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Site-Specific Cancer Series: Head and Neck Cancer

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Contents

Edited by: Linda K. Clarke, MS, RN, CORLN and Mary Jo Dropkin, PhD, RN

Foreword.............................................................................................................................. vii
   
Preface.................................................................................................................................. ix
   
Acknowledgments............................................................................................................... xi
   
Chapter 1. Introduction....................................................................................................... 1
Overview and Definition.......................................................................................................... 1
Vital Statistics......................................................................................................................... 1
Stage...................................................................................................................................... 2
Treatment Modalities.............................................................................................................. 2
Summary................................................................................................................................. 2
   
Chapter 2. Anatomy and Physiology.................................................................................. 5
Introduction............................................................................................................................. 5
The Ear................................................................................................................................... 5
The Nose and Paranasal Sinuses........................................................................................... 6
The Oral Cavity and Salivary Glands...................................................................................... 7
Pharynx................................................................................................................................... 10
Trachea.................................................................................................................................. 12
Esophagus.............................................................................................................................. 12
General Head and Neck Anatomy and Physiology ................................................................. 12
Summary................................................................................................................................. 15
   
Chapter 3. Pathophysiology............................................................................................... 17
Introduction............................................................................................................................. 17
Carcinogenesis....................................................................................................................... 17
Histology................................................................................................................................. 23
Rare Carcinomas.................................................................................................................... 27
Summary................................................................................................................................. 27
   
Chapter 4. Prevention and Early Detection .................................................................... 29
Introduction............................................................................................................................. 29
Risk Factors........................................................................................................................... 29
Cancer Screening................................................................................................................... 32
Chemoprevention................................................................................................................... 32
Summary................................................................................................................................. 33
   
Chapter 5. Patient Assessment......................................................................................... 35
Introduction............................................................................................................................. 35
Clinical Presentation............................................................................................................... 35
Comprehensive Health History................................................................................................ 36
Diagnostic Evaluation—Histologic Diagnosis.......................................................................... 41
Diagnostic Evaluation—Consultations.................................................................................... 42
Tumor Staging........................................................................................................................ 44
Treatment............................................................................................................................... 45
Summary................................................................................................................................. 47
   
Chapter 6. Surgical Management of Head and Neck Malignancies.............................. 49
Introduction............................................................................................................................. 49
Neck Dissection...................................................................................................................... 49
Laryngectomy......................................................................................................................... 54
Maxillectomy............................................................................................................................ 57
Mandibulectomy...................................................................................................................... 58
Glossectomy........................................................................................................................... 60
Summary................................................................................................................................. 60
   
Chapter 7. Radiation Treatment and Symptom Management......................................... 63
Introduction............................................................................................................................. 63
Principles of Treatment .......................................................................................................... 63
Radiation Therapy Delivery Techniques................................................................................. 64
Radiation Therapy Process.................................................................................................... 65
Side Effects............................................................................................................................. 66
Summary................................................................................................................................ 71
   
Chapter 8. Chemotherapy.................................................................................................. 73
Introduction.............................................................................................................................. 73
Principles of Treatment .......................................................................................................... 73
The Nursing Role ................................................................................................................... 75
Chemotherapeutic Agents Used to Treat Head and Neck Cancers ........................................ 75
Issues Associated With Chemotherapy Treatment.................................................................. 82
Summary................................................................................................................................. 83
Chapter 9. Postoperative Management of the Head and Neck Surgical Patient................................................................................................................................... 85
Introduction.............................................................................................................................. 85
Airway Management................................................................................................................ 85
Pain Management ................................................................................................................... 90
Wound Management............................................................................................................... 91
Postsurgical Complications ..................................................................................................... 95
Nutritional Management .......................................................................................................... 96
Communication........................................................................................................................ 100
Body Image Disturbance.......................................................................................................... 100
Conclusion.............................................................................................................................. 101
   
Chapter 10. Survivorship................................................................................................... 103
Introduction.............................................................................................................................. 103
Survival Rates......................................................................................................................... 104
Rehabilitation........................................................................................................................... 104
Costs....................................................................................................................................... 105
Insurance................................................................................................................................. 105
Employment............................................................................................................................. 106
Support Groups ...................................................................................................................... 106
Palliative Care......................................................................................................................... 107
Summary................................................................................................................................. 107
   
Chapter 11. Nursing Research Issues.............................................................................. 111
Introduction.............................................................................................................................. 111
Physical Recovery: Surgical Treatment .................................................................................. 111
Physical Recovery: Radiation Therapy ................................................................................... 114
Physical Recovery: Chemotherapy ......................................................................................... 116
Summary: Physical Recovery ................................................................................................. 116
Functional Recovery: Surgical Treatment ............................................................................... 117
Functional Recovery: Radiation Therapy................................................................................ 118
Functional Recovery: Chemotherapy ..................................................................................... 118
Summary: Functional Recovery............................................................................................... 118
Cognitive Recovery: Surgical Treatment ................................................................................ 119
Cognitive Recovery: Radiation Therapy ................................................................................. 120
Cognitive Recovery: Chemotherapy........................................................................................ 120
Summary: Cognitive Recovery ............................................................................................... 120
Emotional Recovery: Surgical Treatment ............................................................................... 121
Emotional Recovery: Radiation Therapy ................................................................................ 121
Emotional Recovery: Chemotherapy....................................................................................... 122
Summary: Emotional Recovery................................................................................................ 122
Future Directions .................................................................................................................... 122