Head and Neck Cancer: What to Know

Head and neck cancer is a group of cancers that starts in or near your throat, voice box, nose, sinuses, or mouth. Usually, it begins in the cells that line the surfaces of these body parts. Doctors call these squamous cells.

There are five main types of head and neck cancer. They’re named for the specific part of your head or neck they affect. The symptoms are a little bit different for each.

1. Oral cavity

This type of cancer affects your lips and the inside of your mouth. This includes:

  • Your gums
  • The insides of your cheeks
  • Under your tongue
  • The top of the inside of your mouth (hard palate)
  • The front two-thirds of your tongue

The symptoms of oral cancer are:

  • Red or white patches in your mouth, including your gums and tongue
  • Swelling in your jaw, including swelling that makes false teeth fit badly
  • Bleeding or pain in your mouth

2. Pharynx

This is another name for your throat. It’s a tube about 5 inches long that goes from behind your nose to the top of your esophagus (which is the tube in your chest leading down to your stomach). Your pharynx includes your tonsils, the back of your tongue, and your soft palate. That’s the soft part at the back of the roof of your mouth.

The symptoms of cancer of your pharynx are:

  • Trouble breathing or talking
  • Painful swallowing
  • Neck or throat pain that doesn’t go away
  • Earaches, pain, or ringing in your ears that keeps coming back
  • Trouble hearing

3. Larynx

This is your voice box. It holds your vocal cords and your epiglottis. That’s the little piece of flesh that hangs in the back of your throat. It caps over your larynx when you eat or drink to keep food and liquid from getting in (“going down the wrong pipe”).

Signs of larynx cancer include:

  • Painful swallowing
  • Ear pain
  • Changes in your voice

4. Nasal cavity and paranasal sinuses

Your nasal cavity is the space inside your nose. The paranasal sinuses are small spaces in the bones of your head around your nose.

See your doctor if you have symptoms of this type of cancer. Here are signs to look out for:

  • Chronic sinus infections that antibiotics don’t cure
  • Blocked sinuses you can’t clear
  • Nosebleeds
  • Headaches
  • Swelling around the eyes
  • Pain in your upper teeth
  • Problems with false teeth not fitting anymore

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5. Salivary glands

These make saliva (spit). They’re in the lower part of your mouth near your jawbone.

The following are symptoms of salivary gland cancer:

  • Swelling under your chin
  • Swelling around your jawbone
  • Numb or paralyzed face muscles
  • Pain in your face, chin, or neck that doesn’t go away

Other Symptoms

Each kind of head and neck cancer has specific symptoms, but there are some general ones, too. They are:

  • A lump in your neck
  • Growths or sores in your mouth (even if they don’t hurt)
  • Blood in your spit or phlegm
  • Changes in your skin that may signal skin cancer

Causes and Risks

The biggest cause of head and neck cancers is tobacco. This includes chewing tobacco and using snuff, not just smoking. Secondhand smoke (smoke from other people’s cigarettes, cigars, or pipes) can also raise your risk of getting head and neck cancer.

Drinking too much alcohol raises your risk, too. If you use tobacco and drink too much alcohol, you raise your risk even more.

Other things that raise your risk are:

Diagnosis

During your yearly checkup, your doctor should look inside your mouth, nose, and throat. He should also check for lumps in your neck. This is especially true if you use tobacco or have used it in the past, or you drink regularly.

If you have symptoms of a head or neck cancer or your doctor finds anything strange at your yearly exam, you might have to get a few tests. These include:

  • Blood tests
  • Pee tests
  • HPV test
  • Endoscopy (a doctor looks at the inside of your head and neck with a tube that goes in through your nose and down your throat)
  • Tissue sample (biopsy) and lab tests on the tumor if there is one
  • X-rays
  • Scans

If you have head or neck cancer, your doctor will try to figure out how far it has advanced, or what stage it is in. She’ll also see if it has spread to other parts of your body.

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Treatment

What kind of treatment you’ll get depends on a few things, such as:

  • Where the cancer is located
  • What stage the cancer is in
  • How old you are
  • Your general health
  • If you have HPV

You might get just one kind of treatment, or you might get a combination of them. Options include surgery, radiation, chemotherapy, and targeted therapy.

Surgery. Your doctor might zap the cancer with a laser or take out the tumor and some of the healthy tissue around it. If there’s a chance the cancer has spread, your doctor might take out some of the small glands called lymph nodes in your neck.

The side effects and risks depend on what kind of surgery you get. They include:

  • Losing your voice
  • Hearing loss
  • Trouble chewing or swallowing
  • Swelling of the mouth or throat

If the surgery changes your face a lot, or it makes it hard to eat and breathe, you might need another surgery.

Radiation. Your doctor might use X-rays or other energy particles to kill the cancer cells. Some of the side effects include:

  • Pain or trouble swallowing
  • Changes in your voice
  • Loss of appetite
  • Red or irritated skin
  • Thick spit
  • Feeling sick to your stomach
  • Being tired
  • Sore throat
  • Sores in your mouth

Chemotherapy (“Chemo”). You’ll be given medication to stop the cancer cells from growing and dividing, which should destroy them. The following are possible side effects:

Targeted therapy. You’ll be given medications that work on the genes, proteins, and other parts of the cancer cells. Side effects of target therapy depend on the medication that is used. But often, they include problems with your skin, hair, nails, or eyes.

Immunotherapy . This treatment uses parts of your immune system to help fight cancer. Doctors can either stimulate your immune system to attack cancer cells, or they can give you man-made proteins to strengthen your immune system.

WebMD Medical Reference Reviewed by William Blahd, MD on February 1, 2017

Sources

SOURCES:

American Society of Clinical Oncology: “Head and Neck Cancer -- Overview,” “Understanding Targeted Therapy.”

National Cancer Institute: “Head and Neck Cancers.”

American Academy of Otolaryngology -- Head and Neck Surgery: “Head and Neck Cancer.”

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