harsha-oral cancer Flashcards
(27 cards)
Describe malignant neoplasm
A neoplasm characterised by uncontrolled cell growth, often referred to as cancer
Describe spread of malignancy
- new cells take nutrients and destroy surrounding tissues, including nerves, blood vessels, muscle
Describe cancer morbidity and mortality
- obstructive symptoms
- local/distant tissue destruction
- non healing wounds and intercurrent infections (reduced immunity) can be sign of cancer
- death
- survival rate is a way of expressing a cure from malignant disease
What are some head and neck skin cancers
- basal cell carcinoma
- squamous cell carcinoma
- malignant melanoma
What are some intra-oral cancers
- oral tongue (ant 2/3)
- floor of mouth
- buccal mucosa
- maxillary and mandibular alveolus
- gingiva
- palate
What other cancers can occur in the head and neck
- lip cancer
- pharyngeal cancer
- antral (sinus) malignancies
- salivary gland malignancies
- malignancies involving bone
- lymphoma
Describe cancer progression
Initiation:
- genetic susceptibility
- environmental factors
- gene mutations
- disrupted cell cycle
Promotion:
- drugs
- viruses
- radiation
- spontaneous gene mutations
Progression
What is the early stage of oral cancer like
- often painless!
- white/red patch/plaque
- exophytic growth
- nodule/lump
- non healing ulcer/fissure
- mobile tooth/teeth
- non-healing extraction socket
What is the advanced stage of oral cancer like
local invasion
- distortion of tissues
- distruction of tissues
- dysfunction
- non-healing ulcers
metastasis to regional lymph nodes
distant metastasis
How to take history when suspecting oral cancer
- onset and duration
- progression
- associated symptoms
- previous investigations
- previous treatment
How to perform clinical examination for oral cancer
- use good illumination and moisture control
- examine all sub-sites particularly retromolar trigone
- facial skin
- neck
Describe diagnosis of oral cancer
- vigilance and suspicion
- biopsy
- radiography
- ultrasound/CT/MRI/PET
Describe stages of oral cancer
look at size of primary tumor and nearby lymph node status to determine if any metastasis then stage I-III
What is the goal of oral cancer treatment
Attempt to maintain a good quality of life for the patient via cure or palliation
Who is involved in multidisciplinary treatment of oral cancer patients
- Head and neck surgeons
- Oncologists
- Pathologists
- Radiologists
- Speech language therapists
- Dieticians
- Maxillofacial prosthodontists
- GP, OT, nurse
- Dentist, OHT
- Social workers
What are some definitive treatments of oral cancer
- surgery
- radiotherapy (teletherapy or brachytherapy)
What are some adjuvant therapies for oral cancer
- chemotherapy
- gene therapy
- immunotherapy
Describe oral surgery
- wide excision of primary tumor
- excision of cervical lymph nodes
- histopathological exam of specimens
- reconstruction
- rehab
Describe oral radiation therapy
- curative or palliative dose
Adverse effects: - radiation mucositis
- radiation caries
- osteoradionecrosis
- loss of function
- disfigurement
How does oral cancer usually occur
- habit related
- usually travels through an easily identifiable and sometimes reversible precursor stage known as oral potentially malignant disorders
Describe primary prevention of oral cancer
- health intervention
- habit intervention
- screening and followup with high risk pts
Describe secondary prevention of oral cancer
- recognise and treat OPMDs
- regular followup
Describe tertiary prevention of oral cancer
- early recognition and treatment of OSCC to improve survival and QOL
- regular followup for recurrent disease
Define oral potentially malignant disorder
A morphologically altered area in which a cancer is more likely to develop than on its normal counterpart
