ENT Exam 1 (Head and Neck cancers)
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| Locations of head and neck cancers | Oral (mouth)
Pharynx (throat)
Larynx (voicebox and neck)
Nasal cavity and sinuses
Salivary glands
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| Prevalence of head and neck cancers | Increased in patients over 40
Due to ingested (air and food) substances constantly exposed to these locations
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| What is NOT included in head and neck cancers? | Brain
Eye
Ear
Scalp/skin
Teeth
Bone/muscle
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| What lymph nodes would be associated with head and neck cancers? | Superior cervical lymph nodes
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| What would inferior cervical lymph node involvement indicate? | Metastatic cancer
aka not head or neck cancer
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| What nerves may be associated with head and neck cancers? | Cranial nerves
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| What type of cancer accounts for 90% of head and neck cancers? What other type of cancer can be found? | Squamous cell carcinoma (SCC)
May be adenocarcinoma
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| What is SCC? | Squamous cell carcinoma
Cancer of epithelial tissues/cells
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| What is adenocarcinoma? | Cancer of glands and/or ducts
May be mucous glands
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| Risk factors for head and neck cancers | Smoking/tobacco use
Alcohol
Viral infx (EBV, HPV, HIV, ~HSV)
Occupational exposures
Poor oral hygiene
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| Some radiological tests that may be used to screen for head and neck cancers | X-ray
MRI
CT scan
PET scan
Usually need a combination of tests to build an entire picture for dx
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| What radiological test would be initially performed? | X-ray
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| What site accounts for most metastases? | Lung (66%)
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| What are some common sites of metastases? | Lung
Bone (~20%)
Liver (10%)
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| Where does nasopharyngeal cancer usually spread? | Bone
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| What cancer is EBV most associated with? | Nasopharyngeal cancer
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| What are some symptoms of oral cancer? | Nonhealing ulcers
Loose teeth/dentures
Dysphagia/odynophagia
Weight loss
Bleeding
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| What should be checked when oral cancer is suspected? | Lymph nodes!
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| What are 3 major warning signs of oral cancer? | Leukoplakia
Erythroplakia
Leukoerythroplakia
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| What virus should be thought of when oropharyngeal cancer is suspected? | HPV!
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| Common locations of oropharyngeal cancer | Base of the tongue
Tonsillar area
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| What patient population has oropharyngeal cancer in an increasing incidence? | Young non-smoking males
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| Symptoms of oropharyngeal cancer | Change in voice
Otalgia
Dysphagia
Cough
Leukoplakia
Erythroplakia
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| What virus should be thought of when nasopharyngeal cancer is suspected? | EBV!
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| Where is nasopharyngeal cancer found commonly? | China
Asia
Middle East
North Africa
Arctic
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| Symptoms of nasopharyngeal cancer | Headache
Nasal obstruction
Tinnitus
Epistaxis
Serrous OM
Potential impaired function of CN II-VI
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| Distant metastases are found in what percentage of nasopharyngeal cancer? | 50% of cases
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| What diagnostic test should be used to detect nasopharyngeal cancer and metastases? | MRI
(Look in distant sites for metastases)
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| What patient population is most affected by laryngopharyngeal cancer? | 65 years old or older
Mostly men
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| Symptoms of laryngopharyngeal cancer | Hoarseness
Dysphagia
Chronic cough
Hemoptysis
Stridor
Dyspnea
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| What diagnostic tests can be performed to detect laryngopharyngeal cancer? | CT scan: initial imaging, hard tissue, assesses local tumor extent
MRI: soft tissue, differentiate between muscles & mucosa & lymph
PET scan: evaluate for metastases
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| Laryngopharyngeal cancer tx | Radiation: primary tx
Combination of radiation and surgery
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| What is the primary purpose of laryngeal cancer tx? | Preservation of airway
Preservation of swallowing
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| When should chemotherapy be used in head and neck cancers? | When head/neck cancers reach stage III-IV
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| Common symptoms of sinus tumors/cancer | Epistaxis
Unilateral nasal obstruction
Chronic sinusitis
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| What might be found on a physical exam of a patient with a sinus tumor? | Sinusitis symptoms (usually will be chronic cases)
Pooling of secretions
Bleeding
Asymmetries (unilateral)
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| What is our best tx, as a primary care PA, when suspecting head or neck cancer? | REFER! ;-)
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Created by:
Carrie D.
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