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Head & Neck Cancer

  • HEAD & NECK CANCER

  • Definition

    • Cancers of the lip, mouth, nose, sinuses, pharynx, larynx, and (possibly) trachea.
    • 90% are squamous cell carcinomas.
  • Signs and symptoms

    • Throat lump.
    • Sore throat and odynophagia.
    • Dysarthria and dysphonia. A hoarse voice suggests laryngeal disease or lung cancer invading the recurrent laryngeal nerve.
    • Earache
    • Cough
    • Leukoplakia: white areas of keratosis in the mouth or throat, which can be premalignant. Hairy leukoplakia is a non-malignant type caused by EBV in HIV patients.
    • Weight loss.
    • Epistaxis
    • Cervical lymphadenopathy: cervical nodes are a common site of spread. Supraclavicular lymphadenopathy suggests GI or lung cancer.
  • Risk factors

    UV-HEAD for SCC:
    • UV light: lip cancer.
    • HPV: oropharyngeal cancer.
    • EBV: nasopharyngeal cancer.
    • Alcohol
    • Having a Drag i.e. smoking, especially oral and laryngeal cancer.
    Adenocarcinomas:
    • Furniture factory workers are at increased risk due to wood dust exposure. Usually affects ethmoidal sinus.
  • Investigations

    • Nasopharyngoscopy
    • Needle biopsy including of lymph nodes.
    • MRI for staging.
  • Management

    • Radiotherapy is mainstay, especially if small.
    • Many will also need surgery ± adjuvant chemotherapy.







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