Head and Neck Tumors

Question 1

Epidemiology of head and neck cancer

Answer 1

• 0.5 million per year
• highest incident in Asia, specifically China
• 3-7% of all cancers
• most frequently: oral (30%), laryngeal (35%), pharyngeal (35%)
• men over the age of 50

Question 2

Etiology of head and neck cancer

Answer 2

• alcohol and tobacco use
• HPV (esp. type 16) and EBV
• poor oral hygiene, Paan

Question 3

Histology of head and neck cancer

Answer 3

• 80% are squamous cell carcinoma
• thyroid cancer
  
  • papillary: children, orphan annie eye, psammoma bodies
  • follicular: prominent nucleoli
  • medullary
  • anaplastic
• oral cavity (30%), laryngeal (35%), pharyngeal (35%)

Question 4

Symptoms of head and neck cancer

Answer 4

• swollen lymph nodes
• hoarseness
• dysphagia
• tongue pain: posterior part, CN9, CN10, and pain to the ear

Question 5

Diagnosis of head and neck cancer

Answer 5

• indirect, direct imaging
• MRI
• PET/CT
• thyroid: US guided cytology, 131/123 Iodine scintigraphy

Question 6

Radiation therapy for head and neck cancer

Answer 6

• 75% use of RT
• T1-2: surgery or RT
• T3-4: surgery w/ postop. RT or w/ chemo
• treat surrouding lymph nodes

Question 7

Surgical therapy for head and neck cancer

Answer 7

• functional approach
• reconstructive
• lymphadectomy

Question 8

Pharmacological therapy for head and neck cancer

Answer 8

• use for T3-4
• neoadjuvant therapy paired with RT
• chemo: cisplatin
• bioRT: cetuximab