Cancer
- ____ leading cause of ___ in the USA
- Half of all ___ and one-third of all ___ will have some form of cancer.
- ___ ___ that is out of control.
- Risk factors for head and neck cancer:
1. ____ USE
2. HEAVY _____ USE
3. POOR ___ _____
4. MECHANICAL ______
- Second leading cause of death in the USA
- Half of all men and one-third of all women will have some form of cancer.
- Cell growth that is out of control.
- Risk factors for head and neck cancer:
1. TOBACCO USE
2. HEAVY ALCOHOL USE
3. POOR ORAL HYGIENE
4. MECHANICAL IRRITATION
Signs and Symptoms
~General warning signs of head & Neck cancer:
- Unexplained __ ___
- ___
- ____
- _____
~Specific symptoms:
- Change in ___ or ___ function
- ____ that do not heal
- Unusual ___ or ___
- Thickening or a ____
- ____ or difficulty____
- Change in a ___ or ___
- Nagging ___ or ____
~General warning signs of head &
Neck cancer:
Unexplained weight loss
Fever
Fatigue
Pain
~Specific symptoms: Change in bowel or bladder function Sores that do not heal Unusual bleeding or discharge Thickening or a lump Indigestion or difficulty swallowing Change in a mole or wart Nagging cough or hoarseness
Head and Neck Cancer Treatment Team Members
- Head and Neck surgeon
- Radiation oncologist
- Medical oncologist
- Dentist
- Prosthedontist
- Social worker
- Nutritionist
- Rehabilitation specialists
1. Speech-Language Pathologist
2. Occupational Therapist
3. Physical Therapist
Head and Neck surgeon Radiation oncologist Medical oncologist Dentist Prosthedontist Social worker Nutritionist Rehabilitation specialists Speech-Language Pathologist Occupational Therapist Physical Therapist
Defining Cancers
~\_\_\_ or \_\_\_ ~TNM 1. \_\_\_- size of the tumor 0-4 2. \_\_\_- lymph nodes involved 0-3 3. \_\_\_\_ –spreading 0-1 ~Staging: -See Box 6-5 , page 103
Benign or malignant TNM Tumor- size of the tumor 0-4 Nodes- lymph nodes involved 0-3 Metastasis –spreading 0-1 Staging: See Box 6-5 , page 103
Surgical treatments (look these up)
Primary tumor surgery: Mandibulectomy: Mandibulotomy: Maxillectomy: Mohs surgery: Laser surgery: Laryngectomy: Partial laryngectomy: Laryngopharyngectomy: Tracheostomy: Gastrostomy: Neck Dissection: Reconstructive surgery:
Primary tumor surgery: Mandibulectomy: Mandibulotomy: Maxillectomy: Mohs surgery: Laser surgery: Laryngectomy: Partial laryngectomy: Laryngopharyngectomy: Tracheostomy: Gastrostomy: Neck Dissection: Reconstructive surgery:
Radiation Therapy
~High-energy x-rays to ……
~Different types:
- __-___ radiation- one-daily, high-beam hits tumor and ____
- ___-___ radiation – hits just the tumor
- ___ (small dose several times a day)
- Internal _____ therapy
~Side effects: (Box 6-8, page 105)
- Redness skin ____
- ___ glands change
- ____ pain
- ___ and ____
- ____
- Mouth ___ or sore ____
- ____ problems
- Painful ______
- Loss of ____
- Reduced sense of _____ (smell)
- Earaches/hardening of ____
- ________
- ______- reduced movement
- Peripheral ______
- Bone, cartilage, __ ___ death
~High-energy x-rays to kill cancer cells and shrink tumor.
