Management of Head and Neck Cancer Flashcards
Who has commissioned head and neck surgery as a specialised service?
NHS England
- Within how many days must any 2-week-rule patient be diagnosed including scans and histology?
- When must the first definitive treatment have started?
- 31 days post-referral
- 62 days post-referral
What does the national head & neck cancer audit DAHNO do?
Collects data from head & neck cases and provides assurance to patients, networks, commissioners, trust boards that the quality of services meets appropriate standards
Where is the most common oral subsite for SCC to develop?
The tongue - dorsum and lateral boarders
Give 3 types of management/treatment options for H&N cancer:
- Primary and adjuvant radiotherapy
- Surgery
- Chemoradiotherapy
What is a main complication of radiotherapy treatment in H&N cancer?
Toxicity to normal cells due to rapid rate of cell turnover of mucosal lining (becomes stained)
List 5 short term oral complications of H&N treatment:
- Mucositis - inflammation and ulceration of mucosal lining
- Infection - oral Candidal infections common
- Xerostomia
- Pain
- Dysgeusia - change in taste and smell
List 4 long term complications of H&N cancer treatment:
- Altered anatomy
- Rampant dental caries - due to reduced saliva flow
- Trismus and mastication difficulties
- Osteoradionecrosis
How do we as DT help manage H&N cancer patients?
- List 5 things
- Maintain good OH - effective toothbrushing and ID cleaning
- Diet advice for caries prevention
- Daily fluoride application - 5000ppm toothpaste
- Fluoride mouth rinse
- GC tooth mousse
How is oral mucositis treated? - list 3
Patients recommended to avoid spicy food, manuka honey and calcium phosphate
How are oral candial infections treated?
With antifungal drugs but avoid chlorhexidine
How is xerostomia treated?
Patients recommended to drinks sugar-free fluids regularly and chew sugar-free gum
