Head and Neck Cancers

Question 1

What are the four major divisions of cancer of the head and neck?

Answer 1

• Oral
• Pharyngeal
• Laryngeal
• Nasopharyngeal

Question 2

True or false: black and white women have similar rates of oral cavity / pharyngeal cancers

Answer 2

True

Question 3

Black men have (__)% highers rates of oral/pharyngeal cancers than white males

Answer 3

30%

Question 4

Which ethnicity has the lowest rates of oral cavity/pharyngeal cancers?

Answer 4

Hispanics

Question 5

Which ethnicity has the lowest rates of laryngeal cancers?

Answer 5

Asians

Question 6

Both black men and women have 2x the risk of which cancer relative to white men and women?

Answer 6

Laryngeal

Question 7

What is the most common type of head/neck cancer?

Answer 7

SCC

Question 8

What are the chemicals that predispose patients to head and neck cancerS?

Answer 8

• Asbestos
• Ni
• Cr
• Ar
• Formaldehyde

Question 9

What is the classic triad of plummer vinson syndrome?

Answer 9

• Anemia
• Esophageal webs
• Glossitis

Question 10

What is the viral family of EBV? Genetic material? Enveloped?

Answer 10

• HSV (HHV-4)
• dsDNA
• Enveloped

Question 11

What is the viral family of HPV? Genetic material? Enveloped?

Answer 11

• Papillomavirus
• dsDNA
• Naked

Question 12

What are the two proteins that are utilized by HPV?

Answer 12

E6–inhibits p53

E7–inhibits Rb

Question 13

Most people who have head or neck cancers have what environmental exposures?

Answer 13

EtOH and smoking

Question 14

What are the major occupations that predispose patients to head and neck cancers? (5)

Answer 14

• Woodworking
• Leather manufacturing
• Ni refining
• Textile industry
• Ra dial painting

Question 15

What are the strains of HPV that cause cancer?

Answer 15

16, 18, 31, 33

Question 16

What are the HPV strains that cause genital warts?

Answer 16

6 and 11

Question 17

What ear findings may be suggestive of head/neck cancer?

Answer 17

• Referred otalgia

- Serous OM

Question 18

What are the throat findings suggestive of head/neck cancer? (3)

Answer 18

• Hoarseness
• Persistent odynophagia
• Dysphagia

Question 19

What are the hematological findings suggestive of head/neck cancers? (2)

Answer 19

• Erythroplasia

- Non-healing ulcers

Question 20

What are the nasal findings suggestive of head/neck cancer? (3)

Answer 20

• Recurrent epistaxis
• Nasal obstruction
• Submucosal mass

Question 21

What is the process of progression with head/neck cancers?

Answer 21

Dysplasia
CIS
Carcinoma

Question 22

White patches that do not rub off = ?

Answer 22

Leukoplakia

Question 23

White patches on the tongue that rub off = ?

Answer 23

Candidiasis

Question 24

What is the genetic mutation in Peutz-Jeghers syndrome?

Answer 24

STK11

Question 25

What is the adenoma-carcinoma sequence of the GI tract?

Answer 25

APC - Kras - p53

Question 26

What is the role of ASA in the prevention of GI carcinoma?

Answer 26

p53 mutations and increased expression of COX allow for progression to CA

Question 27

What is the prognosis for red patches in the mouth that do not go away in 2 weeks?

Answer 27

20-30% will develop into cancer

Question 28

How do you diagnose laryngeal cancer?

Answer 28

Endoscopy

Question 29

What is the gross appearance of tumors in the mouth?

Answer 29

Nodular appearance

Question 30

What type of voice will a patient with a unilateral vocal cord mass present with?

Answer 30

Breathy sounding

Question 31

What type of voice will a patient with hypopharynx mass present with?

Answer 31

Garbled voice

Question 32

The lymphatic in the true vocal cords are minimal. What is the significance of this, relative to hypopharyngeal cancers?

Answer 32

higher incidence of mets in hypopharyngeal than in true glottic cancers

Question 33

What is the general treatment technique for head and neck cancers?

Answer 33

-Surgery with radiation and chemo