In this series of patients there were four cases of nasopharyngeal carcinoma, four cases of the major or minor salivary glands and three tongue carcinomas. Diagnosis of head and neck cancer during the pregnancy had an impact on gestation of delivery with the majority delivered preterm to accommodate further treatment intervention. One patient had a termination of pregnancy to undergo treatment. However all infants recovered well and there were no maternal deaths (need to confirm). Diagnosis and management of cancer prior to pregnancy did not appear to result in any adverse consequences.
Head and neck cancer includes a range of cancers that originate in the head and neck. According to Parkin et al it is the fifth most common cancer worldwide [Parkin, 2005 #5], but it is uncommon in young women and very rare in pregnancy
Counselling pregnant patients with head and neck cancer can be a challenge and prognosis and survival are dependent on the tumor type, stage and grade. One thing is certain and that is optimum management is provided within the realm of a multidisciplary approach.
Radiological studies including CT and MRI play an integral role in establishing the extent of local invasion, whether lymph nodes are involved and to help stage the disease by detecting metastases. Lungs, liver and bone are the most common sites for metastatic spread.
The maximum recommended radiation doses in pregnancy are 50 mGy [Stovall, 1995 #6]. A CT has a dose of _________ which is well below the max recommended. A MRI is a preferable mode of assessment and even when contrast has been used it has not been associated with any teratogenic effect. CT scans may be more widely available and a diagnosis in a suspected case should not be delayed because...
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...jor salivary gland cancers published by Hocwald et al in Laryngoscope, positive prognostic factors included female gender, younger age and lack of perineural invasion, lack of facial nerve involvement and negative nodes.
Conclusion
The management of head and neck cancers is quite variable, highlighting the importance of multidisciplinary input. Symptoms can be non-specific but investigations should not be delayed, if indicated. Ideally while management in pregnancy should conform to standard practices in the non-pregnant population, this may not always be feasible.
Further studies are required to help determine whether the benefits of radiotherapy in pregnancy in terms of reduced tumor recurrence and death can be balanced against the risks to the fetus. The role of concurrent chemoradiation needs further evaluation for head and neck cancer in pregnancy.
the effective doses from diagnostic CT procedures are typically estimated to be in the range of 1 to 10 mSv. This range is not much less than the lowest doses of 5 to 20 mSv estimated to have been received by some of the Japanese survivors of the atomic bombs. These survivors, who are estimated to have experienced doses slightly larger than those encountered in CT, have demonstrated a small but increased radiation-related excess relative risk for
Cancer is one of the 9 National Health Priority Areas (NHPA), areas which account for a significant portion of the burden of disease, but have sizeable potential for improvement. In Australia, CRC is the second most common cancer, after prostate (in men) and breast cancer (in women) (AIHW, Cancer incidence projections). The incidence has gradually increased (by 13% in males from 1982-2007) (AIHW, Cancer in Australia an overview). This is compounded by the ageing population and population growth, with 14,860 new cases in 2010 (http://www.cancer.org.au/about-cancer/types-of-cancer/bowel-cancer). This graph demonstrates this upward trend ((AIHW, Cancer incidence projections):
Since the beginning of the propitious world, the core aspect that keeps it thriving is the propensity for people to discover innovations; however, progress of the past is, systematically, detrimental to the future. Not long after the revolutionary invention of the X-ray in the late 19th Century, an unprecedented number of medical examiners noticed (unknown to the time) radiation burns all over their body; decades later, an extraordinary surge in cancer cases had arisen. Perhaps, during the course of these years, scientists and researchers desired to further progress the x-ray (into the immense subsidiaries that are here today), and disregarded any flaws in the apparatus. This systematic inclination continues into the present time as Gary Marshall and Shane Keene notes in their 2007 article, “New technologies allow for patients to be overexposed routinely, and also allow for repeats to be taken quickly, making it easier for a technologist to multiply the patients dose without considering the implications” (5). The gaffes of radiology are present not only in the diagnostic setting, but also in the surgical and therapeutic areas. Working with radiation, it is imperative that the staff is aware of mistakes that are potentially fatal not only for patients, but themselves. It is especially important for medical radiologists to be cognizant of pediatric patients. The standard practice of pediatric radiology in the United States is to follow the step-by step formula from which adult patients are treated and diagnosed. There are copious consequences for following this technique since a child naturally has less body mass and a weaker immune and lymphatic system to manage radiation and its adverse effects. Medical radiology, being a...
At this day in age we are constantly trying to improve the field of medicine in any way that we possibly can. We cherish every birthday and continually try to prolong life. Not only through every field of medicine, especially in terms of cancer. The American Cancer Society is “the official sponsor of birthdays” and is making leaps and bounds in the types of care that cancer patients receive. One of these many breakthroughs is the practice of Stereotactic (Body) Radiotherapy or S(B)RT. SBRT and other radiation therapies have the ability to greatly improve the way that we treat the issue of cancer and the variation of treatment options; however, they have raised the concerns of long term effects from radiation and cost-effectiveness. As research has begun to show, radiation therapies are having great success in curing cancer.
