
Contents
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Basic epidemiology and pathology Basic epidemiology and pathology
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Histology Histology
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Staging Staging
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References References
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References References
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The patient with head and neck cancer The patient with head and neck cancer
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Possible psychiatric complications Possible psychiatric complications
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References References
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References References
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Tumour treatment: implications for the palliative stage Tumour treatment: implications for the palliative stage
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Treatments Treatments
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Surgical treatment Surgical treatment
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Radical neck dissection Radical neck dissection
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Radical radiotherapy Radical radiotherapy
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Palliative radiotherapy Palliative radiotherapy
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Chemotherapy Chemotherapy
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Chemoradiotherapy Chemoradiotherapy
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Immunomodulators Immunomodulators
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Some notes on specific tumours, with emphasis on advanced disease Some notes on specific tumours, with emphasis on advanced disease
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Oral cavity tumours Oral cavity tumours
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Carcinomas of the sinuses Carcinomas of the sinuses
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Salivary gland tumours Salivary gland tumours
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Malignant melanoma Malignant melanoma
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Carcinoma of the larynx Carcinoma of the larynx
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Carcinomas of the pharynx Carcinomas of the pharynx
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References References
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References References
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Pain Pain
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Sources of pain in cancer of the head and neck Sources of pain in cancer of the head and neck
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Approach to pain assessment Approach to pain assessment
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Further pain management options Further pain management options
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Mouth problems in head and neck cancer Mouth problems in head and neck cancer
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Management of xerostomia Management of xerostomia
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Dribbling Dribbling
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Sticky, viscous saliva Sticky, viscous saliva
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Mucositis Mucositis
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References References
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References References
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Tracheostomy Tracheostomy
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Types of tracheostomy Types of tracheostomy
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A guide to types of tracheostomy tube A guide to types of tracheostomy tube
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Signs of problems with a tracheostomy Signs of problems with a tracheostomy
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Reference Reference
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Reference Reference
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Swallowing problems Swallowing problems
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Improving swallowing Improving swallowing
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Other helpful manoeuvres Other helpful manoeuvres
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Is the patient at risk of aspiration? Is the patient at risk of aspiration?
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Gastrostomies Gastrostomies
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Types of gastrostomy Types of gastrostomy
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Care of the gastrostomy tube Care of the gastrostomy tube
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Feeding Feeding
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Problems with gastrostomies Problems with gastrostomies
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Reference Reference
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Reference Reference
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Speech problems Speech problems
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Production and articulation of speech Production and articulation of speech
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Laryngectomy Laryngectomy
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Recurrent laryngeal nerve palsy Recurrent laryngeal nerve palsy
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There are various techniques for treating vocal fold palsies: There are various techniques for treating vocal fold palsies:
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Articulation problems Articulation problems
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References References
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References References
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Infection and fistulae Infection and fistulae
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Local infection Local infection
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Osteomyelitis Osteomyelitis
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Treatment Treatment
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Fistulae Fistulae
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Emergencies Emergencies
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Catastrophic bleeds Catastrophic bleeds
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Risk factors Risk factors
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Warning signs Warning signs
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Management Management
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Checklist Checklist
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Tracheostomy tube obstruction Tracheostomy tube obstruction
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Causes Causes
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Management Management
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Reference Reference
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Reference Reference
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Quality of life Quality of life
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References References
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Body image and sexuality Body image and sexuality
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Working with body image Working with body image
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References References
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Further reading Further reading
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References References
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Further reading Further reading
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General medical problems in patients with head and neck cancer General medical problems in patients with head and neck cancer
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Syncope Syncope
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Steroids Steroids
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Further reading Further reading
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Further reading Further reading
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Cite
Abstract
As a consequence of its location, head and neck cancer can affect breathing, speech, swallowing, and most of the special senses, and can impact massively on quality of life and body image. The head has a particularly complex anatomy in a very restricted space, and tumours have the potential to cause very complex and severe pain, often with a major neuropathic element. Disease in the mouth can lead to fistulae and aspiration pneumonia. Some tumours carry a risk of life-threatening bleeding. Management of all of these and other features of advanced head and neck cancer require skill and knowledge. Head and neck cancer, perhaps more than any other cancer, involves the total person, and requires a multidisciplinary response. This chapter summarizes the clinically important aspects of the main pathologies, and discusses a practical approach to symptom control of this difficult area.
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