Presented By Shirley Jordan Seay PhD, RN, CTR

Transcription

1 Presented By Shirley Jordan Seay PhD, RN, CTR

2 Objectives Discuss the unintended consequences of HPV infection. Identify cancers associated with HPV infection

3 HPV Associated Cancers Cervix Vagina Vulva Anus Penis Oropharynx

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5 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

6 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).

7 HPV Associated Cancers

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9 Risk Factors Occupational asbestos coal products nickel textiles wood dust organic compounds leather workers machinists

10 Risk Factors Personal/environmental Tobacco use Alcohol Poor oral hygiene Long-term sun exposure

11 Risk Factors Herpes simplex and Human Papilloma Viruses: head and neck cancers

12 Risk Reduction x x

13 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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15 Anatomy

16 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

17 Screening Thorough oral examination included in routine check-ups Every 3 years age 20 to 40 Every year for 40 and over

18 Early Indicators Oral Cavity and Oropharynx Leukoplakia Erythroplakia Pain or ulcer that fails to heal Painless, persistent mass Difficulty with dentures

19 Late Indicators Oral Cavity and Oropharynx Dysphasia Aspiration (oropharyngeal) Speech difficulties Trismus (lockjaw) Referred otalgia (ear pain) Weight loss Cervical adenopathy

20 Phillip Rubin Clinical Oncology

21 Phillip Rubin Clinical Oncology

22 TONGUE CANCER Bechara Y. Ghorayeb, MD

23 TONGUE CANCER Bechara Y. Ghorayeb, MD

24 TONGUE CANCER Bechara Y. Ghorayeb, MD

25 SQUAMOUS CELL CARCINOMA OF THE TONSIL. This left tonsillar squamous cell carcinoma exhibits enlargement and ulceration of the tonsil. Bechara Y. Ghorayeb, MD

26 Early Indicators Larynx and Hypopharynx Persistent Hoarseness Throat Pain

27 Late Indicators Larynx and Hypopharynx Pain Dysphagia Dyspnea and stridor Hemoptysis Aspiration (supraglotic) Cervical adenopathy Referred otalgia (supraglotic)

28 Cancer of the Larynx Bechara Y. Ghorayeb, MD

29 Histologic Diagnosis FNA Excisional Biopsy Incisional Biopsy Panendoscopy

30 Tests Panorex Bone and Liver Scans Laboratory studies

31 American Joint Committee on Cancer STAGING TUMOR NODES METASTASIS

32 TUMOR Size; oral cavity/oropharynx Invasion/extension Cord mobility/fixation; larynx TIS T1 T2 T3 T4

33 LYMPH NODES Size Location Number N0 N1 N2 N3

34 METASTASIS M0 Absence M1 Present

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

36 Stage Oropharynx p16- Tumor more than 4 cm in greatest dimension Metastasis in a single ipsilateral lymph node, 3 cm or smaller in greatest dimension and ENE (-) T3 N1 No distant metastasis T3 N1 M0 M0 STAGE III

37 Stage Oropharynx p16+ Tumor more than 4 cm in greatest dimension One or more ipsilateral lymph nodes, none larger than 6 cm T3 N1 No distant metastasis T3 N1 M0 M0 STAGE II

38 Oropharynx p16- HPV Mediated p16+ Orophayngeal

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

40 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.

41 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.

42 Specific Information Collected General Demographic Information Diagnostic tests such as CAT Scans, MRI, X-rays Date diagnosed Treatment Tumor Stage

43 How You Can Help Address when Diagnosed Physician Place of Birth Tobacco History Alcohol History Occupation Race/Ethnicity Exact Dates Other Cancers Follow-up Data

44 Resources Ohio Cancer Incidence Surveillance System (OCISS) National Programs of Cancer Registries Surveillance, Epidemiology, and End Results (SEER) Program Commission on Cancer American Joint Committee on Cancer (AJCC)

45 QUESTIONS PLEASE COMPLETE EVALUATION FORM THANK YOU