Presented By Shirley Jordan Seay PhD, RN, CTRnuchichietaphi.org/images/HPVWHATYOUDIDNOTKNOW.pdf ·...

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Presented By

Shirley Jordan Seay PhD, RN, CTR

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ObjectivesDiscuss the unintended

consequences of HPV

infection.

Identify cancers

associated with HPV

infection

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HPV Associated Cancers

Cervix

Vagina

Vulva

Anus

Penis

Oropharynx

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Summary of Overall HPV Related Cancer Facts

Oropharyngeal cancer has the highest number

of cases of the HPV-associated cancers

HPV-associated cervical cancer was the second

most common

For all HPV-associated cancers combined, the

incidence rate among females was 48 percent

greater than that for males

The incidence rate of oropharyngeal cancer

among males was more than four times that for

females

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Summary of Overall HPV Related Cancer Facts

Incidence rates for HPV-associated cervical and

oropharyngeal cancers were highest in the 50 to 69

years age

Incidence rates for HPV-associated cancers among

males in Ohio were similar to those for the United

States, with the exception that the incidence rate for

HPV-associated oropharyngeal cancer was greater in

Ohio

Among those 50 to 69 years old, Ohio incidence rates of

vulvar cancer (5.0) and oropharyngeal cancer (14.6)

were greater than those in the United States (3.4 and

12.7, respectively).

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HPV Associated Cancers

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Risk Factors

Occupational

asbestos

coal products

nickel

textiles

wood dust

organic compounds

leather workers

machinists

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Risk Factors

Personal/environmental

Tobacco use

Alcohol

Poor oral hygiene

Long-term sun exposure

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Risk Factors

Herpes simplex and

Human Papilloma Viruses:

head and neck cancers

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Risk Reduction

xx

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PREVENTION

HPV vaccine to be most effective, the

series should be given prior to

exposure to HPV.

Two doses recommended for 9–14

year olds, while older adolescents

need three doses

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Anatomy

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Topography

Base of tongue

Lingual tonsil

Soft palate

Uvula

Tonsillar fossa

Tonsillar pillar

Overlaping lesion

of tonsil

Tonsil

Vallecula

Lateral wall of

oropharynx

Posterior

pharyngeal wall

Overlapping lesion

of oropharynx

Orophaynx

Pharyngeal tonsils

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Screening

Thorough oral examination

included in routine check-ups

Every 3 years age 20 to 40

Every year for 40 and over

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Early Indicators

Oral Cavity and Oropharynx

Leukoplakia

Erythroplakia

Pain or ulcer that fails to heal

Painless, persistent mass

Difficulty with dentures

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Late Indicators

Oral Cavity and Oropharynx

Dysphasia

Speech difficulties

Aspiration (oropharyngeal)

Trismus (lockjaw)

Referred otalgia (ear pain)

Weight loss

Cervical adenopathy

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Phillip Rubin Clinical Oncology

Jump to first pagePhillip Rubin Clinical Oncology

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http://www.ghorayeb.com/Pictures.html

TONGUE CANCER

Bechara Y. Ghorayeb, MD

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http://www.ghorayeb.com/Pictures.html

TONGUE CANCER

Bechara Y. Ghorayeb, MD

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http://www.ghorayeb.com/Pictures.html

TONGUE CANCER

Bechara Y. Ghorayeb, MD

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.

This left tonsillar squamous cell carcinoma exhibits

enlargement and ulceration of the tonsil.

SQUAMOUS CELL CARCINOMA OF THE TONSIL

Bechara Y. Ghorayeb, MD

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Early Indicators

Larynx and Hypopharynx

Persistent Hoarseness

Throat Pain

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Late IndicatorsLarynx and Hypopharynx

PainDysphagia

Dyspnea and stridor

Hemoptysis

Referred otalgia (supraglotic)

Aspiration (supraglotic)

Cervical adenopathy

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http://www.ghorayeb.com/Pictures.html

Cancer of the Larynx

Bechara Y. Ghorayeb, MD

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Histologic Diagnosis

Incisional Biopsy

FNA

Excisional Biopsy

Panendoscopy

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Tests

Laboratory studies

Bone and Liver Scans

Panorex

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American Joint Committee on Cancer

STAGING

TUMOR NODES METASTASIS

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TUMOR

Size; oral cavity/oropharynx

Invasion/extension

Cord mobility/fixation; larynx

TIS T1 T2 T3 T4

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LYMPH NODES

Size

Location

NumberN0 N1 N2 N3

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METASTASIS

PresentAbsence

M0 M1

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OROPHARYNX(Including Base of Tongue, Soft Palate and Uvula)

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Stage Oropharynx p16-

T3 N1 M0

Tumor more than 4 cm in greatest dimension

Metastasis in a single ipsilateral lymph node, 3 cm or smaller in greatest dimension and ENE (-)

No distant metastasis

T3

N1

M0

STAGE III

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Stage Oropharynx p16+

T3 N1 M0

Tumor more than 4 cm in greatest dimension

One or more ipsilateral lymph nodes, none larger than 6 cm

No distant metastasis

T3

N1

M0

STAGE II

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Oropharynx p16-

HPV Mediated – p16+ Orophayngeal

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Mandatory Reportable Disease

Cancer is a reportable disease. State and Federal law mandates that cancer cases be reported

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Tumor Registry

Cancer Registries collect and analyze data on all cancer cases diagnosed and/or treated at various facilities. The data includes diagnosis, treatment, follow-up, and survival information on all cancer patients.

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Tumor Registry

A Tumor Registry is a coordinated

data collection system which

analyzes data on persons with a

diagnosis of cancer for the

purpose of improving the quality

of patient care and promoting

life-time follow-up.

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Specific Information

Collected

General Demographic Information

Diagnostic tests such as CAT Scans, MRI,

X-rays

Date diagnosed

Treatment

Tumor Stage

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How You Can Help

Address when Diagnosed

Physician Occupation

Place of Birth Race/Ethnicity

Tobacco History Exact Dates

Alcohol History Other Cancers

Follow-up Data

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ResourcesOhio Cancer Incidence Surveillance System (OCISS) https://www.odh.ohio.gov/health/cancer/ocisshs/ci_surv1.aspx

National Programs of Cancer Registries https://www.cdc.gov/cancer/npcr/

Surveillance, Epidemiology, and End Results (SEER) Program https://seer.cancer.gov/

Commission on Cancer

https://www.facs.org/quality-programs/cancer/ncdb/qualitytools

American Joint Committee on Cancer (AJCC)

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QUESTIONS

THANK YOU

PLEASE COMPLETE

EVALUATION FORM

DrJordanSeay@gmail.com