tailieunhanh - Tài liệu: DIAGNOSIS AND MANAGEMENT OF HEAD AND NECK CANCER

Control. Research suggests that an organism’s perception of control during stressful events is very important to both psychological and physical health. For example, cancer- ous tumor growth has been found to be enhanced in rats exposed to inescapable shock compared to tumor growth in rats given escapable shocks (Sklar & Anisman 1979; Vis- intainer, Volpicelli, & Seligman, 1982). Several studies have shown that increasing indi- viduals’ sense of control can have profound health implications. Rodin and Langer (1977) found that nursing home patients given control over their schedule of activities lived considerably longer than a matched comparison group | SIGN Scottish Intercollegiate Guidelines Network NHS Quality Improvement Scotland Diagnosis and management 90 of head and neck cancer Quick Reference Guide October 2006 COPIES OF ALL SIGN GUIDELINES ARE AVAILABLE ONLINE AT ALL HEAD AND NECK CANCERS REDUCING RISK The risk of having head and neck cancer can be reduced by B not smoking or chewing tobacco B limiting alcohol consumption in line with government guidelines C increasing the intake of fruit and vegetables specifically tomatoes olive oil and fish oils C reducing the intake of red meat fried food and fat. PRESENTATION AND SCREENING 0 All healthcare practitioners including dental and medical practitioners should be aware of the presenting features of head and neck cancer and the local referral pathways for suspected cancers. 0 Dental practitioners should include a full examination of the oral mucosa as part of routine dental check up. Leaflets about signs symptoms and risks of head and neck cancer should be available in primary care. REFERRAL Rapid access or one stop clinics should be available for patients who fulfil appropriate referral criteria. 0 Patients should be seen within two weeks of urgent referral. DIAGNOSIS AND STAGING D Fine needle aspiration cytology should be used in the investigation of head and neck masses. D All patients with head and neck cancer should have direct pharyngolaryngoscopy and chest X-ray with symptom-directed endoscopy where indicated. D CT or MRI of the primary tumour site should be performed to help define the T stage of the tumour. MRI should be used to stage oropharyngeal and oral tumours. D MRI should be used in assessing laryngeal cartilage invasion tumour involvement of the skull base orbit cervical spine or neurovascular structures most suprahyoid tumours . 1 ALL HEAD AND NECK CANCERS DIAGNOSIS AND STAGING cont D CT or MRI from skull-base to sternoclavicular joints should be performed in all patients at the time of imaging the primary tumour to stage the