Head and Neck Cancers

Question 1

A vast majority of cancer of the oral cavity, pharynx, and larynx are what cancer type?

Answer 1

Squamous Cell Carcinoma

Question 2

What is the most common age at diagnosis for oral cavity, pharynx, or larynx cancer?

Answer 2

Early 60’s

Question 3

What are the major risk factors for OC, Pharynx, and Larynx cancer?

Answer 3

Tobacco
Alcohol
HPV
EBV
Betel Nut
Sun Exposure

Question 4

In the U.S. what is the most major risk factor for OC, Pharynx, and Larynx cancer?

Answer 4

Tobacco, dose response relationship

Question 5

What strains of HPV cause throat and neck cancers?

Answer 5

HPV-16 (predominant) followed by 18, 31, 33

Question 6

Where does HPV related cancers most commonly occur?

Answer 6

Base of tongue and tonsils

Question 7

What is Betel Nut?

Answer 7

A carcinogenic nut that is commonly chewed with tobacco

Question 8

What are the general signs and symptoms of OC, Pharynx or Larynx cancers?

Answer 8

Non-healing ulcer/sore
Persistent mass
Sore throat
Hoarseness
Dysphagia/Odynophagia
Cough
Weight loss

Question 9

What is the clinical presentation of oral cavity cancer?

Answer 9

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)

Question 10

What is the clinical presentation of pharyngeal cancer?

Answer 10

Majority present with a neck mass
Chronic serous otitis media
Pain

Question 11

What are late presenting symptoms of pharyngeal cancer?

Answer 11

Change in voice/hoarseness
Dysphagia
Trismus (lockjaw)

Question 12

When does supraglottic cancer typically present?

Answer 12

Late stage and can present with airway obstruction

Question 13

How is head and neck cancer diagnosed?

Answer 13

Biopsy, usually fine needle aspiration

All patients should be referred immediately to ENT

Question 14

Additional testing for head and neck cancer can include?

Answer 14

Panendoscopy (possible secondary tumor)
CT or MRI
PET scan
CBC, LFT’s, CMP

Question 15

Neck masses in kids under 16 are most likely caused by?

Answer 15

Infectious/inflammatory causes or are congenital

Question 16

Should neck masses in patients over 40 be worked up for malignancy?

Answer 16

Yes, most are malignant. Age is the most important risk factor for cancer.

Question 17

What is usually the first line imaging study in working up a neck mass?

Answer 17

CT

Question 18

What are common metastatic sites of head and neck cancers?

Answer 18

Lung, liver, and bone

Question 19

What is erythroplakia?

Answer 19

A red patch on oral mucosa (high chance for invasive carcinoma)

Question 20

Nasal and paranasal cancers are associated with what kind of exposures?

Answer 20

Occupational exposures (leather, textile, wood dust, formaldehyde, nickel)

Air pollution

Question 21

How do nasal/paranasal cancers typically present?

Answer 21

Pain, nasal obstruction, epitaxis, and chronic sinus congestion