Role of Oncologist H&N Flashcards
What does H&N cancer involve?
Any structures above clavicle not including brain
Oral cavity, nasophayrnx, oraphayrnx, larynx, hypophyarnyx, sinuses
What kinds of cancers do oncologist deal with?
Mainly SCC
Salivary gland cancer
Sarcoma
Lymphoma
What are cancers often seen on skin?
SSC
BCC
Melanoma
Merkle cell
What investigations are carried out when dx cancer?
Clinical exam
Blood test
Biopsy
Imaging: MRI/ CT/ PET scancer
Example of glandular carcinoma
Adenocarcinoma
Example of skin/mucous cancer?
SCC
Example of connective tissue carcinoma?
Sarcoma
What is TNM staging?
T = size of tumour N = spread to lymph nodes M = metastasis
H&N cancer management?
Multidisiplinary
What is radiotherapy?
Use of x-ray (ionising radiation) to tx cancer
Energy is higher than used in diagnostic setting
What unit is radiation measured in?
Gray Gy
How does radiotherapy work?
Ionising radiation interact with water molecules producing free radicals
Free radicals = DNA damage
Malignant and normal cell affected
What need consider prior radiotherapy?
Nutritional requirements - feeding tube
Dental assessment
What is provided/made prior radiotherapy H&N
Immobilisation device - minimise movement to ensure accurate/ reproductable tx to reference marks
How is tumour localised?
Clinical exam, radiology, knowledge spread of routes, CT
What are critical structures?
Spinal cord, brain stem, eyes
What are side effects of radiotherapy split into?
Early and late affects
What are early effects of radiotherapy?
General: nausea, fatigue Skin: redness, blistering Mucosa: mucositis, ulceration, altered taste, dysphagia Sticky, dry saliva Hair loss
When see late effects of radiotherapy?
Months- years post RT
Often irreversible and severe
Examples of late effect RT?
Skin - fibrosis, necrosis Permanent hair loss Lungs - fibrosis/ breathlessness Eyes - reduced vision Endocrine = premature menopause, hypothyroidsm, growth hormone defieicnet Infertility
What are risk factors for reoccurance?
Involved or close margins
Advanced T stages
Lympovascular invasion
Perineural invasion
Can RT be used in palliative care?
Yes - relieves symptoms and minimise side effects
Use lower dose
