Oral Cancer: Management - staging, treatment and follow up Flashcards
How has the epidemiology of oral cancer changed?
HPV has become a risk factor for upper aeriodigestive tract tumours. Oropharynx cancer is increasing, almost an endemic but the survival rates seem to be improving.
How are head and neck cancer survival rates changing?
They’re improving. Governance, centralisation and working together is helping this.
What is the current belief on the best treatment method of oral cancer and HPV?
That people with HPV will do better under radiotherapy rather than chemotherapy and the use of lasers and robotics are now more common.
What is meant by the ‘oral cavity’?
Vermillion skin junction of lip to junction of hard and soft palate above and to circumvallate papillae below.
In which sites are oral tumours most commonly seen?
- lateral surface of the tongue
- floor of the mouth
- occasionally the buccal mucosa (more common in South East Asia due to tobacco chewing)
What happens if you continue drinking and smoking habits post-diagnosis with oral cancer?
If you continue drinking you’re much more likely to die within the next year, smoking also increases this chance but less so than continuing drinking.
What is the key message about HPV?
HPV+ tumours are less life threatening. Tumour control is easier.
What are the clinical signs of head and neck cancer?
- ulcer
- white or red patches
- mass
- pain
- bleeding
- tooth mobility
- neck lump
How is head and neck cancer diagnosed?
• Clinical examination
• Imaging CT/MRI/USS/PET
• Histopathology:
– FNAB
– Incisional Biopsy
What are the treatment options for head and neck cancer?
- Surgery
- Radiotherapy
- Chemo-Radiotherapy
What are the factors that influence your chance of survival?
Changes in service protocols
Social deprivation
Continued exposure to smoking and alcohol
Co-morbidities
Human Papilloma Virus
Stage shift
What are some red flags to watch out for?
- Induration (hardened tumour)
- Bleeding
- Rapid increase in size
- Earache
- Necrosis especially with odour
