14458 Head And Neck Cancer

Overview

Head and neck cancer is a general term for a group of cancers that start in the tissues of the mouth, throat, voice box, sinuses, nose, or salivary glands. It does not include brain cancer or cancer of the eyes. These cancers often begin as a sore, lump, or growth that does not heal or go away.

Head and neck cancer is not one of the most common cancers, but it is not rare. Around the world, it accounts for a smaller percentage of cancer cases compared with lung, breast, or bowel cancer.

It is diagnosed most often in men over the age of 50. However, in recent years, younger adults – especially those who are HPV positive – have been developing some types of head and neck cancer.

Symptoms

Common symptoms

• A persistent sore throat that does not go away after two to three weeks
• A lump, thickening, or sore in the mouth, lip, or throat that does not heal
• Difficulty or pain when swallowing
• Hoarseness or a change in your voice that lasts
• A lump or swelling in the neck
• Ear pain on one side
• Numbness in part of the mouth or face
• A persistent blocked nose or nosebleeds
• Unexplained weight loss

Symptoms in children

• Head and neck cancer is very rare in children. When it does occur, the symptoms can be similar to those in adults, including a lingering lump in the neck, a sore throat, difficulty swallowing, or a swollen area in the face or jaw.

Symptoms in older adults

• In older adults, symptoms like a loose tooth, dentures that no longer fit, a sore in the mouth that bleeds easily, or pain when chewing can be signs of head and neck cancer. Changes in voice or swallowing are also important to watch for.

Causes

Main causes

• Tobacco smoke and smokeless tobacco (chewing tobacco or snuff)
• Drinking large amounts of alcohol over a long time
• Infection with the human papillomavirus (HPV), especially HPV type 16
• Infection with the Epstein-Barr virus
• Exposure to certain substances at work, such as wood dust, nickel, asbestos, or chemicals used in some manufacturing

Risk factors

• Being male
• Being over the age of 50
• Using tobacco and alcohol together – this greatly increases the risk
• Having a weakened immune system
• History of head and neck cancer in the family
• Poor oral hygiene or missing teeth
• Eating a diet low in fruits and vegetables

When to see a doctor

See a doctor urgently if:

• See your doctor without delay if you have a lump in your neck, a sore in your mouth or throat that lasts more than three weeks, persistent hoarseness, difficulty swallowing, or unexplained ear pain.

Book a routine appointment if:

• Talk to your doctor if you have any symptoms that worry you, even if they are mild or come and go. Regular dental check-ups can also help spot early changes in your mouth.

Diagnosis

Your doctor will ask about your symptoms, take a medical history, and examine your mouth, throat, and neck. If they suspect head and neck cancer, they will refer you to a specialist (an ear, nose, and throat – ENT – doctor). The specialist may do more tests to find out whether cancer is present and how far it has spread.

Tests that may be done

• Endoscopy – a thin, flexible tube with a camera is used to look inside your nose, throat, and voice box
• Biopsy – a small sample of tissue is taken from the suspicious area and checked under a microscope
• Imaging scans – such as an MRI, CT, or PET scan to see whether cancer has spread
• Fine needle aspiration – a thin needle is used to take a sample from a neck lump
• HPV testing – a sample from the tumor may be tested for the human papillomavirus

What to expect at your appointment

You may need to attend several appointments at a hospital clinic. The diagnostic process can take a few weeks. If cancer is found, you will be referred to a multi-disciplinary team of specialists who will plan your care with you.

Treatment

Treatment for head and neck cancer depends on the type of cancer, its size, where it is, whether it has spread, and your general health. The main types of treatment are surgery, radiotherapy (radiation therapy), chemotherapy, targeted therapies, and immunotherapy. Often, two or more treatments are combined to give the best chance of cure while trying to reduce side effects.

Self-care at home

• Stop smoking if you smoke – this helps treatment work better and lowers the risk of cancer coming back
• Cut down on alcohol or avoid it completely during treatment
• Keep your mouth clean and moist – follow advice from your care team about rinsing and dental care
• Get plenty of rest and let your body recover between treatments

Medical treatments

Radiotherapy uses high-energy rays to kill cancer cells. Chemotherapy uses medicines that attack fast-growing cells; these medicines are given by mouth or intravenously. Targeted therapies and immunotherapy are newer approaches that help your immune system fight cancer more effectively. Some treatments can be given together. Your doctor will explain what is right for you.

When is surgery considered?

Surgery is often used to remove the tumor and some healthy tissue around it. In some cases, surgery is the only treatment needed. After surgery, you may need reconstructive surgery to rebuild the area, as well as help with speaking or swallowing.

Living with this condition

Living with head and neck cancer can change everyday activities like eating, talking, and breathing. Many people need extra support for these challenges. You may work with speech and language therapists, dietitians, and physiotherapists to help you adapt.

Lifestyle tips

• Follow your care team's advice about quitting tobacco and limiting alcohol
• Protect your skin and lips from too much sun exposure
• Keep up with regular follow-up appointments to watch for signs of recurrence
• Find ways to reduce stress, such as gentle walks, hobbies, or talking with someone you trust

Diet and exercise

Eating may be hard, especially if your throat is sore. Try soft, moist foods and nutritional drinks – but always follow the advice of your dietitian. Gentle exercise, like short walks, can help with energy and mood. Let your body guide you and rest when you need it.

Mental health and emotional wellbeing

It is completely normal to feel anxious, sad, or overwhelmed after a cancer diagnosis and during treatment. Your appearance, voice, and ability to eat may change, and this can affect how you feel about yourself. It is important to share these feelings with your care team or a counsellor.

Prevention

You cannot always prevent head and neck cancer, but you can reduce your risk. Avoiding tobacco, limiting alcohol, and getting vaccinated against HPV can lower your chances of getting some types of this disease. Regular dental check-ups may help catch early changes.

Vaccines

There is a safe vaccine that protects against HPV infection. This vaccine is typically offered to pre-teens and young adults, but it may also be recommended for some older adults. Ask your healthcare provider about the HPV vaccine.

Screening programmes

There is no national screening program for head and neck cancer. However, frequent checks by your dentist or doctor can help spot unusual changes early, especially if you are at higher risk.

Complications

If left untreated

• Cancer can spread to nearby lymph nodes and other organs
• Tumors can grow large enough to block the airway or make swallowing impossible
• Severe pain and weight loss may occur
• Treatment becomes harder and less likely to be successful when cancer is advanced

Long-term outlook

The outlook for head and neck cancer has improved greatly in recent years. When caught early, many people are cured. Even for more advanced cancers, modern treatments are often effective. Your care team will give you an honest and hopeful picture based on your specific situation.

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