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Normal cellEnvironmental damagingagent: Smoker and

Alcoholic Drinker(nicotine and alcohol) Alcohol

suppresses DNADNA damage

Failure of DNA repairEnvironmental damagingagent: Wood dust, paint

fumesccupation: !arpenter"

E#posure to $ood dust,paint fumes

%ar&ngectom&

!hemotherap&

D&sphagia'oarseness of voice

Accumulation of in ammator& cells innear & l&mph nodes

*ecurrentlar&ngitis

+n ammation of thelar n#

Formation of mass atsu ra lottic area

E#pression of altered geneproducts and loss of regulator&

!lonal e#pansion

Additional mutations(progression)

'eterogeneit&

alignant neoplasm

+nactivation of cancer

Activation of gro$th"promoting oncogenes

Failure of genes toregulate apoptosis

utations in thegenome of lar&ngeal

+ncreasedmeta olic needs

struction at thelar n# -. !

le to meet caloricre0uirements ." 1artial o struction of

air in the u er air$a

!hemotherap& - ADoceta#el, 2" uorouracil,!ar oplatin (si# c&cles)

1ainlesspalpa le

cervical l&mph Decreased

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&elosuppression

Decreased o#&gen

Dec3 Dec3hemo lo in

Decreased perfusion" pale mucous mem ranes,

pale nail eds

stomatitisAnemia

sertion +ne5ective1eri heral 6issuepallor

ala sorption of vit3.78

+nc3 *DW,normal

*isk for+m alancedNutrition:

%ess than

! - tracheostoma

Air inhalednothumidi9ed

+ncreasedinsensi le Dr& mucosal

mem ranes oftrachea

*isk forDe9cient

uid volume

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