Date:
Patient:
Reason for Visit:
Initial evaluation for suspected salivary gland cancer
Follow-up for known salivary gland cancer
Assessment of treatment response or disease progression
Management plan discussion
History:
Presenting Illness:
Date of initial symptoms (pain, swelling, lump in the face or neck)
Location and size of the mass
Facial nerve symptoms (numbness, weakness)
Recent changes in symptoms (growth, bleeding)
Prior biopsies or surgeries (if any)
Past Medical History (PMH):
Underlying medical conditions (e.g., diabetes, Sjogren’s syndrome)
Smoking history (risk factor)
Radiation exposure to the head and neck (risk factor)
Social History:
Tobacco and alcohol use (risk factors)
Physical Exam:
Head and Neck:
Palpate the parotid, submandibular, and sublingual glands for masses, tenderness, or firmness.
Assess for facial asymmetry or swelling.
Evaluate for facial nerve function (symmetry of facial movements).
Examine the oral cavity for any abnormalities.
Lymph Nodes: Palpate lymph nodes in the neck for enlargement or tenderness.
Diagnostic Tests (may be ordered depending on clinical suspicion):
Fine-needle aspiration (FNA) biopsy: Minimally invasive procedure to collect cells from the mass for microscopic examination.
Core needle biopsy: May be performed if FNA is inconclusive.
Imaging Studies:
CT scan with contrast: Provides detailed view of the tumor size, location, and involvement of surrounding structures.
MRI scan: May be helpful in differentiating tumor types and evaluating facial nerve involvement.
PET scan (may be used for staging): Can help identify distant spread of cancer.
Assessment:
Presumptive diagnosis: Based on clinical presentation, physical exam findings, and biopsy results (if available).
Tumor stage: Once a definitive diagnosis is established, further tests will determine the stage of cancer (extent of spread). Staging helps guide treatment decisions and prognosis.
Facial nerve involvement: Evaluate for any signs of facial nerve dysfunction, which can impact treatment and prognosis.
Plan:
Treatment approach based on definitive diagnosis, stage, and facial nerve involvement:
Surgery: The mainstay of treatment for most salivary gland cancers. The extent of surgery depends on tumor size, location, and involvement of other structures.
Radiation therapy: May be used before or after surgery, or as a primary treatment for inoperable tumors.
Chemotherapy: May be used in combination with radiation therapy or for advanced-stage disease.
Facial nerve reconstruction: May be necessary if surgery involves the facial nerve.
Pain management: Medications and other strategies to manage pain associated with the tumor or treatment side effects.
Nutritional support: May be needed before, during, or after treatment depending on the extent of surgery or other factors.
Patient education: Provide information about salivary gland cancer, the specific diagnosis, treatment options, and potential side effects.
Discuss the importance of treatment adherence and follow-up care.
Address psychosocial concerns and offer support resources.
Follow-up:
Schedule for follow-up appointments based on treatment plan:
Frequent visits during the treatment phase to monitor response and manage side effects.
Less frequent visits for long-term monitoring after treatment completion.
Monitor for signs of recurrence (new lumps, facial nerve symptoms).
Regular imaging studies (CT or MRI scans) to assess for disease recurrence.
Disclaimer: This information is for educational purposes only and should not be interpreted as medical advice. Please consult with a qualified healthcare professional for diagnosis and treatment of salivary gland cancer