Head and Neck Cancer Flashcards
How common is head and neck cancer worldwide, compared to other cancers?
It is the 6th most common cancer worldwide
What % of cases of cancer in the UK are head and neck cancers?
4%
Which gender is head and neck cancer more common in?
Men
What % of cases of head and neck cancer occur in men?
65-90%
How does age affect the incidence of head and neck cancer?
The incidence increases with age, particularly over 50 years
What can head and neck cancer be classified into?
- Oral cavity
- Larynx
- Pharynx
What % of head and neck cancers are in the oral cavity?
44%
What % of head and neck cancers are in the larynx?
31%
What % of head and neck cancers are in the pharynx?
25%
Why do patients with head and neck cancers have particular problems?
- Close proximity of the tumours to important structures in the head
- Severe social consequences to treatment
Give an example of a severe social consequence to treatment of head and neck cancer
Loss of voice in laryngeal cancer
What are the most significant risk factors for head and neck cancers?
- Smoking
- Chewing tobacco or betel nuts
- Alcohol consumption
Which type of alcohol consumption in particular is a risk factor for head and neck cancer?
Spirits, which act synergistically with tobacco
What are the other risk factors for head and neck cancers?
- UV light exposure
- Viral infections
- Environmental exposure
- Radiation
What type of head and neck cancer is UV light exposure a risk factor for?
Lip cancer
What viral infections are risk factors for head and neck cancer?
- EBV
- HPV
What environmental exposures are risk factors for head and neck cancers?
- Wood dust
- Nickel
What type of head and neck cancers is radiation a risk factor for?
- Thyroid
- Salivary gland
Describe the geographical distribution of nasopharyngeal cancer
It is most common in Southeast Asia, and is seen in Arabs and Inuits, but worldwide is rare
What proteins in the body have a strong association with head and neck cancer?
The major histocompatibility complexes H2B, BW46, and B17
What have case-controlled studies in Chinese patients suggested as having a link to nasopharyngeal cancer?
Salted fish consumption
What mutations are associated with head and neck cancer?
TP53 tumour suppressor gene
What type of cancers are the majority of head and neck cancers?
Squamous cell carcinomas
Except nasopharyngeal tumours
What % of head and neck cancers are squamous cell carcinomas?
90%
What type of cancers are most nasopharyngeal cancers?
Anaplastic
What are the rarer histological forms of head and neck cancer?
- Adenoid cystic carcinoma
- Plasmacytoma
- Melanoma
- Sarcoma
- Lymphoma
What % of patients with head and neck cancers have multiple primary sites at presentation?
Up to 20%
What is the best means for detecting a cancer in the head and neck region?
Physical examination
What should be inspected in physical examination for head and neck cancers?
- Teeth
- Gingivae
- Entire mucosal surface
- Lymphoid tissue of tonsillar pillars
- Tongue mobility
What should be noted when inspecting the lymphoid tissue of the tonsillar pillars?
Any asymmetry
What technique should be employed for palpation on examination of the head and neck?
Bimanual technique
What areas of the head and neck should be palpated when examining for cancer?
- Mouth
- Tongue
- Cheeks
How is a bimanual technique carried out on examination of the head and neck?
One finger inside mouth, second hand under the mandible
Why should palpation be the last step in the examination of the head and neck?
Due to stimulation of the gag reflex
What do any suspicious lesions require when examining the head and neck?
Biopsy
What should be done if any mass is located on the neck?
Should document the location, and note it’s relationship to major structures, such as the salivary gland, thyroid, and carotid sheath
What structure in the neck should be palpated when examining for head and neck cancer?
Thyroid
How do cancers of the oral cavity present?
Non-healing ulcers
Describe the potential appearances of the ulcers in cancers of the oral cavity?
- Raised
- Ulcerated
- Excavated
- Pigmented
- Well or poorly demarcated
Are the mouth ulcers caused by cancer of the oral cavity painful?
They may be
How are cancers of the oral cavity often diagnosed?
By dentists