Head and Neck Cancer: Overview

What is head and neck cancer?

Cancer is made of changed cells that grow out of control. The changed (abnormal) cells often grow to form a lump or mass called a tumor. Cancer cells can also grow into (invade) nearby areas. And they can spread to other parts of the body. This is called metastasis.

Head and neck cancer is the term given to cancers that start in the head and neck region. They include:

• Cancer of the hypopharynx. Cancer cells are found in the tissues in the bottom part of the throat, behind and beside the voice box.

• Cancer of the nasopharynx. Cancer cells are found in the tissues of the upper part of the throat, behind the nose.

• Cancer of the oropharynx. Cancer cells are found in the back of the mouth or the middle part of the throat.

• Cancer of the paranasal sinus and nasal cavity. Cancer cells are found in the tissues in the small hollow spaces around the nose, known as the paranasal sinus and nasal cavity. The nasal cavity is just behind the nose.

• Cancer of the salivary gland. Cancer cells are found in the salivary glands. These glands are found just below the tongue, on the sides of the face in front of the ears, and under the jawbone. There are also salivary glands in different parts of the upper digestive tract.

Who is at risk for head and neck cancer?

A risk factor is anything that may increase your chance of having a disease. The exact cause of someone’s cancer may not be known. But risk factors can make it more likely for a person to have cancer. Some risk factors may not be in your control. But others may be things you can change.

The risk factors for head and neck cancer include:

• Using tobacco

• Alcohol use

• Unhealthy diet

• Poor mouth care

• HPV Infection

• Sun exposure

• Age

• Race

• Exposure to certain chemicals

• Weakened immune system

• Inherited syndromes such as Fanconi anemia

Talk with your healthcare provider about your risk factors for head and neck cancer and what you can do about them.

Can head and neck cancer be prevented?

There is no sure way to prevent head and neck cancers, but some things may help lower your risk for certain types of head and neck cancer, such as:

• Not using tobacco in any form

• Limiting or not drinking alcohol

• Protect your lips with sunscreen or lip balm with appropriate SPF protectionReduce your risk for HPV infection. Get the HPV vaccine before you start having sex and limit sexual partnerns.

• Eating a healthy diet with lots of fruits and vegetables

• Get regular dental care

• Having proper-fitting dentures

Talk with your healthcare provider about what you can do to lower your risk. Ask for resources to help. Making changes can be hard, but you don’t have to make them alone. 

What are the symptoms of head and neck cancer?

Common symptoms of head and neck cancer can include:

• Growth or sore in the mouth

• Lump in the neck

• Lump or sore inside the nose, on the lip, or in the mouth that won’t heal

• Sore throat that does not go away

• Feeling that something is stuck in the throat

• Blocked sinuses or nasal congestion that won’t clear

• Chronic sinus infections

• Cough or hoarseness that does not go away

• Coughing up blood/bleeding in the mouth

• Trouble swallowing, speaking, or breathing

• Pain when swallowing

• Frequent headaches or pain around the nose, cheeks, or forehead

• Frequent nosebleeds or ones that don’t stop

• Weakness in the muscles of the face

• Double vision

• Numbness in the face

• Pain in the ear, face, chin, neck, upper back, jaw, or upper teeth

• Ringing in the ears or hearing problems

• Swelling of the eyes or under the chin or around the jaw

• Vomiting

• Bad breath even when proper oral hygiene is practiced

• Red or white patches in the mouth

• Loose teeth

• Loose dentures

• Unexplained weight loss

Many of these may be caused by other health problems. But it is important to see your healthcare provider if you have these symptoms. Only a healthcare provider can tell if you have cancer.

How is head and neck cancer diagnosed?

If your healthcare provider thinks you may have head and neck cancer, you will need exams and tests to be sure. Your healthcare provider will ask you about your health history, your symptoms, risk factors, and family history of disease. He or she will also give you a physical exam. You may also have one or more tests, such as a CT scan or MRI.

A biopsy is the only way to confirm cancer. Small pieces of tissue are taken out from the tumor and checked for cancer cells. It may also be tested for signs of HPV infection. Your results will come back in about 1 week.

After a diagnosis of head and neck cancer, you’ll likely need other tests. These help your healthcare providers learn more about your cancer. They can help determine the stage of the cancer. The stage is how much and how far the cancer has spread (metastasized) in your body. It is one of the most important things to know when deciding how to treat the cancer.

Once your cancer is staged, your healthcare provider will talk with you about what the stage means for your treatment. Be sure to ask your healthcare provider to explain the stage of your cancer to you in a way you can understand.

How is head and neck cancer treated?

Your treatment choices depend on the type of head and neck cancer you have, tests results, and the stage of the cancer. The goal of treatment may be to cure you, control the cancer or, help ease problems caused by the cancer. Talk with your healthcare team about your treatment choices, the goals of treatment and what the risks and side effects may be.

Types of treatment for cancer are either local or systemic. Local treatments remove, destroy, or control cancer cells in one area. Surgery and radiation are local treatments. Systemic treatment is used to destroy or control cancer cells that may have traveled around your body. When taken by pill or injection, chemotherapy is a systemic treatment. You may have just one treatment or a combination of treatments.

Common treatments for head and neck cancer include:

• Radiation therapy

• Surgery

• Chemotherapy

• Targeted therapy

Talk with your healthcare providers about your treatment options. Make a list of questions. Think about the benefits and possible side effects of each option. Talk about your concerns with your healthcare provider before making a decision.

What are treatment side effects?

Cancer treatment such as chemotherapy and radiation can damage normal cells. This can cause side effects such as hair loss, mouth sores, or vomiting. Talk with your healthcare provider about side effects you might have and ways to manage them. There may be things you can do and medicines you can take to help prevent or control side effects

Coping with head and neck cancer

Many people feel worried, depressed, and stressed when dealing with cancer. Getting treatment for cancer can be hard on your mind and body. Keep talking with your healthcare team about any problems or concerns you may have. Work together to ease the effect of cancer and its symptoms on your daily life.

Here are tips:

• Talk with your family or friends.

• Ask your healthcare team or social worker for help.

• Speak with a counselor.

• Talk with a spiritual advisor, such as a minister or rabbi.

• Ask your healthcare team about medicines for depression or anxiety.

• Keep socially active.

• Join a cancer support group.

Cancer treatment is also hard on the body. To help yourself stay healthier, try to:

• Eat a healthy diet, with as many protein foods as possible.

• Drink plenty of water, fruit juices, and other liquids.

• Keep physically active.

• Rest as much as needed.

• Talk with your healthcare team about ways to manage treatment side effects.

• Take your medicines as directed by your team.

When should I call my healthcare provider?

Your healthcare provider will talk with you about when to call. You may be told to call if you have any of the below:

• New symptoms or symptoms that get worse

• Signs of an infection, such as a fever

• Side effects of treatment that affect your daily function or don't get better with treatment

Ask your healthcare provider what signs to watch for, and when to call. Know how to get help after office hours and on weekends and holidays. 

Key points about head and neck cancer

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your provider if you have questions.