By Bruce Brockstein, Gregory Masters
Intriguing advances are taking place within the figuring out of the molecular pathogenesis of squamous head and neck cancers. Epidemiology, staging and screening, in addition to premalignancy, chemoprevention and the molecular biology of head and neck melanoma, lay the basis for the knowledge of the scientific chapters that stick to. debatable remedies might be in comparison to the traditional administration of sufferer care. remedy chapters are divided into level or classification particular (resectable complicated, unresectable complex or metastatic) difficulties, permitting the reader to check the present criteria and recommendations for sufferer forms or particular sufferers simply. issues of supportive care, past due toxicities and caliber of existence, usually missed are reviewed intimately. this can be a complete precis of the present state-of-the-art examine and remedy.
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Additional info for Head and Neck Cancer (Cancer Treatment and Research)
Sample text
Hypopharynx, Larynx, Oral Cavity, Paranasal Sinuses, Salivary Glands NX Regional lymph nodes cannot be assessed No regional lymph nodes metastasis N0 Metastasis in a single ipsilateral lymph node, 3 cm or less in N1 greatest dimension N2 Metastasis in a single ipsilateral lymph node, more than 3 cm but not more than 6 cm in greatest dimension: or in multiple ipsilateral lymph nodes, none more than 6 cm in greatest dimension; or in bilateral or contralateral lymph nodes, none more than 6 cm in greatest dimension N2a Metastasis in single ipsilateral lymph node more than 3 cm but not more than 6 cm in greatest dimension N2b Metastasis in multiple ipsilateral lymph nodes, none more than 6 cm in greatest dimension Metastasis in bilateral or contralateral lymph nodes, none more N2c than 6 cm in greatest dimension Metastasis in a lymph node more than 6 cm in greatest dimension N3 43 Head and Neck cancer DISTANT METASTASIS (M): ALL SITES Mx M0 M1 Distant metastasis cannot be assessed No distant metastasis Distant metastasis STAGE GROUPINGS: NASOPHARNYX Stage 0 Stage I Stage IIA Stage IIB Stage III Stage IVA Stage IVB Stage IVC Tis T1 T2a T1 T2a T2b T1 T2a,b T3 T4 Any T Any T N0 N0 N0 N1 N1 N0-1 N2 N2 N0-2 N0-2 N3 Any N M0 M0 M0 M0 M0 M0 M0 M0 M0 M0 M0 M1 N0 N0 N0 N1 N1 N0 N1 N1 N2 N3 Any N M0 M0 M0 M0 M0 M0 M0 M0 M0 M0 M1 SALIVARY GLANDS Stage I Stage II Stage III Stage IV T1 T2 T3 T1 T2 T4 T3 T4 Any T Any T Any T ALL OTHERS (oral cavity, oropharynx, hypopharynx, larynx,,paranasal sinuses) Stage 0 Stage I Stage II Stage III Stage I V A Stage I V B Stage IVC Tis T1 T2 T3 T1 T2 T3 T4 T4 Any T Any T Any T N0 N0 N0 N0 N1 N1 N1 N0 N1 N2 N3 Any N M0 M0 M0 M0 M0 M0 M0 M0 M0 M0 M0 M1 44 Epidemiology, Staging, and Screening of Head and Neck Cancer SCREENING Ways to contribute to head and neck cancer control include education about the risks of tobacco and alcohol, screening, and chemopreventive agents.
A sexual mode of transmission has been suggested but has yet to be proven. Patients with other HPV-associated neoplasms or premalignant conditions may be at a higher risk for the development of head and neck cancer. An increased risk for oropharyngeal cancer among spouses of women with a history of cervical dysplasia attributed to HPV has been reported 90. Another study showed a higher risk of tonsillar cancer in patients with history of anogenital cancer 91 . 6) was reported in a study of HPV-associated cancers in over 300,000 HIV positive subjects.
RACE AND SOCIOECONOMIC FACTORS Head and neck cancer is more common in blacks in comparison to whites with more pronounced differences in laryngeal cancer and in males. Higher rates of tobacco and alcohol consumption in blacks primarily account for these differences 9. Moreover, data from the SEER database show that between 1989-1996 blacks were diagnosed with a higher incidence of distant disease at presentation when compared to whites for both laryngeal and oral cavity/pharyngeal cancers. The majority of patients with nasopharyngeal carcinoma are of Asian descent.