The birth of a healthy child is a blessing. The prenatal period is susceptible in terms of embryonic development, and some exposures to teratogens can have adverse and lifelong affects on a baby. Although physical outcomes resulting from teratogen exposure cannot be reversed, with hope, some of the behavioral effects of Teratogens may have a decreased impact on the life of the child, though all mothers should pay special attention to the health of their child throughout their pregnancy.
Teratogens are defined as “those substances which exert an adverse influence on development [of a developing fetus]” (Hepper, 2007, p. 48). Teratogens can be environmental influences, such as chemicals or infectious agents. They can also be physical conditions or nutritional deficiencies present in the mother. Thousands of known teratogens have been discovered. For example, Purdue University’s Department of Radiological and Environmental Management (2014) maintains an internet-based list of teratogens which currently names over 2000 substances. This paper will discuss two of these teratogens in further detail: maternal cigarette smoking and vitamin A.
In 2011, Colleagues from the National Cancer Institute conducted a study involving dental x-rays. Sara Schonfield and others did comparisons with the number of x-rays in the dental field for a group of people who have been diagnosed with thyroid cancer (Radiation and Thyroid Cancer.) She studied that group before they were even diagnosed to others without thyroid cancer. The ones who have had dental x-rays had more chances of developing thyroid cancer. More than 75% were diagnosed with thyroid cancer before turning 44 years old. Because of this study, their result was that the more x-rays conducted, the higher the chance of being diagnosed with thyroid cancer. From 1972 to 2002 there was a 140% increase in thyroid cancer diagnosis (Brody.) Because of this, more researchers have decided to do studies about the increase and the causes. From the year 2000 to the year 2008, it was recorded that twice as many women were diagnosed with thyroid cancer than ever before. The numbers keep rising year after year. There has been a sharp increase involving the diagnosis of thyroid cancer within the past 2 decades. But according to the researchers at the Vetera...
My mum was diagnosed with nasopharyngeal cancer in 2012. She went through multiple major surgeries, cycles of chemotherapy and radiotherapy due to recurrent disease. Leaving her with pain, unilateral hearing loss, weakness of the facial muscles, tingling of hands and feet, loss of sense of taste and difficulties in swallowing
Computed tomography (CT) and Radionuclide imaging (RNI) are both a form of diagnostic imaging. Since they have been first introduced in medical imaging they both suffered a huge development over the years in terms of image acquisition and also patient radiation protection. The following essay it is going to focus on just a few important things that make CT and RNI similar and different in the same time. However this subject can be discussed in much depth, the focus is going to be on the similarities and differences of the physics imaging methods and also a small awareness of biological effects and radiation protection.
Ionizing radiation can have many different effects on a fetus. There are many significant factors to consider when looking at an overall effect of radiation on a fetus in each trimester of pregnancy. The effects of radiation on a fetus vary dramatically depending on gestational age, the dosage of radiation they receive, and the manner in which they were exposed. The first trimester of pregnancy is the most sensitive trimester for a developing fetus.
Papillary Carcinoma a lot of times grows very slowly. Typically mature in only one of the lobes of the thyroid gland, in patients under the age of forty-five. Cancer often spreads to the lymph nodes in the neck, still resulting in treatment which is usually successful and is rarely fatal. Papillary carcinoma is most likely to affect women that are in their childbearing stages in life. According to MedicineNet.com, “About eight of ten thyro...
Although no adverse health effects have been directly linked to low-dose radiation exposure, the medical community is playing it safe with regards to radiation. Most physicians are very careful about ordering radiologic tests. They should not order a study unless it will improve patient care. If you have a question about the importance or the necessity of a radiologic test that has been ordered for you, be sure to ask your physician.
Jose MD, and Irma Russo, MD, "Susceptibility of the Mammary Gland to Carcinogenesis. Pregnancy Interruption as a Risk Factor in Tumor Incidence," The American Journal of Pathology, Aug. 1980
(Gilman, Breslau, Subramanian, Hitsman, & Koenen, 2008). Despite the warnings about the dangers of smoking while pregnant, some women still choose to smoke, which places themselves and their baby at risk for many health issues. Damage caused by smoking while pregnant During pregnancy, smoking can cause problems for a woman’s own health, including, ectopic pregnancy, vaginal bleeding, placental abruption, in which the placenta peels away, partially or almost completely, from the uterine wall before delivery; Placenta Previa, a low-lying placenta that covers part or all of the opening of the uterus (March of Dimes, 2011). Women that smoke expose their unborn baby to dangerous chemicals, like carbon monoxide, tar and nicotine.... ...
Jancárková, N., & Gregor, V. (2000). [Teratogens during pregnancy]. Ceska gynekologie/Ceska lekarska spolecnost J. Ev. Purkyne, 65(3), 188-194.