Head and Neck Cancers
If you or a loved one has been diagnosed with head or neck cancer, take a deep breath and know that we are here for you. In addition to providing you information, our highly skilled medical oncologists, radiation oncologists and compassionate staff will support you and your family every step of the way.
Your journey begins by learning more about your condition.
Cancers that are known collectively as head and neck cancers usually begin in the squamous cells that line the moist, mucosal surfaces inside the head and neck, such as inside the mouth, nose and throat. These squamous cell cancers are often referred to as squamous cell carcinomas of the head and neck.
Head and neck cancers can also begin in the salivary glands, but salivary gland cancers are relatively uncommon. Salivary glands contain many types of cells that can become cancerous, so there are many different types of salivary gland cancer.
Cancers of the head and neck are further categorized by the area of the head or neck in which they begin:
- Oral cavity: Includes the lips, the front two-thirds of the tongue, gums, lining inside the cheeks and lips, the floor (bottom) of the mouth under the tongue, the hard palate (bony top of the mouth), and the small area of the gum behind the wisdom teeth.
- Pharynx: The pharynx (throat) is a hollow tube about 5 inches long that starts behind the nose and leads to the esophagus. It has three parts:
- nasopharynx (the upper part of the pharynx, behind the nose); the
- oropharynx (the middle part of the pharynx, including the soft palate [the back of the mouth], the base of the tongue, and the tonsils); the
- hypopharynx (the lower part of the pharynx).
- Larynx: The larynx, also called the voice box, is a short passageway formed by cartilage just below the pharynx in the neck. The larynx contains the vocal cords. It also has a small piece of tissue, called the epiglottis, which moves to cover the larynx to prevent food from entering the air passages.
- Paranasal sinuses and nasal cavity: The paranasal sinuses are small, hollow spaces in the bones of the head surrounding the nose. The nasal cavity is the hollow space inside the nose.
- Salivary glands: The major salivary glands are in the floor of the mouth and near the jawbone. The salivary glands produce saliva.
- Signs and Symptoms of Head & Neck Cancers
- Detecting and Diagnosing Head & Neck Cancers
- Staging Head & Neck Cancers
- Treatment Options for Head & Neck Cancers
- Clinical Trials and Research
- Follow-Up Cancer Care
Also, talk with your oncologist about nutrition counseling, provided by one of our registered and licensed dietitians, who have specialize in oncology nutrition.
What are the signs and symptoms of head and neck cancers?
It is important to check with a doctor if you have any of the following symptoms:
- a lump or a sore that does not heal
- a sore throat that does not go away
- difficulty swallowing
- a change or hoarseness in the voice
These symptoms may also be caused by other, less serious conditions.
Symptoms that may affect specific areas of the head and neck include the following:
- Oral cavity: A white or red patch on the gums, the tongue or the lining of the mouth; a swelling of the jaw that causes dentures to fit poorly or become uncomfortable; and unusual bleeding or pain in the mouth.
- Pharynx: Trouble breathing or speaking; pain when swallowing; pain in the neck or the throat that does not go away; frequent headaches, pain or ringing in the ears, or trouble hearing.
- Larynx: Pain when swallowing or ear pain; hoarse voice
- Paranasal sinuses and nasal cavity: Sinuses that are blocked and do not clear; chronic sinus infections that do not respond to treatment with antibiotics; bleeding through the nose; frequent headaches, swelling or other trouble with the eyes; pain in the upper teeth; or problems with dentures.
- Salivary glands: Swelling under the chin or around the jawbone; numbness or paralysis of the muscles in the face; or pain in the face, the chin, or the neck that does not go away.
Head and Neck Cancer Diagnosis
To find a problem in the head and neck area, an ear, nose and throat specialist will evaluate your medical history, perform a physical exam and order diagnostic tests. The exams and tests may vary depending on your symptoms. Examination of a sample of tissue under a microscope is always necessary to confirm a diagnosis of cancer.
Staging Head and Neck Cancers
If the diagnosis is cancer, the next step is to determine the stage (or extent) of disease. Staging is a careful attempt to find out whether the cancer has spread and, if so, to which parts of the body. Staging may involve laboratory tests, an examination under anesthesia, X-rays and other imaging procedures. Knowing the stage of the disease will help your oncologist plan your customized treatment.
Treatment Options for Head and Neck Cancers
Your treatment plan will depend on many factors, including the exact location of the tumor, the stage of the cancer, as well as your age and general health. Treatment for head and neck cancer can include: radiation therapy, chemotherapy, targeted therapy, or a combination of treatments.
Advances in radiation technology have given us the ability to pinpoint cancer and avoid or minimize damage to surrounding healthy tissue during treatment. One of the techniques we use to accomplish this is Intensity-modulated radiotherapy (IMRT). This radiation technique allows us to safely deliver precise radiation doses to a tumor while minimizing the dose to surrounding normal tissue.
More information about specific types of head and neck cancers can be found in the following summaries:
- Hypopharyngeal Cancer
- Laryngeal Cancer
- Lip and Oral Cavity Cancer
- Metastatic Squamous Neck Cancer with Occult Primary
- Nasopharyngeal Cancer
- Oropharyngeal Cancer
- Paranasal Sinus and Nasal Cavity Cancer
- Salivary Gland Cancer
Patients who are diagnosed with HPV-positive oropharyngeal cancer may be treated differently than people with oropharyngeal cancers that are HPV-negative. Recent research has shown that patients with HPV-positive oropharyngeal tumors have a better prognosis and may do just as well on less intense treatment.
What are the side effects of treatment?
Together, we will consider any possible side effects when planning your course of treatment and discuss how to prevent or deal with them. The goal of treatment for head and neck cancers is to control the disease, but we are also concerned about preserving the function of the affected areas as much as possible, and helping you return to normal activities after treatment.
Patients who receive radiation to the head and neck may experience redness, irritation, and sores in the mouth, a dry mouth or thickened saliva, difficulty in swallowing, changes in taste, or nausea. Patients may also experience loss of taste, which may decrease appetite and affect nutrition. Depending on the treatment, some patients may also notice swelling or drooping of the skin under the chin and changes in the texture of the skin. The jaw may feel stiff, and you may not be able to open your mouth as wide as before treatment.
Clinical trials for head and neck cancers
If you are interested in taking part in a clinical trial, talk with your doctor.
Follow-up care for head and neck cancers
Regular follow-up care is very important after treatment for head and neck cancer to ensure that the cancer has not returned, or that a second primary (new) cancer has not developed. Depending on the type of cancer, medical checkups could include exams of the stoma, if one has been created, and of the mouth, neck and throat. Regular dental exams are also important. As part of your follow-up exams, your doctor may perform a complete physical exam, blood tests, X-rays, and other imaging. Your doctor may also monitor your thyroid and pituitary gland function, especially if the head or neck was treated with radiation.