Head & neck tumors

Presented by: Ghiada Al-Rashed

:Learning objectives

What alternatives can and

should the doctor offer, and

why?

Alternative Cancer Treatments

Alternative cancer treatments may not play a direct

role in curing the cancer.

BUT, they may help the patient to cope with signs and

symptoms caused by cancer and cancer treatments.

To Maintaining a patient’s quality of life and To

improve the comfort is another important goal of

treatment.

Related to our patient

He is hardly able to eat

or drink.

His weight has fallen by 15 kg.

WorseningPain

Constant thirst.

Dry mouth

Hardly able to eat or drink

and His weight has fallen by

15 Kg

Cachexia

cachexia

Neck metastasis &

Side effect of radiotherapy

Difficulties in eating and drinking

Malnutrition and dehydrationcachexia

• It is loss of weight, muscle atrophy, fatigue and weakness in someone who is not actively trying to lose weight.

Lead to cause

Management of cachexia

By : Nutrition

Nutrition

They need it for short- term or long-term.

Preferred mode of feeding Oral route.

Regarding our patient the tumor & side effect of therapy

affects How a person eats or drinks they will need to

have a other rote of feeding (feeding tube placed)

For Long-Term

Gastrostomy Tube Percutaneous Endoscopic Gastrostomy( PEG tube)

Feeding tube (catheter) that is placed through the skin and muscle of your abdomen directly into your stomach.

Placed during an operation.

Under general anesthesia.

It is gastrostomy tubes , placed under endoscopic guidance, using a much smaller incision.

Passes through the skin of the abdomen.

Under local anesthesia.

For Short-Term

Nasogastric feeding tube ( NG tube):This tube goes in through the nose, down the esophagus, and into the stomach.

The pain is worsening

Analgesic

s

Pain

If the patient have severe pain,

the doctor will try to find the

treatment plan that best relieves

patient’s pain with the fewest side

effects.

Pain is caused by : the cancer itself, But can

also be caused by cancer-related treatment

or tests.

Step for Treatment Cancer Pain:

Use non-

opioidse.g:

Paracetamol

or

NSAID

Add mild-

opioidse.g:

Tramadol

Replace

mild-opioids

with strong-

opioid e.g:

Morphin

Refer for invasive pain

management

ANALGESIC

Constant thirst

Xerostomia

Xerostomia

Xerostomia is defined as dry mouth resulting from

reduced or absent saliva flow.

It is the most common side effect may be caused by

either chemotherapy or radiation therapy.

Management of Xerostomia

• Medications that stimulate the salivary glands such

as pilocarpine.

• Medication that prevent or lessens the side effect of

radiation treatment e.g. amifostine.

There is a metastasis in the neck

which threatens to perforate the

skin.

Carotid

blowout

syndrome

• This is an extremely high risk condition

associated with significant degrees of

morbidity and mortality.

• Is defined as rupture of the carotid artery

that caused by head and neck tumor.

• Result of radiotherapy which cause a

fetal hemorrhage.

Carotid blow out syndrome

• Saving lives of these patients Rapid diagnosis of this condition and active intervention will help in.

Management

Endovascular therapy:

• Stent graft placement

Summary

How to deal with pain,

dray mouth, unable to eat

Carotid blow out syndrome

Alternative cancer

treatments

References http://www.cancer.org/cancer/oralcavityandoropharyngeal

cancer/detailedguide/oral-cavity-and-oropharyngeal-

cancer-treating-pain-control

http://www.drtbalu.co.in/cartoid_blow.html

http://www.cancer.org/treatment/survivorshipduringandaft

ertreatment/nutritionforpeoplewithcancer/nutritionforthepe

rsonwithcancer/index#t6UBHrKSbH3dAeyY.97

http://www.cancer.org/cancer/oralcavityandoropharyngeal

cancer/detailedguide/oral-cavity-and-oropharyngeal-

cancer-treating-pain-control

http://www.cancer.org/treatment/treatmentsandsideeffect

s/physicalsideeffects/pain/paindiary/pain-control-treating-

cancer-pain