Head and neck cancers

What is a stage 0 tumour?

carcinoma in situ = a group of abnormal cells in an area of the body.

What is a stage 1 tumour?

localised spread in organ it started in

What is a stage 2 tumour?

the tumour is larger than in stage 1 but the cancer hasn't started to spread into the surrounding tissues

What is a stage 3 tumour?

cancer is larger, may have started to spread into surrounding tissues and there are cancer cells in the lymph nodes nearby.

What is a stage 4 tumour?

the cancer has spread from where it started to another body organ

T = tumour size

primary tumour 1 - 4

1-3 = size of tunmour located in 1 organ.

4 - breach of organ

N = lymph nodes in neck involved?

0 = no spread, 3 = lots of lymph nodes containing cancer cells

M = metastasis = has the cancer spread to another part of the body?

0 = no spread

1 = spread to other lesions in the body

(unusual for head and neck cancers to metastisise)

Who manages brain tumours and associated SLCN?

neuro-oncology MDT

Effects of tumour on speech/ swallowing

- Structural changes to -------

- Structural changes to resonance chambers

- Structural changes to ---------- mechanism

- Space-occupying lesions may disrupt the ------- / swallowing/ phonation process

- Pain, appetite, weight, etc.

articulators

swallowing

breathing

What is primary closure surgery?

Tumour extracted and surrounding tissue pulled across to cover wound.

What is reconstruction surgery?

importing tissue, usually containing a blood supply, from a 'donor' site, and 'plumbing' it in to help reconstruct (e.g. inner forearm, shoulder)

Effects of treatment on speech and swallowing: surgery

Change in ------

Loss of --------

Swelling

Pain

Tracheostomy

----------- issues

anatomy

function

psychosocial

How can radiotherapy be delivered?

as primary or adjuvant treatment (BUT can only have RT to same area once)

Effects of treatment on speech and swallowing: radiotherapy

Mucositis = sore ----

Pain

Xerostomia/ altered -------

Fatigue

Psychosocial issues

mouth

saliva

What is chemotherapy?

the use of cytotoxic drugs to destroy cancer cells. (heightens toxicity of RT)

What is concurrent chemotherapy?

radiotherapy + chemotherapy

What is neoadjuvant chemotherapy?

Chemo administered before a primary treatment to shrink tumor and increase effectiveness of primary treatment (surgery, radiation, etc)

What is palliative chemotherapy?

relieve symptoms and improve quality of life

Effects of treatment on speech and swallowing: chemotherapy

Fatigue

Nausea/ vomiting

Reduced appetite

Infections

Sore -------

-> difficult to motivate ppl to ------ and -------- treatment.

attend and continue

mouth

dysgeusia

taste change

Sialorrhea

hypersalivation or excessive drooling