Head and neck cancer Flashcards
risk factors for head and neck cancers
tobacco alcohol HPV/EBV betel nut hardwood
presentation of head and neck cancers
lump in neck swelling painless lymphadenopathy vocal cord change - dysphonia dysphagia otalgia stridor odonophagia
most common site for head and neck cancer
larynx, oropharynx is becoming more common
what is nasopharyngeal cancer related to
EBV
what is laryngeal cancer associated with
cigarrettes
alcohol
what is oropharyngeal cancer associated with
HPV
typical vs oropharyngeal cancer demographic
> 55, smoker and drinker
OP SCC - non smoker, higher SE status and multiple sexual partners
investigation for head and neck cancer
USS/FNA laryngoscopy, tacheoscopy, oesophagoscopy CT H&N, chest MRI PET
management of early laryngeal cancer
transoral laser surgery
radiotherapy
management of advanced laryngeal cancer
partial/total laryngectomy
chemoradiotherapy
management of early oropharyngeal cancer
chemo-radiotherapy
transoral surgery
management of advanced oropharyngeal cancer
chemo-radiotherapy
managing cancer in lymph nodes
chemoradiotherapy
surgery
management of nasopharyngeal cancer
chemo-radiotherapy
investigation in salivary gland mass?
USS/FNA
CT, maybe MRI
what is a mass in the parotid gland most likely
pleomorphic adenoma
where is salivary gland malignancy more likely
small glands, sublingual or submandibular glands
aims of palliative care
increase QOL
greater tx efficacy and survival
manage morbidity
functional outcome
when do palliative care get involved
diagnosis
treatment
disease free, recurrent, metastatic, end of life
why is pain worse in lips, tongue and face
higher number of neural connections so can be hard to manage pain
first line treatment of neuropathic pain
amitriptyline
first step on WHO pain ladder
non-opioid
adjuvant
2nd step WHO pain ladder
mild/mod opioid
±non-opioid
± adjuvant
3rd step WHO pain ladder
opioid for mod/severe pain
±non opioid painkiller
±adjuvant
adjuvants for paun
gabapentin
amitriptyline
