Head and Neck Cancer

Question 1

What are the two biggest risk factors for squamous cell carcinoma of the head and neck?

Answer 1

Smoking and alcohol

Question 2

Which age group of people tend to be affected by squamous cell carcinoma?

Answer 2

Older people

Question 3

What is responsible for causing nasopharyngeal carcinoma? Where in the world is this commonly seen?

Answer 3

EBV- seen in China

Question 4

Who does HPV associated cancer tend to affect? How do they get this?

Answer 4

Younger people, sexually transmitted

Question 5

How will an HPV associated cancer in a young person present?

Answer 5

Small tumour, large lymph nodes

Question 6

Where in the head and neck does HPV associated cancer tend to affect?

Answer 6

Tonsils and tongue base

Question 7

Chewing of betel nuts predisposes to cancer where?

Answer 7

Oral cancer (mouth)

Question 8

Hardwood exposure e.g. joiners predisposes to what type of cancer?

Answer 8

Paranasal sinus cancer

Question 9

If you suspect a head and neck cancer, you should always do a thorough examination of where? Why?

Answer 9

The mouth- especially the sides as the most serious pathologies occur on the buccal mucosa and sides of the tongue

Question 10

Neck lumps where move when you swallow?

Answer 10

Thyroid

Question 11

What are some investigations which can be used for head and neck cancers?

Answer 11

Endoscopy, FNA, ultrasound, CT, MRI

Question 12

Why is an FNA used in the diagnosis of head and neck cancer?

Answer 12

Cells are taken for cytology

Question 13

Ultrasound is an especially useful test for pathologies where?

Answer 13

Neck

Question 14

CT is useful test for assessing pathologies where?

Answer 14

At a bony/soft tissue interface

Question 15

A CT of where else in the body is always taken as part of the workup for head and neck cancer?

Answer 15

CT chest

Question 16

What type of anaesthetic should be used for investigations in the a) mouth? b) throat?

Answer 16

a) Local b) General

Question 17

Are blood tests useful for head and neck cancer?

Answer 17

Not really

Question 18

The majority of head and neck cancers are what type?

Answer 18

Squamous cell carcinoma

Question 19

What other type of cancer can occur in the head and neck apart from squamous cell?

Answer 19

Adenocarcinoma

Question 20

Apart from head and neck cancer, what are some other causes for voice changes?

Answer 20

Lung cancer, aortic aneurysm (pressing on the recurrent laryngeal nerve)

Question 21

Tumours of the parotid/submandibular glands affect which nerve?

Answer 21

Facial nerve

Question 22

What is a lump in the left supraclavicular fossa most likely to be?

Answer 22

Lymph in the thoracic duct- can be a cancer from anywhere

Question 23

If parathyroid glands are removed, what is the immediate problem?

Answer 23

Hypocalcaemia

Question 24

What clinical signs can be seen if the larynx or trachea are compressed by a cancer?

Answer 24

Stertor and then stridor

Question 25

What does noisy breathing with a normal SaO2 suggest?

Answer 25

Compensation- the airway is compromised

Question 26

What strain of HPV is most commonly the cause of head and neck cancer?

Answer 26

Type 16