Head and Neck Cancer Flashcards Preview

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Flashcards in Head and Neck Cancer Deck (6):
1

What is the most common type of head and neck cancer, and what is the pathophysiology?

  • Squamous Cell Carcinoma
  • Represents >90% of all head and neck cancer
  • Arises from squamous epithelium
  • May be various grades of dysplasia, before basal layer is violated
  • Distinguishes carcinoma-in-situ from ‘invasive’ carcinoma
     

2

Aside from squamous cell carcinoma, what are some other types of head and neck cancers?

  • Glandular Origin
    • Adenocarcinoma
    • Adenoid cystic carcinoma
    • Acinic Cell carcinoma
    • Mucoepidermoid carcinoma
    • Undifferentiated carcinoma
  • Sarcoma
  • Lymphoma
  • Mucosal Melanoma

3

What are the risk factors for head and neck cancers?

  • Risk Factors:
    • Tobacco
    • Alcohol
    • Epstein Barr Virus: nasopharynx
    • Human Papilloma Virus: oropharynx
      • Associated with HPV16: 14x increase in risk of scca
      • Younger patients
      • Latency of 15-20 years
      • Sexual activity
      • Potential impact of vaccination
  • Family History: relatively small risk factor

4

What is the clinical presentation of head and neck cancer?

  • Symptoms
    • Pain
    • Bleeding
    • Dysphagia, Odynophagia
    • Hoarseness, Hemoptysis
    • Neck mass
    • Otalgia
  • Findings
    • Ulcerative or exophytic lesion
    • Cervical adenopathy

5

Describe the diagnostic workup for head and neck cancer.

  • Biopsy of primary site, FNA cervical node
  • CT Neck with Contrast
  • CT Chest: r/o synchronous primary lung ca vs metastatic dx
  • LFT’s
  • PET/CT is widely utilized in common practice, though it is not formally required (NCCN Guidelines)
  • Staging, according to AJCC staging criteria
  • Discussion at multi-disciplinary Tumor Conference
     

6

What are the basic guidelines for treatment of head and neck cancers?

  • Stage I/II disease (T1/T2 N0M0) generally well-treated with single modality treatment: surgery vs radiation therapy
  • May require treatment of the cervical nodes, neck dissection yields diagnostic and therapeutic benefit
  • Advanced stage disease (Stage III, IV) generally treated with multi-modality therapy
  • Organ-preservation regimens: larynx, oropharynx
  • 5-year survival rates similar to standard of surgery/xrt; surgery for primary was reserved for salvage