Embed Size (px)
Citation preview
Jump to first page
Presented By
Shirley Jordan Seay PhD, RN, CTR
Jump to first page
ObjectivesDiscuss the unintended
consequences of HPV
infection.
Identify cancers
associated with HPV
infection
Jump to first page
HPV Associated Cancers
Cervix
Vagina
Vulva
Anus
Penis
Oropharynx
Jump to first page
Jump to first page
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
Jump to first page
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).
Jump to first page
HPV Associated Cancers
Jump to first page
Jump to first page
Risk Factors
Occupational
asbestos
coal products
nickel
textiles
wood dust
organic compounds
leather workers
machinists
Jump to first page
Risk Factors
Personal/environmental
Tobacco use
Alcohol
Poor oral hygiene
Long-term sun exposure
Jump to first page
Risk Factors
Herpes simplex and
Human Papilloma Viruses:
head and neck cancers
Jump to first page
Risk Reduction
xx
Jump to first page
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
Jump to first page
Jump to first page
Anatomy
Jump to first page
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
Jump to first page
Screening
Thorough oral examination
included in routine check-ups
Every 3 years age 20 to 40
Every year for 40 and over
Jump to first page
Early Indicators
Oral Cavity and Oropharynx
Leukoplakia
Erythroplakia
Pain or ulcer that fails to heal
Painless, persistent mass
Difficulty with dentures
Jump to first page
Late Indicators
Oral Cavity and Oropharynx
Dysphasia
Speech difficulties
Aspiration (oropharyngeal)
Trismus (lockjaw)
Referred otalgia (ear pain)
Weight loss
Cervical adenopathy
Jump to first page
Phillip Rubin Clinical Oncology
Jump to first pagePhillip Rubin Clinical Oncology
Jump to first page
http://www.ghorayeb.com/Pictures.html
TONGUE CANCER
Bechara Y. Ghorayeb, MD
Jump to first page
http://www.ghorayeb.com/Pictures.html
TONGUE CANCER
Bechara Y. Ghorayeb, MD
Jump to first page
http://www.ghorayeb.com/Pictures.html
TONGUE CANCER
Bechara Y. Ghorayeb, MD
Jump to first pagehttp://www.ghorayeb.com/Pictures.html
.
This left tonsillar squamous cell carcinoma exhibits
enlargement and ulceration of the tonsil.
SQUAMOUS CELL CARCINOMA OF THE TONSIL
Bechara Y. Ghorayeb, MD
Jump to first page
Early Indicators
Larynx and Hypopharynx
Persistent Hoarseness
Throat Pain
Jump to first page
Late IndicatorsLarynx and Hypopharynx
PainDysphagia
Dyspnea and stridor
Hemoptysis
Referred otalgia (supraglotic)
Aspiration (supraglotic)
Cervical adenopathy
Jump to first page
http://www.ghorayeb.com/Pictures.html
Cancer of the Larynx
Bechara Y. Ghorayeb, MD
Jump to first page
Histologic Diagnosis
Incisional Biopsy
FNA
Excisional Biopsy
Panendoscopy
Jump to first page
Tests
Laboratory studies
Bone and Liver Scans
Panorex
Jump to first page
American Joint Committee on Cancer
STAGING
TUMOR NODES METASTASIS
Jump to first page
TUMOR
Size; oral cavity/oropharynx
Invasion/extension
Cord mobility/fixation; larynx
TIS T1 T2 T3 T4
Jump to first page
LYMPH NODES
Size
Location
NumberN0 N1 N2 N3
Jump to first page
METASTASIS
PresentAbsence
M0 M1
Jump to first page
OROPHARYNX(Including Base of Tongue, Soft Palate and Uvula)
Jump to first page
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
Jump to first page
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
Jump to first page
Oropharynx p16-
HPV Mediated – p16+ Orophayngeal
Jump to first page
Mandatory Reportable Disease
Cancer is a reportable disease. State and Federal law mandates that cancer cases be reported
Jump to first page
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.
Jump to first page
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.
Jump to first page
Specific Information
Collected
General Demographic Information
Diagnostic tests such as CAT Scans, MRI,
X-rays
Date diagnosed
Treatment
Tumor Stage
Jump to first page
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
Jump to first page
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)
