What is head and neck cancer?

Head and neck cancer is the term given to cancers that start in the head and neck region. There are many different types of tissues in this area. These cancers can begin in any of these places:

• Voice box or larynx

• Nasal cavity, the passage behind the nose that air passes through it on its way to the throat during breathing

• Mouth or oral cavity

• Paranasal sinuses, spaces around the nose, lined with cells that make mucus that keeps the nose from drying out. They are also a space that allows your voice to echo when you talk or sing.

• Throat or pharynx

• Salivary glands, the glands that make saliva, which keeps food moist and helps dissolve food

Types of head and neck cancer

There are many types of head and neck cancer. Here's an overview of the types and which areas they affect:

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

• Cancer of the oral cavity. Cancer cells are found in the oral cavity. These areas include the lips, teeth, gums, the front two-thirds of the tongue, the inner lining of the lips and cheeks, the area underneath of the tongue, the roof of the mouth and the small area behind the wisdom teeth. 

• Cancer of the larynx. Cancer cells are found in the larynx. Most cancers cells may begin on the mucosal surface, also known as squamous cell carcinoma (SCC). Other less common forms are salivary gland cancers or cancers arising from muscle, cartilage or other structural tissues (sarcomas).

• Cancer of the skin. Cancer cells are found in tissue that forms on the surface of the skin.

• Melanoma of the head and neck. Melanoma is a cancer that arises from melanocytes, the cells that give skin its pigment or color.
• Basal cell cancer of the head and neck. Basal cell cancers are a type of nonmelanoma malignancy that arise from abnormal basal cells in the skin.
• Squamous cell cancer of the head and neck. It is a type of nonmelanoma malignancy. It is the second most common form of skin cancer. It is more aggressive and may require extensive surgery depending on location and nerve involvement.

• Sarcoma of the head and neck. Cancer cells are found in the soft tissue parts of the body, which include the muscles, connective tissues (tendons), vessels that carry blood or lymph, joints, and fat.

• Head and neck cancer of unknown primary site. This type of cancer usually presents as a lump in the neck, which is a sign that the cancer has spread to one or several of the lymph nodes in the neck.

Risk and Screening

Individuals known to have an increased risk of head and neck cancer have a history of smoking, chewing tobacco or betel nut or drink alcohol. Many patients with head and neck cancer have no identified risk factors. At this time we do not have a good way of identifying who will develop cancer. Therefore, screening for head and neck cancers in not currently recommended by the United States Preventive Task Force.

Risk factors for head and neck cancers include:

• Cigarette smoking
• Excessive alcohol consumption
• Chewing smokeless tobacco
• Betel nut

Additional risk factors include:

• Sun exposure
• Radiation
• Inhalation of asbestos or wood or nickel dust
• Poor oral hygiene

Risk factors for HPV-related head and neck cancers include:

• Sexual exposure to HPV
• Smoking marijuana

Symptoms

Common symptoms include:

• A new lump or bump on the neck, face or breathing and swallowing passages
• A sore that does not heal
• A sore throat that does not go away
• Difficulty swallowing
• A change in the voice
• New hoarseness
• White or red patches on the gums, tongue, or lining of the mouth
• Jaw swelling that causes dentures to fit poorly or become uncomfortable
• Unusual bleeding or pain in the mouth, throat or nose
• Chronic sinus infections that do not respond to antibiotic treatment
• Numbness or paralysis of the facial muscles
• Ear pain

These symptoms may result from cancer or other conditions. It is important to be evaluated by a physician to get the right diagnosis and treatment.

Diagnosis

Head and neck cancers are diagnosed by clinical examinations, imaging tests and other specialized tests.

If you are suspected to have a type of head and neck cancer, you will see a head and neck cancer specialist within a few days to be evaluated. Once you have received your test results, a head and neck cancer team will develop an appropriate and highly individualized treatment plan.

Tumor Staging

The place where a cancer starts is called the primary site. The cancer can spread from the primary site (metastasize) to other parts of the body. Regardless of where a cancer may spread, it is always named for the place it began. For example, breast cancer that spreads to the liver is still called breast cancer.

Different types of cancer can behave very differently. They can grow at different rates and respond to different kinds of treatments. That is why people with cancer need treatment aimed at their particular type of cancer.

Treatment Options

Treatment for head and neck cancers differ per diagnosis and stage. It may include surgery, radiation therapy (including proton therapy), and/or chemotherapy.

Reconstruction

Some head and neck cancers may require reconstruction after receiving treatment. These may reconstruction procedures may include: anaplastology, dental implants, and surgery “free-flap” procedure.

Learn more information about reconstruction for head and neck cancer.