~Different types:
-External-beam radiation- one-daily, high-beam hits tumor and surrounding tissue
-Intensity-modulated radiation – hits just the tumor
-Hyperfractionation (small does several times a day)
-Internal radiation therapy
~Side effects: (Box 6-8, page 105)
- Redness skin irritation
- Salivary glands change
- Bone pain
- Nausea and vomiting
- Fatigue
- Mouth sores or sore throat
- Dental problems Painful swallowing
- Loss of appetite
- Reduced sense of taste (smell)
- Earaches/hardening of ear wax
- Hypothyroidism
- Fibrosis- reduced movement
- Peripheral neuropathy
- Bone, cartilage soft tissue death
Chemo-therapy
~Using drugs to kill cancer cells ~Often have side effects (Box 6-9, page 106) -\_\_\_\_ -Nausea and \_\_\_\_ -\_\_\_\_ loss -Dry \_\_\_\_ -Loss of \_\_\_\_ -Reduced sense of \_\_\_\_ -Weakened \_\_\_ \_\_\_\_ -\_\_\_\_ and/or constipation -Open sores in the mouth/ \_\_\_\_
~Using drugs to kill cancer cells ~Often have side effects (Box 6-9, page 106) -Fatigue -Nausea and vomiting -Hair loss -Dry mouth -Loss of appetite -Reduced sense of taste -Weakened immune system -Diarrhea and/or constipation -Open sores in the mouth/ infection
Surgical management of Head/Neck Cancer (look up)
- “Majority of head and neck cancer patients have some ____ from cancer or ____.”
- Glossectomy:
- Palatal resection:
- Anterior/floor of mouth:
- Partial ____ resection
- Hemilaryngectomy
- Supraglottic ____
- Total _____
- “Majority of head and neck cancer patients have some dysphagia from cancer or treatments.”
- Glossectomy:
- Palatal resection:
- Anterior/floor of mouth:
- Partial pharyngeal resection
- Hemilaryngectomy
- Supraglottic laryngectomy
- Total laryngectomy
Effects of Radiation Therapy (Box 6-10)
\_\_\_\_ Xerostomia Sensory Changes in \_\_ and \_\_\_\_ \_\_\_\_ Neuropathy \_\_\_\_\_\_ Odynophagia Loss of\_\_\_\_ Edema \_\_\_\_\_ \_\_\_\_\_ Changes
Mucositis Xerostomia Sensory Changes in taste and smell Fibrosis Neuropathy Stricture Odynophagia Loss of appetite Edema Infection Dental Changes
Common Swallowing Disorders: Head and Neck Cancer
- ____ glossectomy
- ____ glossectomy
- Tonsil/base of ____
- Palatal resection
- Anterior/lateral floor of mouth
- ___ ____ resection
- Hemilaryngectomy
- _____ laryngectomy
- Total laryngectomy
- Partial glossectomy
- Total glossectomy
- Tonsil/base of tongue
- Palatal resection
- Anterior/lateral floor of mouth
- Partial pharyngeal resection
- Hemilaryngectomy
- Supraglottic laryngectomy
- Total laryngectomy
Esophageal Disorders
-Not the role of the SLP to treat ___ ___—refer to ___
-BUT…if problems impact other __ ___, (e.g. GERD) falls within our area of expertise.
-More common for SLP to screen ___ ____.
Differential Diagnosis: Figure 7-9, pg. 139
-Not the role of the SLP to treat esophageal dysphagia—refer to gastroenterologist
-BUT…if problems impact other swallowing issues, (e.g. GERD) falls within our area of expertise.
-More common for SLP to screen esophogeal dysphagia.
Differential Diagnosis: Figure 7-9, pg. 139
Esophageal Disorders
- Esophageal ____- lumen narrows
- ____ strictures
- Rings and ____
- ____ Stricture
- Esophageal _____
- Drug or pill _____
- Gastro-esophageal Reflux Disease (GERD)
- Infections
- _____-TE Fistula
- Acute ____ ingestion
- Radiation
- ____ conditions
- ___ disorders
- _____ Diverticulum
- Esophageal Stenosis- lumen narrows
- Malignant strictures
- Rings and Webs
- Benign Stricture
- Esophageal Diverticulum
- Drug or pill esophagitis
- Gastro-esophageal Reflux Disease (GERD)
- Infections
- Trauma-TE Fistula
- Acute chemical ingestion
- Radiation
- Skin conditions
- Motility disorders
- Zenker’s Diverticulum
Gastroesophageal Reflux Disease
- ___ ___ ___ ____ (NERD)
- Transient lower ___ ___ ___ (tSLERs)
- Non-erosive gastroesophageal reflux disease (NERD)
- Transient lower esophageal sphinctor relaxations (tSLERs)
