AWARENESS DRIVE Dr Swati Lambor Consultant ENT Head Neck Surgery Manipal Hospital DonaPaula Goa Cancer is a class of diseases characterized by outofcontrol cell growth Malignant tumors ID: 597842
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HEAD NECK CANCER- AWARENESS DRIVE
Dr. Swati Lambor
Consultant ENT, Head Neck Surgery
Manipal
Hospital
Dona-Paula, GoaSlide2
Cancer is a class of diseases characterized by out-of-control cell growth.Malignant tumors form when two things occur
:
a cancerous cell manages to move throughout the body using the blood or lymph systems, destroying healthy tissue in a process called invasion.that cell manages to divide and grow, making new blood vessels to feed itself in a process called angiogenesis.When a tumor successfully spreads to other parts of the body and grows, invading and destroying other healthy tissues, it is said to have metastasized. This process itself is called metastasis, and is very difficult to treat.
What is a CANCERSlide3
What is a CANCER - videoSlide4
Include a wide range of tumours occurring in several areas of head & neck regionNasal cavityParanasal
sinuses
Mouth/ Oral cavityVoicebox/ LarynxPharynx – nasopharynx –oropharynx –hypopharynxSalivary glands- Parotid –Submandibular –SublingualThyroid cancersSkin malignancies
Head Neck CancersSlide5
Head Neck Cancers- AnatomySlide6
Head Neck Cancers- Anatomy
PARANASAL SINUSESSlide7
Head Neck Cancers-Anatomy
SALIVARY GLANDS
THYROID GLANDSlide8
In UK : 5-10% Indian subcontinent : 45% of all malignanciesMen are 2-3 times more commonly affected than women.
98% of patients are >40 years of age.
15% will have another cancer in nearby area. 10-40% will develop second cancer later Some statistics…Slide9
Better patient outcome (prognosis) if diagnosed at an early stage, esp. thyroid tumours.Affect 3 most important functions
Breathing
SwallowingVoiceObvious deformity after treatment.Many are preventable.What is special about HFN cancers?Slide10
CAUSESSlide11
Smoking and smokeless tobacco useAlcohol
Causes Slide12
Viruses – Human Papilloma Virus (tonsil), Epstein-Barr virus (nasopharynx
)
Causes
HPV
EBVSlide13
Causes
RADIATION EXPOSURESlide14
Causes
WOOD DUST EXPOSURESlide15
Diet – nasopharynx, thyroidChemical exposure- Nickel, Chromium, RadiumPoor dental hygiene, sharp teethSunlight exposure- skin
Genetic susceptibility
CausesSlide16
Squamous cell carcinomaAdenocarcinomaAdenoid cystic carcinomaLymphomaMelanoma
Basal cell
carcinomaSarcomas Types of HFN cancersSlide17
Symptoms and signsSlide18
MouthWhite/red patch- gums, tongue, inside of cheekSwelling of the jawBleeding from mouthPain in mouth
Symptoms one must not ignoreSlide19
CA OF LIPSSlide20
CA BUCCAL MUCOSASlide21
CA TONGUESlide22
CA OF JAWSlide23
Hidden areasSlide24
Hidden Areas
CA HARD PALATESlide25
Nasal cavity/ sinusesBlocked noseBleeding from nosePersistent nasal discharge, blood stained
Headaches
Displacement of eye/ watering/ visual impairmentsSwelling of cheekNumbness over faceLoose upper teeth/ ill-fitting denturesSymptoms Slide26
Nasal examination
SPECULUM
NASAL ENDOSCOPYSlide27
Tumours of Nose & SinusesSlide28
Tumours of sinusesSlide29
Tumours of sinusesSlide30
Tumours of sinusesSlide31
Symptoms -Pharynx Slide32
Tumour of nasopharynxSlide33
Symptoms -Pharynx Slide34
Oropharynx cancersSlide35
Symptoms -Pharynx Slide36
Hypopharynx/ laryngopharynx ExaminationSlide37
Hypopharynx/ laryngopharynx Examination
RIGID SCOPE
FLEXIBLE SCOPESlide38
Hypopharynx/ Laryngopharynx
PYRIFORM FOSSA CA
POSTCRICOID CASlide39
Symptoms-Voicebox/ Larynx
Hoarse
voiceDifficulty in breathingDifficulty in swallowing, Hot potato speechNeck swellingSlide40
Cancers of voiceboxSlide41
Cancers of voiceboxSlide42
Cancers of voiceboxSlide43
Swelling under the chin or around the jawbone numbness or paralysis of the muscles in the facepain in the face, the chin, or the neck that does not go away.
Symptoms-Salivary glandSlide44
Salivary Gland tumours
PAROTID GLANDSlide45
Salivary Gland tumours
SUBMANDIBULAR GLAND TUMOURSSlide46
Swelling in neckCommoner in females
Thyroid glandSlide47
Nonhealing ulcerEnlarging skin mole/ naevus
Skin cancersSlide48
Symptoms of spread - NeckSlide49
Symptoms of spread - OrgansSlide50
LungsCough, hemoptysis
Liver
Pain in abdomen, jaundiceSymptoms of spreadSlide51
Symptoms of spread
SPINE
Bone painsBRAINSeizures, paralysis,headacheSlide52
Sore in mouthPain in throatDifficulty in swallowing/ breathingChange in voiceLoose dentures/teethNasal block/ bleeding from nose
Lump/ mass in neck
Weight lossTo summarise the warning signsSlide53
Physical examinationInvestigationsTreatment options
What does the doctor do?Slide54
Investigations Slide55
Biopsy of growth/ FNACBlood testsRadiological inv- USG, CT scan, MRI scan, PET scanAim of inv:
Identify the
type of tumourStage the tumour- assess spreadFind the tumourFitness to undergo treatmentInvestigations Slide56
Investigations
NECK USGSlide57
Investigations
CHEST XRAYSlide58
Investigations Slide59
Investigations
NECK LN METSSlide60
Investigations
LIVER METS
BRAIN METSSlide61
Investigations
MRISlide62
Investigations
PET SCANSlide63
Investigations
PET SCANSlide64
Treatment Slide65
SurgeryRadiation therapyChemotherapy
Combinations
Treatment Slide66
Surgery Slide67
Radiotherapy Slide68
Chemotherapy Slide69
Minimally invasive surgeryRobotic surgeryTissue bioengineering
Future advances in treatmentSlide70
Avoid tobacco and alcohol.Use of ventilators, industrial mask filters, protective clothing recommended for occupational exposure.Diet rich in fruits and vegetables give valuable antioxidants.
Iodine rich diet for thyroid cancer prevention
Avoid midday sunPrevention of cancerSlide71
Many head neck cancers are preventable.Regular checkup is helpful.Do not ignore the warning signs.A healthy balanced diet should be the aim.
Take home messageSlide72
Thank you