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17 terms

Head and Neck Cancer

STUDY
PLAY
Nasopharynx, Tongue, Larynx, Oropharynx
Head and Neck Cancer is specifically targeted to these areas
N_______
T_____
L____ and the Oro_____
Salivary Glands
Cervical, 45
Incidence
C______ node involvement is the MOST important prognostic factor in H&N cancer
Neck Examination Essential
Incidence >90% over age ##
squamous cell carcinoma, leukoplakia, erythroplakia
Histology
A disease of epithelial tissue of the upper GI and respiratory
1. S______ C_____ C______ is the predominant form of head and neck cancer
2. L____ is a white patch that cannot be characterized as ANY other disease
3. E_______is a RED VELVELTY patch that cannot be characterized as any other condition
tobacco, alcohol, sunlight, dental, asbestos, diet, viruses, genetic
Risk factors for head and neck
1. T_____
2. A______
3. Su_____
4. D____ factors (poor oral hygiene, poorly fitting dentures)
5. I________ E_____ (wood/furniture)
6. D_____
7. V_____ (HPV, HSV, EBV)
8. G______ causes
muscle, bone, cartilage, lymphatics, lung, bone, liver, skin, brain
Head and Neck spread
1. Local: M_____, then late b___ and c____
2. Ly_______
3. Distant (10%) is lu____, b_____, liv____, sk____, b_____
screening, pain, neck mass
Diagnosis
1. S_______
2. _____ is UNCOMMON in early disease
3. There may be a lateralized n___ M___
1, 2, 3, 4
stages # or ##
small primary tumor with NO lymph node involvement
Stage # or # is a large primary tumor which may invade underlying structures and spread to lymph nodes
IVc
This stage of H+N cancer is what someone defaults to WITH ANY M1
(roman numeral) _
eliminate, function, speech, respiration, surgery, radiation
Management of H+N cancer
1. E_______ cancer
2. Maintain F_____
(special senses, s___ch, resp______)
3. ONLY curative forms of therapy are S____ and R______
tissue exposure, speed, radiation radiation, staging
Advantages of surgery
Limited T____ E_____
2. S______ (pace?)
3. NO r______ sequalae
3. Subsequent r___ possible
4. More complete S______
Xerostomia, lubricants, amifostine, taste, caries, osteoradionecrosis
Acute Complications of radiation therapy
1. X________
can use Lu______, glycerine, A_______ before procedure)
2. Loss of ____
3. Must remove/repair bad teeth before surgery (dental C____)
4. O___________ of the mandible possible
surgery, cosmesis, nodes, surgery
XRT advantages
1. avoids major S_____
2. No tissue removed, better function and cos_____
3. Can simultaneously treat n___
4. S____ for failures/recurrences
infection, fistulae, sloughing, aspiration
Disadvantages
Complications of surgery
i_______
f______
S_____ of skin flaps
A______
Difficulty with speech, swallowing
Cosmetic
Cure, surgery, radiation
Stages I and II
Goal of therapy is the C_____
S___ and R_____ therapy provide equivalent
Surgery
Advanced staged (Locoregional Stages III-IVb)
S_____ --> post op radiation or post-op chemoradiation
radiation, platinum, hypomagnesemia
Cetuximab
in Squamous Cell H and N cancer
In combination with r______ therapy for initial treatment of locally or regionally advanced disease
As a single agent for patients with recurrent metastic disease for whom prior p_____ based therapy has failed
Recurrent locoreginoal or metastatic carcinoma of the head and neck in combo
Increased hyp____________
Cetuximab
Phase II trials in patients refractory to cisplatin based therapy
C___ is appropriate