What is head and neck cancer?
Cancer develops when cells grow out of control. Head and neck cancer refers to a variety of different malignancies involving the mouth, throat, larynx (voice box), tonsils, salivary glands, jaw, nose and sinuses. Most head and neck cancer is squamous cell carcinoma that arises in mucous membranes lining the mouth, throat and nose.
A majority of head and neck cancers develop in the mouth and upper part of the throat, known as oral or oropharyngeal cancer. A growing proportion of oral cancers are caused by the human papillomavirus (HPV), which can be prevented with a vaccine. Click here for more information about oral cancer.
Cancers of the thyroid gland, esophagus, eye and brain are not classified as head and neck cancer.
Who gets head and neck cancer?
More than 65,000 people get head and neck cancer annually, and these malignancies account for about 4% of all cancer cases, according to the National Cancer Institute. About 80% of these are mouth and throat cancers. Salivary gland tumors are rare.
Most people with these cancers are diagnosed at age 50 or older, and men are more likely to develop them than women.
What are the risk factors for head and neck cancer?
The risk factors for developing head and neck cancer depend on the specific malignancy. Overall, smoking or chewing tobacco and alcohol consumption are major risk factors. A large and growing proportion of mouth and throat cancers are caused by HPV, while those attributable to other causes are falling. Sexual contact, including oral sex, is a common way to contract HPV, but the virus can also be transmitted through nonsexual contact.
Epstein-Barr virus causes some cases of nasopharyngeal (nose and upper throat) cancer and salivary gland cancer. Other risk factors include a family history of cancer, excessive sun exposure, poor oral health and a weakened immune system.
What are the symptoms of head and neck cancer?
Head and neck cancer can cause a variety of symptoms, depending on where it occurs and how advanced it is. Some malignancies don’t cause symptoms until they’ve reached a more advanced stage, or they may cause nonspecific symptoms similar to those associated with other conditions. Symptoms may include:
- Lumps, bumps or swelling anywhere in the mouth, throat, face or neck
- Unexplained pain, tenderness or numbness in the mouth, throat, face or neck
- Unexplained bleeding
- Blocked sinuses and chronic sinus infections
- Difficulty swallowing, speaking or breathing
- Swollen lymph nodes in the neck.
How is oral cancer diagnosed?
Often, dentists are the first to detect head and neck cancers during routine exams. Any unusual symptoms should be checked by a doctor, as early diagnosis and treatment increases the likelihood of long-term survival.
The diagnosis process starts with a physical exam and medical history, including family history and how long symptoms have been present. The exam will check for any unusual lumps or sores in the mouth or on the face, head and neck. An endoscope, a flexible tube with a tiny camera, may be used to look into the throat or nasal cavity. During these exams, a small tissue sample (a biopsy) may be removed to examine in a laboratory.
X-rays, computed tomography (CT), positron emission tomography (PET), magnetic resonance imaging (MRI) or ultrasound scans may be performed to see how extensive the cancer is and how much it has spread.
How is head and neck cancer treated?
Treatment depends on where the cancer is located and how advanced it is when it is detected, including how many tumors there are, how large they are and whether they have spread to nearby lymph nodes or other parts of the body. Cancers caused by HPV are treated differently and typically have better outcomes than cancers with other causes.
Surgery: Some small and localized tumors can be surgically removed; this is known as resection.
Radiation: Radiation may be used to kill cancer cells that remain after surgery or to shrink tumors that cannot be surgically removed. It is often used in conjunction with other forms of treatment.
Chemotherapy: Traditional chemotherapy works by killing fast-growing cells, including cancer cells. It can also destroy rapidly dividing healthy cells, such as those in the gut or hair follicles, leading to side effects like nausea and hair loss.
Targeted therapy: Targeted drugs work against cancers with specific characteristics. For example, they may interfere with signaling pathways that regulate cell growth. Targeted therapy is often better tolerated than chemotherapy, but cancer may develop resistance over time.
Immunotherapy: This type of treatment helps the immune system fight cancer. For example, some tumors can turn off immune responses against them, and drugs known as checkpoint inhibitors can restore T cells’ ability to recognize and destroy cancer cells. Some immunotherapy drugs are approved for treatment of advanced head and neck cancer.
For more information about head and neck cancer, see the following resources:
American Society of Clinical Oncology: Head and Neck Cancer
National Cancer Institute: Head and Neck Cancer
Last Reviewed: September 10, 2019