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.
What are tools for diagnosis of s.c.c.?
Endoscopy important for staging (see how far the cancer progressed) and treatment surveillance.
What percent of cancers are head and neck cancers?
15%
What is most common type of cancer and what percent does it take up?
squamous cell carcinoma, 75% of all cancers.
What are concerning features to find on ultrasound for thyroid?
poorly defined, calcifications, increased length to width ratio. Ultrasound more information than nuclear med scan.
What are the different type of skin flaps?
Local - same area, same blood supply
Regional - different area, same blood supply
Free - different area, different blood supply (forearm to face for example)
What is the prognosis for each stage of upper aerodigestive tract cancer?
1 - 80%
2 - 60%
3 - 40%
4 - 20%
What is the purpose of chemoradiation therapy?
adding chemo to radiation for more aggressive treatment. If it doesn’t work, move onto surgery
Describe thyroid location and anatomy in the body?
Level of C5 to T1. Extends to 5th or 6th tracheal ring. Below cricoid cartilage of trachea.
