Thyroid | Head + Neck Cancers Flashcards
(36 cards)
Risk factors of head + neck cancers
- smoking
- alcohol
- beta nut chewing (oral cancer)
- dental hygiene (oral cancer)
- viruses (e.g. HPV 16 for oropharynx)
- erythroplakia
Risks of thyroid cancer
- radiation exposure
- family history
- female
- young + old people’s lumps are more likely to be malignant
Supportive Managment of H+N cancers
- swallowing
- feeding
- voice rehab
- pain
- supportive care
Presentation of lip/oral cavity cancer
- lump
- pain > can refer to ear
- fixation of tongue
- dysphagia
- odynophagia
What is odynophagia?
Pain on swallowing
Investigations of lip/oral cavity cancer
- biopsy
- CT +/- MRI (including chest)
- PET
Treatment of lip/oral cavity treatment
- small tumour excise + repair
- radiotherapy
- extensive surgery for larger tumours that don’t respond to radiotherapy (hemiglossectomy/total glossectomy)
when does NICE reccommend 2WW pathway for suspected oral cancer
- unexplained ulceration in oral cavity >3 weeks
- persistent + unexplained neck lump
- lump on lip or in oral cavity
-red/white patch in oral cavity consistent with erythroplakia or erytholeukoplakia
Presentation of pharynx cancer
- often asymptotic > present with advanced disease
- lump
- pain
- referred otalgia
- dysphagia
- odynophagia
- weight loss
Investigation of pharynx cancer
- biopsy
- CT +/- MRI (including chest)
- PET
Treatment of pharynx cancer
- small tumour excise + repair
- radiotherapy
- extensive surgery for larger tumours that don’t respond to radiotherapy
Presentation of larynx cancer
- dyphnoia (main feature) - hoarse voice
- dysphagia
- referred otalgia
- globus
- neck lump
- weight loss
- cacexia
What is dyphonia?
Voice change
What is globus?
Persistent or intermittent non painful sensation of lump in throat
What is cacexia?
Weakening + wasting of body due to severe chronic illness
Investigations of larynx cancer
- CT (including chest)
- PET
- biopsy
when does NICE recommend 2WW pathway for suspected laryngeal cancer?
- > 45 years old with:
- persistent unexplained hoarseness or unexplained lump in neck
- perisitent sore throat
Treatment of larynx cancer
- small tumours: laser resection or radiotherapy
- medium sized tumours: radiotherapy +/- chemotherapy
- large tumours: that do not respond to radiotherapy may need laryngectomy
Presentation of thyroid cancer
- lump in thyroid
- neck nodal metastasis
- dysphagia
- feeling like being strangled
- dysphonia - hoarseness of voice
Investigations of thyroid cancer
Triple assessment
- full history + exam
- ultrasound
- needle testing of suspicious lumps as fine needle aspiration cytology
Head and neck cancers red flags
- persistent hoarseness of voice
- unexplained neck lump
- mass on lip or oral cavity
- erythroplakia or erythroleukoplakia
What is erythroplakia?
Red patches on tongue + oral cavity
What is erythroleukoplakia
Combination of leukoplakia + erythroplakia
White + red patches on tongue + oral cavity
What is the most common type of thyroid cancer?
Papillary adenocarcinoma
Then follicular adenocarcinoma
