Head and Neck Cancers Flashcards
A vast majority of cancer of the oral cavity, pharynx, and larynx are what cancer type?
Squamous Cell Carcinoma
What is the most common age at diagnosis for oral cavity, pharynx, or larynx cancer?
Early 60’s
What are the major risk factors for OC, Pharynx, and Larynx cancer?
Tobacco
Alcohol
HPV
EBV
Betel Nut
Sun Exposure
In the U.S. what is the most major risk factor for OC, Pharynx, and Larynx cancer?
Tobacco, dose response relationship
What strains of HPV cause throat and neck cancers?
HPV-16 (predominant) followed by 18, 31, 33
Where does HPV related cancers most commonly occur?
Base of tongue and tonsils
What is Betel Nut?
A carcinogenic nut that is commonly chewed with tobacco
What are the general signs and symptoms of OC, Pharynx or Larynx cancers?
Non-healing ulcer/sore
Persistent mass
Sore throat
Hoarseness
Dysphagia/Odynophagia
Cough
Weight loss
What is the clinical presentation of oral cavity cancer?
Non-healing mouth or lip ulcers/mass
Loosening of teeth or ill-fitting dentures
Dysphagia/Odynophagia
Weight Loss
Bleeding
Referred Otalgia
Neck Mass (>65% of patients)
What is the clinical presentation of pharyngeal cancer?
Majority present with a neck mass
Chronic serous otitis media
Pain
What are late presenting symptoms of pharyngeal cancer?
Change in voice/hoarseness
Dysphagia
Trismus (lockjaw)
When does supraglottic cancer typically present?
Late stage and can present with airway obstruction
How is head and neck cancer diagnosed?
Biopsy, usually fine needle aspiration
All patients should be referred immediately to ENT
Additional testing for head and neck cancer can include?
Panendoscopy (possible secondary tumor)
CT or MRI
PET scan
CBC, LFT’s, CMP
Neck masses in kids under 16 are most likely caused by?
Infectious/inflammatory causes or are congenital
Should neck masses in patients over 40 be worked up for malignancy?
Yes, most are malignant. Age is the most important risk factor for cancer.
What is usually the first line imaging study in working up a neck mass?
CT
What are common metastatic sites of head and neck cancers?
Lung, liver, and bone
What is erythroplakia?
A red patch on oral mucosa (high chance for invasive carcinoma)
Nasal and paranasal cancers are associated with what kind of exposures?
Occupational exposures (leather, textile, wood dust, formaldehyde, nickel)
Air pollution
How do nasal/paranasal cancers typically present?
Pain, nasal obstruction, epitaxis, and chronic sinus congestion
