dysphagia or odynophagia 
Oral/oropharynx red or white patches, swelling or ulceration lasting over 3 weeks 
Unexplained tooth mobility 
Otalgia without local ear problems 
Orbital masses 
Cranial nerve palsies 
Unilateral bloody nasal discharge

Question 3

What is involved in the patient pathway?

Answer 3

History 
Examination 
Investigation 
Histology and staging 
Multidisciplinary team meeting
Management plan 
Surveillance

Question 4

What are some common investigations carried out in patients with suspected head and neck cancer?

Answer 4

FBP 
U&E 
LFT 
Coag 
TFT 
Alb/Ca 
OPG 
CXR
USS
CT
MRI
PET CT 
FNA 
Panendoscopy and biopsy

Question 5

What is the staging of a tumour?

Answer 5

TNM

• tumour stage- site, size, structures involved
• nodal stage- site, number, size
• metastases- present or not

Question 6

What is PET CT scan?

Answer 6

Positron emission tomography with CT
FDG (2-fluoro-2-deoxy-D-glucose)- stain taken up by cells for metabolism as they need glucose therefore can help see cancer cells as they take up more glucose as they are fast growing cells

Question 7

What are PET CT scans used for?

Answer 7

Diagnosis- unknown primary detection
Staging- metastases, second primaries
Detection of therapy response
Surveillance- detecting recurrence

Question 8

What are the treatment options for patients with head and neck cancers?

Answer 8

Surgery
Radiotherapy 
Chemotherapy 
Combined therapy 
Pallation 
No treatment