Head and Neck Cancer
Cancers of the mouth, throat, voice box, and nearby areas
Quick Facts
- Type: Group of related cancers
- Main areas: Mouth, throat, voice box, sinuses
- Major causes: Tobacco, alcohol, HPV
- Common signs: Sore that won't heal, neck lump
Overview
Head and neck cancer is an umbrella term for cancers that start in several nearby areas: the mouth (oral cavity), the throat (pharynx), the voice box (larynx), the nose and sinuses, and the salivary glands. Most of these cancers are squamous cell carcinomas, which arise from the flat cells that line the moist surfaces of the head and neck.
These cancers are strongly linked to tobacco and alcohol use, and increasingly to infection with the human papillomavirus (HPV), particularly for cancers of the throat. Because the head and neck are involved in breathing, speaking, eating, and swallowing, both the cancer and its treatment can affect these functions, making early detection and specialized care especially important.
Symptoms
Symptoms depend on where the cancer begins, but warning signs to watch for include:
- A sore in the mouth or throat that does not heal
- A lump in the neck, mouth, or throat
- Persistent sore throat or difficulty swallowing
- A change in or hoarseness of the voice
- Pain in the ear, especially on one side
- White or red patches in the mouth
- Persistent nasal congestion, nosebleeds, or sinus problems
- Unexplained weight loss
Many of these symptoms are common and usually not cancer, but those lasting more than two to three weeks should be checked.
Causes
Head and neck cancers develop when cells in these lining tissues grow abnormally. The main contributing factors are:
- Tobacco: Smoking and smokeless tobacco are the strongest risk factors.
- Alcohol: Heavy drinking, and especially the combination of alcohol and tobacco, sharply raises risk.
- HPV infection: High-risk HPV types are a major cause of cancers in the throat and tonsils.
- Other exposures: Certain workplace substances such as wood dust or chemicals, and the Epstein-Barr virus for some nose and throat cancers.
Risk Factors
- Tobacco use of any kind
- Heavy alcohol use, particularly with smoking
- Infection with high-risk HPV
- Older age and male sex, though HPV-related cases can affect younger adults
- Sun exposure for cancers of the lip
- Certain occupational exposures and poor oral health
Diagnosis
Diagnosis involves examining the area, sampling tissue, and assessing spread:
- Examination: Inspecting the mouth, throat, and neck, often with a thin flexible scope to view the deeper throat and voice box.
- Biopsy: Taking a tissue sample to confirm cancer and, for throat cancers, testing for HPV.
- Imaging: CT, MRI, PET, or ultrasound scans to determine the tumor's size and whether lymph nodes or other sites are involved.
Treatment
Treatment is tailored to the cancer's location, stage, and HPV status, and usually involves a team of specialists.
- Surgery: To remove the tumor and affected lymph nodes, sometimes with reconstruction.
- Radiation therapy: A common treatment, used alone or with surgery or chemotherapy.
- Chemotherapy: Often combined with radiation for more advanced disease.
- Targeted therapy and immunotherapy: Used in selected cases, especially for advanced or recurrent cancer.
Rehabilitation for speech, swallowing, and nutrition is an important part of care, since these functions can be affected by both the cancer and its treatment.
Prevention
- Avoid all forms of tobacco
- Limit alcohol intake
- Get the HPV vaccine to reduce the risk of HPV-related throat cancers
- Protect your lips from sun exposure
- Maintain good oral hygiene and have regular dental checkups
- Use protective equipment around occupational dusts and chemicals
When to See a Doctor
See a doctor or dentist if any of the following last more than two to three weeks:
- A mouth or throat sore that does not heal
- A lump in the neck, mouth, or throat
- Persistent hoarseness or trouble swallowing
- One-sided ear pain with a normal-looking ear
- White or red patches in the mouth, or unexplained weight loss
Most such symptoms are not cancer, but having them evaluated promptly allows any serious cause to be found early, when treatment works best.
Frequently Asked Questions
What areas does head and neck cancer affect?
It is a group of cancers that begin in the mouth, throat, voice box, nose and sinuses, and salivary glands. Most are squamous cell carcinomas that start in the cells lining these moist surfaces.
What are the biggest risk factors?
Tobacco and heavy alcohol use are the strongest risk factors, and using both together greatly increases risk. High-risk HPV infection is an increasingly important cause, especially for cancers of the throat and tonsils.
Can head and neck cancer be prevented?
Many cases can be prevented by avoiding tobacco, limiting alcohol, and getting the HPV vaccine. Protecting the lips from sun and maintaining good oral health also help lower the risk.
How does treatment affect speaking and swallowing?
Because these cancers involve areas used for breathing, speech, and eating, both the cancer and its treatment can affect these functions. Rehabilitation with speech and swallowing therapists is an important part of recovery.
When should I see a doctor about throat or mouth symptoms?
See a doctor or dentist for a mouth or throat sore that does not heal, a neck lump, lasting hoarseness, persistent trouble swallowing, or one-sided ear pain that continues beyond two to three weeks. Early evaluation gives the best chance of successful treatment.
References
- National Cancer Institute (NCI). Head and Neck Cancers.
- American Cancer Society. Head and neck cancers.
- Centers for Disease Control and Prevention (CDC). HPV-Associated Cancers.
- MedlinePlus, U.S. National Library of Medicine. Head and neck cancer.