Head and Neck Cancers

Question 1

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

Answer 1

Squamous cell carcinoma

Question 2

What proportion of head an neck cancers are squamous cell?

Answer 2

90%

Question 3

Where do the majority of squamous cell carcinomas originate from in the head and neck/

Answer 3

• Oral cavity
• Oropharynx
• Hypopharynx
• Larynx
• Trachea

Question 4

What are risk factors for the development of head and neck cancers?

Answer 4

• Smoking
• Increased alcohol consumption
• Vitamin A and C deficiency
• Nitrosamines in salted fish
• HPV
• GORD
• Deprivation

Question 5

What are symptoms of head and neck cancers?

Answer 5

• Neck pain/lump
• Hoarse voice > 6 weeks
• Sore throat > 6 weeks
• Mouth bleeding
• Mouth numbness
• Sore tongue
• Painful ulcers
• Patches in the mouth
• Earache/effusion
• Lumps
• Speech change
• Dysphagia

Question 6

What investigations might you do for someone presenting with features of a head and neck cancer?

Answer 6

• Fibre-optic panendoscopy - aerodigestive tract
• FNA/Biopsy
• CT/MRI - staging

Question 7

What are clinical features of oral cavity/tongue carcinomas?

Answer 7

• Persistent painful ulcers
• Leukoplackia/Erythroplakia - tongue, gums, mucosa
• Otalgia
• Odynophagia
• Lymphadenopathy

Question 9

Which gender is more likely to develop oro-pharyngeal carcinoma?

Answer 9

Male

Question 10

How do those with oropharyngeal carcinoma teend to present?

Answer 10

More often Smokers than not

• Sore throat
• Sensation of a lump
• Referred otalgia

Question 11

What is the most commonly connected virus to oropharyngeal cancers?

Answer 11

HPV 16

Question 12

What cancers has HPV 16 been linked to?

Answer 12

Carcinomas of the

• Tongue
• Tonsil
• Pharynx

Question 13

How would someone with laryngeal cancer present??

Answer 13

Male smoker

• Progressive hoarseness
• Stridor
• Dysphagia/odynophagia
• Haemoptysis
• Otalgia - if pharynx involved

Question 14

What investigations might you do in someone with suspected laryngeal cancer?

Answer 14

• Laryngoscopy + Biopsy
• HPV status
• MRI staging

Question 15

How would you manage laryngeal cancer?

Answer 15

• Small tumours - Radical radiotherapy
• Large tumours - partial/total laryngectomy +/- block dissection of neck glands

Question 16

How would you manage oropharyngeal cancer?

Answer 16

Surgery and chemoradiotherapy

Question 17

How can hypopharyngeal tumours present?

Answer 17

• Lump in the throat
• Dysphagia
• Odynophagia
• Referred otalgia
• Dysphonia

Question 18

What procedures can be used to help with voice restoration after laryngectomy surgery?

Answer 18

• Trans-oesophageal puncture - one way valve inserted between trachea and pharynx/oesophagus - valve vibrates pharyngeal/oesophageal segment
• Artificial larynx

Question 19

How are laryngeal carcinomas staged?

Answer 19

TNM staging