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Special Care Dentistry BDS4 > Head and Neck Cancer > Flashcards

Head and Neck Cancer Flashcards

1
Q

what is the characteristic presentation of oral cavity cancer

A

ulcerated
uneven surface
indurated
rolled edges
well defined margins
exophytic

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2
Q

what imaging is used for head and neck cancer

A

CT scan
MRI
ultrasound
PET CT

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3
Q

what is the purpose of a CT scan in head and neck cancer

A

assess primary tumour
assess synchronous head and neck tumours
assess regional spread
assess for distant metastasis or unrelated second cancers

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4
Q

what are the advantages of MRI scanning

A

no radiation
improved soft tissue definition
not affected by amalgam
extent of bone involvement
extent of nerve involvement
surgical planning

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5
Q

what are ultrasounds used for

A

neck mass
salivary gland mass

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6
Q

what system is used for staging

A

TNM

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7
Q

what does T stand for in TNM

A

primary tumour size/depth

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8
Q

what does N stand for in TNM

A

nodal status

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9
Q

what does M stand for in TNM

A

disease distant to primary tumour

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10
Q

what is the purpose of staging

A

treatment planning
prognostic
research purposes

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11
Q

what are the different treatment options for head and neck cancer

A

curative vs palliative
surgery alone
radiotherapy alone
chemoradiotherapy
dual or triple modality
immunotherapy

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12
Q

when is radiology needed

A

diagnosis
staging
pre-radiotherapy
treatment response
recurrence
post operative complications
dental rehabilitation

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13
Q

what are the features on an OPT that are significant of cancer

A

moth eaten bone
pathological fractures
non-healing sockets
floating teeth
spiking root resorption
unusual periodontal bone loss
spiculated periosteal reaction
generalised widening of PDL spaces and loss of lamina dura
loss of bony outlines for anatomical features
thinning of cortico-endosteal margin

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14
Q

what are the ultrasound features of cancer

A

rounded lymph nodes
enlarged lymph nodes
conglomerate lymph nodes
necrosis of nodes
increased vascularity or avascular
loss of hilum
internal calcification
extrascapular spread

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15
Q

what is the role of the pathologist in head and neck cancer

A

establish diagnosis, subtype and grading of cancer
examine surgical margins of specimen in laboratory
establish final staging of disease

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16
Q

why is it important to report malignancies

A

epidemiology
healthcare planning

17
Q

what are the risk factors for oral and oropharyngeal cancer

A

HPV
cigarettes and alcohol
betel nut
nutrition
poor OH and dental health

18
Q

what are the potentially malignant lesions

A

erythroplakia
leukoplakia
submucous fibrosis
lichen planus
SCC arising in pre-existing actinic keratosis
palatal keratosis in reverse smokers

19
Q

what guidelines do we refer to when referring someone for head and neck cancer

A

scottish referral guidelines for suspected cancer

20
Q

what is the role of the dentist in head and neck cancer

A

early detection of soft tissue lesions
pre-treatment and assessment
minimal role during treatment
maintenance of oral and dental health post-treatment
palliative care

21
Q

what treatment do we provide for patients before cancer treatment

A

make sure dentally fit
immediate treatment
scaling
impressions for fluoride trays
start fluoride therapy

22
Q

why is prevention a key aspect of pre-treatment

A

avoid unscheduled interruption of chemotherapy
avoid exacerbation of mucositis
remove potential source of infection

23
Q

what are the effects of radiotherapy

A

mucositis
trismus
dry mouth
caries
ORN

24
Q

what issues do dentists need to deal with during cancer treatment

A

oral ulceration
oral infection
emergency dental treatment

25
Q

what is the presentation of mucositis

A

inflammation and ulceration
severe pain
impacts on eating

26
Q

what advice do we give for mucositis

A

stop smoking
no spirits
avoid spicy foods

27
Q

what treatment do we give for mucositis

A

topical lidocaine
saline mouthwash
benzydamine HCL
gelclair
cryotherapy
morphine

28
Q

what is the role of the dentist in post-treatment for cancer

A

prevention
monitoring

29
Q

what does the risk of ORN depend on

A

dose and field

30
Q

what dose of radiation gives a higher chance of ORN

A

over 50Gy

31
Q

if you must extract a tooth before radiotherapy treatment when must it be done

A

10 days prior at least

Special Care Dentistry BDS4 (5 decks)

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