This is an extract of our Head And Neck Cancer document, which we sell as part of our Oncology Notes collection written by the top tier of University Of Leicester students.
The following is a more accessble plain text extract of the PDF sample above, taken from our Oncology Notes. Due to the challenges of extracting text from PDFs, it will have odd formatting:
Head and Neck cancer EpidemiologyMostly SCC (90%) o Common sites Oropharyngeal cancer = 6th commonest cancer Incidence increasing M>F (excluding thyroid cancer)
Risk factorsOral cavity Larynx Nasal cavity Pharynx Middle ear Salivary gland Thyroid glands
Smoking Alcohol Low socioeconomic status Male Age
< 16 years H+N cancer rare; thyroid and nasopharyngeal cancer are commonest +
Clinical featuresSymptoms arise from local irritation, ulceration and swelling Ulceration in oral cavity = pain Swelling in larynx = hoarseness, breathing problems + local pain o "Sore throat" is commonest complaintNICE referral criteria (low pick up rate, non-specific) o o o o o o o
Unexplained ulceration of mass in oral mucosa for > 3 weeks Unexplained tooth mobility for > 3 weeks Persistent hoarseness for > 3 weeks with normal CXR Unexplained neck lump of recent onset/ not previously diagnosed + changed over past 3-6 weeks Persistence of unexplained swelling of parotid/submandibular gland Unexplained/persistent sore/painful throat Persistent/unexplained pain in H+N area for > 4 weeks, associated with otalgia + normal otoscopy
Prognostic factorsSCC of H+N region is staged using TNM system Lung, liver + bone are commonest sites of metastatic spread The lower the location of nodal involvement in the neck, the worse the prognosis If patient survives the primary tumour they have an increased risk of developing a second malignancy
Oral cavity cancer o Surgery +/- radiotherapyRadiotherapy alone if small tumour o Chemo + radiotherapy for inoperable disease Laryngeal cancer o Early glottic cancer - endoscopic laser surgery/radiotherapy o Advanced glottic cancer - chemo + radiotherapy/total laryngectomy o Supraglottic - if small - radiotherapy, if larger, surgery/chemo/radiotherapy
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