HEENT Flashcards
What is the most common type of cancer found in the Head and Neck region? What is the 5 year survival rate?
squamous cell carcinoma, survival is 50 - 60%
What are the well-differentiated thyroid cancers?
Papillary Thyroid - 80% of all thyroid cancer, 3/4 of well-differentiated
Follicular carcinoma - 10% of all thyroid cancer, 1/4 of well-differentiated thyroid cancer.
Which well-differentiated thyroid cancer is more common in middle-aged women versus young women (18-30)?
Papillary thyroid cancer is more common in young women and follicular cancer is more common in middle-aged women.
Which thyroid cancer has the higher survival rate?
papillary thyroid cancer is ~ 95% even with metastasis. Follicular carcinoma is ~ 90%.
When does prognosis go down hill in papillary thyroid cancer?
Typically in women over 50 and men over 40.
What is the treatment for well-differentiated thyroid cancer?
Total thyroidectomy, followed by radioactive iodine. Goal is to preserve recurrent laryngeal nerve function and parathyroid function.
How do you evaluate the thyroid nodule?
Fine needle aspiration for nodules 1.5 - 2 cm, or with concerning features on ultrasound.
What are the other thyroid cancers (4)?
Medullary
Undifferentiated/Anaplastic - extremely aggressive! Grows overnight! Survival is less than one year, no current therapy and seen mostly in older patients.
What are high grade vs. low grade salivary gland cancers?
High grade treatment involves excision, with possible neck dissection and radiation.
Low grade involves surgery alone. Goal is to preserve nerve function.
Which nerves are at risk in salivary gland surgery?
VII, V3, XII. Parotid glad has full VII dissection. Removing salivary gland doesn’t effect salivation.
How do you treat skin cancer?
Surgery - complete excision with adequate margins. Can use Mohs (maps edges of cancer) - saves more tissue.
How does skin cancers heal after surgery?
If you let them heal by secondary intention, it can take a long time. Speed things up by using local flaps (intact blood supply), skin grafts (no intact blood supply).
What is the outcome of soft tissue malignancies and what kind of treatment is typically employed?
-Sarcomas, very rare, but prognosis is poor. Treat with surgical excision with chemo or radiation tx.
What type of cancers make up Upper Airway Cancers? What parts of the upper airway?
Squamous cell carcinoma - 95%, seen in sinus, nose, oral cavity, pharynx, larynx, tracheal, and esophagus. Basically any mucosal surface.
What clinical signs will you see in squamous cell carcinoma of the upper airway tract? (EXAM)
Otalgia (ear pain), hoarseness, dysphagia, lymphadenopathy (swollen, enlarged lympth nodes)- cancer in a smoker until proven otherwise.
