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head and neck cancer > management of head and neck cancer > Flashcards

management of head and neck cancer Flashcards

1
Q

What are the 2 most prevalent sites of head and neck cancer?

A

In the larynx and the tonsils.

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2
Q

What is the next step in patient care following a positive biopsy?

A

A diagnostic work-up involving further examination and investigations.

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3
Q

How is the grading of cancer cells achieved?

A

Done based on histological appearance and how the cells differentiate, rate of cell division and how likely they are to spread.

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4
Q

What does the staging of cancer cells tell you?

A

The extent of the cancer and whether it has metastasised.

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5
Q

What does T1 represent in terms of tumour size?

A

A tumour measuring 2cm or less.

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6
Q

What does T2 represent in terms of tumour size?

A

A tumour measuring greater than 2cm but LESS than 4cm.

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7
Q

What does T3 represent in terms of tumour size?

A

A tumour measuring greater than 4 cm with NO local invasion.

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8
Q

What does T4 represent in terms of tumour size?

A

A tumour measuring greater 4cm with local involvement.

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9
Q

What does N0 represent in tumour staging?

A

No nodal involvement.

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10
Q

What does N1 represent in tumour staging?

A

Single ipsilateral node involvement measuring less than 3cm.

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11
Q

What does N2 represent in tumour staging?

A

Ipsilateral node measuring greater than 3cm but greater than 6cm or bilateral nodes.

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12
Q

What does N3 represent in tumour staging?

A

Nodal involvement in any nodes measuring greater than 6cm.

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13
Q

What does M0 represent in tumour staging?

A

No metastases.

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14
Q

What does M1 represent in tumour staging?

A

Metastases.

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15
Q

Which stage corresponds to T1 N0 M0?

A

Stage 1

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16
Q

Which stage corresponds to T2 N0 M0?

A

Stage II

17
Q

Which stage corresponds to T3 N0 M0 or any N1?

A

Stage III

18
Q

Which stage corresponds to T4 N2 or N3 M1?

A

Stage IV

19
Q

Which diagnostic imaging test is based on levels of glucose metabolism?

A

PET scan

20
Q

Why is chest imaging mandatory in cancer diagnosis?

A

As this confirms whether the disease has spread to the lungs.

21
Q

Which type of imaging scan is useful to assess undiagnosed neck lumps and guide a fine needle aspiration to allow cell cytology?

A

An ultrasound scan.

22
Q

What are the 2 aims of treatment?

A

Either curative or palliative.

23
Q

Which types of lesions is surgery most commonly used to target?

A

Larger and more extensive tumours.

24
Q

Describe the basis of radiotherapy.

A

The use of high energy waves (similar to x-rays) to kill the cancer cells.

25
Q

Name some short-term side effects of radiotherapy.

A
  • Sore skin.
  • Sore mouth.
  • Difficulty swallowing.
26
Q

5 long-term implications of radiotherapy:

A
  • Xerostomia - impact of radiotherapy on the salivary glands.
  • Loss of taste due to xerostomia.
  • Risk of osteoradionecrosis.
  • Trismus
  • Mucositis
27
Q

What is the newer form of radiotherapy with a narrower beam which has been shown to reduce radiation-induced xerostomia?

A

Intensity-modulated radiotherapy (IMRT)

28
Q

Can chemotherapy alone cure head and neck cancer?

A

No.

29
Q

What are the 3 timings chemotherapy can be delivered?

A
  1. Neoadjuvant/Induction - before treatment.
  2. Concurrently with radiotherapy.
  3. Adjuvant - after radiotherapy.
30
Q

Name the 2 most common chemotherapy drugs for mouth and oropharyngeal cancer:

A
  1. Cisplatin
  2. Fluorouracil (5FU)

(or methotrexate)

31
Q

Which type of cancer therapy uses drugs to target the differences in cancer cells that help them to grow and survive.

A

Immunotherapy

32
Q

Name 3 drugs used in immunotherapy treatment for mouth and oropharyngeal cancer.

A
  1. Cetuximab
  2. Nivolumab
  3. Pembrolizumab
33
Q

How do Monoclonal Antibodies work?

A

By recognising and finding specific proteins on cancer cells.

head and neck cancer (5 decks)

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