Head + Neck Cancer

Question 1

what are the majority of head and neck cancers

Answer 1

squamous cell carcinomas

Question 2

what infection are nasopharyngeal carcinomas linked to

Answer 2

EBV

Question 3

what ethnicity are nasopharyngeal carcinomas most common in

Answer 3

Asian

Question 4

how might nasopharyngeal carcinomas present

Answer 4

otalgia (ear pain)
unilateral otitis media with effusion 
nasal discharge / epistaxis 
cervical lymphadenopathy
cranial nerve palsies

Question 5

tx of nasopharyngeal carcinoma

Answer 5

radiotherapy

Question 6

typical presentation of a pharyngeal carcinoma

Answer 6

elderly smoker with sore throat, painful swallow/ difficulty swallowing, referred otalgia, stertor (snore)

Question 7

oropharyngeal cancer is linked to what infection

Answer 7

HPV

Question 8

Premalignant oral cavity lesions

Answer 8

leukoplakia (white patches)
erythroplakia (red patches)
erythroleukoplakia (red + white patches)

Question 9

presentation of oral cavity cancer

Answer 9

painless mass on inner lip, side of tongue, floor of mouth

Question 10

presentation of laryngeal cancer

Answer 10

progressive hoarseness, stridor, dysphagia, persistent cough

Question 11

strong risk factors for head and neck cancer

Answer 11

smoking

alcohol

Question 12

criteria for urgent (2 week referral) for suspected laryngeal cancer

Answer 12

> 45 with:

• persistent unexplained hoarseness
• unexplained neck lump

Question 13

criteria for urgent (2 week referral) for suspected oral cancer

Answer 13

lump on lip/tongue/oral cavity
erythroplakia / erythroleukoplakia

consider in patients with unexplained ulcer > 3 weeks

Question 14

investigation of suspected head and neck cancer

Answer 14

flexible nasal endoscopy (FNE)

- Examination under anaesthesia + biopsy if a lesion is seen