Head and neck cancers

Question 1

What are the risk factors

Answer 1

Life style
SMOKING, ALCOHOL, BETEL NUTS
viruses
EBV, HPV (on the rise)

Question 2

What cancers are associated with HPV viruses?

Answer 2

Penile, vulval, anal, H+N, cervical

Question 3

What are the symptoms of H+N cancers?

Answer 3

Depends on the location of the tumour
Often involved lymph nodes are the first thing which are noticed by the patients
If you miss the first presentation then it becomes awful for the patient as they can develop
Breathing, eating problems
If it evades the carotid- then you get bleeding

Question 4

What is the workup

Answer 4

Gp- history/exam 
referall for 2WW: 
US and FNA 
Fine needle spiration 
CT/MRI to look for mets 
Panendoscopy and biopsy EUA (looks for primary cancers) 
PET scan 
P16 (HPV-OROPHARYNGEAL) 
all throughout treatment patients are discussed in MDT

Question 5

What is the prognosis for P16 HPV oropharyngeal cancer?

Answer 5

VERY GOOD! 90%

Question 6

What is the management of H+N

Answer 6

depends on the stage
For early tumours- laser/robotic surgery, may need flap reconstruction for oral cavity, laryngectomy

Neck dissection can be done to get rid of lymph nodes

May need adjuvant treatment (Chemoradiotherapy)

Question 7

What are some radiotherapy side effects?

Answer 7

Skin reaction 
Mucositis 
Dry mouth 
difficulty swallowing 
Osteonecrosis 
Secondary cancers 
Patients have to stop smoking!