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Head/Neck Cancers

ENT Exam 1 (Head and Neck cancers)

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