View source for Head and neck cancer

<section begin="oncology" />
* Tumours of the head and neck include
** Eye and orbital tumours
** [[Oral cavity and oropharynx cancer|Oral cavity cancer]]
** Pharyngeal tumours
*** [[Nasopharynx cancer|Nasopharynx]]
*** [[Oral cavity and oropharynx cancer|Oropharynx]]
*** [[Hypopharynx cancer|Hypopharynx]]
** [[Laryngeal cancer|Laryngeal tumours]]
*** Supraglottic
*** Glottic
*** Subglottic
** Tumours of the nasal cavity and paranasal sinuses
** Tumours of the salivary gland
** Tumours of the thyroid gland
* Epidemiology
** Head and neck cancer is the 6th most common cancer worldwide
* Etiology
** Smoking
** Alcohol
** Poor oral hygiene
** EBV – for nasopharyngeal carcinoma
** HPV – for oropharyngeal and laryngeal cancer
* Pathology
** 80% are squamous cell
** 20% are adenocarcinoma, lymphoma, sarcoma, etc.
** Precancerous lesions
*** Leukoplakia
*** Erythroplakia
*** Lichen planus
** Metastasizes most often to lung
* Clinical features
** Ulceration of mucosa
** Exophytic growth of mucosa
** Neck mass
** Sore throat
** Hoarseness
** Pain radiating into the ear
*** Due to cranial nerve affection
** Dysphagia
* Diagnosis
** FNAB or direct excision biopsy
* Work-up after diagnosis
** CT with contrast or MRI of head and neck
** Laryngoscopy
** Neck US
** PET scan
* Treatment
** Majority of cases are treated with multiple modalities
** Surgery
*** Only used if R0 resection with acceptable functional results is expected
**** This means that surgery is not performed unless the surgeon believes that he can completely resect the tumour
*** If early stage cancer -> transoral surgery (TORS)
*** If cancer has spread to lymph nodes, neck dissection must be performed
**** Modified radical neck dissection
**** Selective neck dissection
*** Surgery, especially of pharynx and larynx, impairs quality of life, which must be taken into account when deciding treatment modality
** Radiotherapy
*** External beam radiotherapy or brachytherapy
*** Can be given with curative or palliative intention
*** Can be given postoperatively or primarily
*** Primary radiotherapy alone is usually sufficient in
**** Cancer of the lip
**** Cancer of the nose
**** Cancer of the floor of the mouth (brachytherapy)
**** Cutaneous lymphoma
** Chemotherapy
*** Cisplatin
*** Taxanes
*** 5-FU
** Biological and immunotherapy
*** Cetuximab (anti-EGFR)
*** Nivolumab (anti-PD-1)
*** Pembrolizumab (anti-PD-1)
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[[Category:Ear, nose, throat (ENT)]]
[[Category:Oncology]]