Head and Neck Cancers Flashcards
List the risk factors associated with head, neck and thyroid cancers
Alcohol
Tobacco use
Age
Gender = male
Epstein-Barr virus
Chewing of betel quid
Long term exposure to sunlight/sunbeds
HPV
Leucoplakia - thick white plaques, higher risk for mouth cancer
Name the common sites for HN squamous cell carcinoma
Lip/Oral cavity
Pharynx (oropharynx, nasopharynx, hypopharynx)
Larynx (supraglottis, glottis, subglottis)
Outline the presentation, investigation and treatment of lip/oral cancer
Present: lump, pain (inc referred pain to ear), fixation of tongue, dysphagia, odynophagia (pain on swallowing)
Invest: Take CT/MRI of chest as lung cancer associated with smoking too
Treat: Excision, radiotherapy, surgery – hemiglossectomy or total glossectomy
Outline the presentation, investigation and treatment of pharyngeal cancer
Present: Dysphagia, Odynophagia (painful swallow), Lump secondary to cervical mets, Pain (referred pain otalgia), weight loss
Invest: Biopsy, imaging – CT/MRI
Treat: Supportive – feed via gastronomy tubes, excise, radiotherapy, surgery
Outline the presentation, investigation and treatment of laryngeal cancer
Present: Dysphonia, Dysphagia, Referred otalgia (earache), Neck lump, Weight loss, Cachexia (body wasting)
Invest: laryngoscopy, biopsy
Treat: support long term voice issues and swallowing problems, surgery (laryngectomy), chemo
Laryngectomy: removal of larynx, pt breathes through opening in the neck known as a stoma.
Tracheostomy: opening created at front of neck so a tube can be inserted into windpipe (trachea) to help you breath.
Outline the presentation, investigation and treatment of thyroid cancer
Present: lump in thyroid or neck nodal metastasis, problems swallowing, feeling like strangled, voice change, rarely problems with thyroid status
Invest: History, examination, imaging via ultrasound, fine needle aspiration cytology
Treatment: Thyroidectomy, radioactive iodine, radiotherapy/chemotherapy
Investigations to diagnose HNC
Clinical exam
Biopsy
Imaging = CT, MRI, x-ray
Endoscopic investigation
Outline some possible causes of neck lumps
Enlarged lymph nodes
Abscess
Infected sebaceous cyst
Lipoma (benign tumour)
Thyroid swelling
Thyrogossal cyst
Dermoid cyst
Branchial cyst
Pharyngeal pouch
Cervical rib
What is the most common thyroid cancer?
Papillary adenocarcinoma (70-80%)
then follicular adenocarcinoma
As a general rule what type of cancer are HNCs (including the lips and oral cavity)?
squamous cell carcinoma
