head and neck cancers Flashcards
More than 90% of head and neck malignancies are
are squamous cell carcinomas.
Squamous cell carcinoma s
- Cancer of oral cavity & oropharynx
- Cancer of larynx & hypophaynx
- Cancer of nasopharynx
- Cancer of nasal cavity & paranasal Sinuses
Non - Squamous cell carcinomas
- Cancer of thyroid
- Cancer of salivary glands
- Sarcomas
- soft tissue
- hard tissue
aetiology
- Tobacco
- Alcohol
- Dental factors
- Occupational exposures
- Infections
- Nutritional factors
- Inflammatory cause
- Genetic factors
- Immunologic factors
- Endocrinal disturbances
- Radiation
inflammatory causes
GERD : Risk factor in 36-54 % cases of laryngeal pharyngeal cancer.
- PRECANCEROUS CONDITIONS OR
LESIONS : leukoplakia, erythroplakia
aetiology: radiation
NPC : Previous history of radiation therapy for cricoid
carcinoma or carcinoma of posterior wall of pharynx.
• Thyroid & salivary gland cancer : history of radiation
therapy, exposure to radiation fallot from nuclear power plant or nuclear weapon in childhood .
4 stages of tumour growth
- Malignant changes in 1 cell (transformation)
- Growth of transformed cell
- Local invasion
- Distant metastasis
molecular basis of cancer: Alteration in 4 normal regulatory genes
I. Growth promoting oncogenes
II. Growth inhibiting tumor suppressor genes
III. Genes that regulate apoptosis
IV. Genes involved in DNA repair
tumour metastasis: pathway of metastasis
• Pathway of metastasis
- Haematogenous spread
- Lymphatic spread
- Other routes
- Transcelomic spread
- Spread through the epithelial surface
- Spread through CSF
- Implantation
common signs and symptoms of head and neck cancers
- chronic sore throat
- hoarse voice
- dysphagia
- earache
- headache
- Unusual bleeding in the mouth
- discolouration on the gums, tongue, or lining of the mouth
- Nasal obstruction
- Numbness of the face
- Trouble when breathing or speaking
- Undefined weight loss
red flag symptoms
more than three weeks of:
- Sore throat
- Hoarseness
- Stridor
- Dysphagia
- Lump in neck
- Unilateral otalgia
red flag signs
- Red or white patch in mouth
- Oral ulceration, swelling or loose tooth
- Lateral neck mass
- Rapidly growing thyroid mass
- New Cranial nerve palsy
- Orbital mass
- Unilateral ear effusion
staging of cancer: TNM system
T (1-4): enlargement of & invasion by primary tumor
N (1-3: spread to regional lymph nodes
M (0 or 1) : spread to different metastatic sites
T - Primary Tumour
TX. Primary tumor cannot be assessed
T0. No evidence of primary tumor
Tis. Carcinoma in situ
T1, T2, T3, T4. Increasing size and/or local extent of the primary tumor
N. Regional Lymph Nodes
NX. Regional lymph nodes cannot be assessed
N0. No regional lymph node metastasis
N1, N2, N3. Increasing involvement of regional lymph nodes
