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Head and Neck
Reviewed December 2011
This information should not be used to self-diagnose, or be used in place of a qualified physician’s care.
Head and Neck Cancer
- These relatively uncommon cancers are treated by members of the BC Cancer Agency’s Head & Neck Tumour Group.
- For healthcare professional information on treating this cancer, please see our Cancer Management Guidelines.
- Head & neck tumours arise in the mouth, nose or throat. Other names for these cancers include: oral cancer, cancer of the oral cavity, mouth cancer, cancer of the nasal cavity, nasopharyngeal cancer, cancer of the sinuses, throat cancer, pharyngeal cancer, cancer of the pharynx, cancer of the larynx, laryngeal cancer, cancer of the salivary gland, cancer of the tonsils.
- Head & neck cancers can affect talking, eating, chewing, swallowing, and the senses of smell and taste.
- Head & neck cancers discussed on this page do not include brain cancer, thyroid cancer and eye (or orbital) cancer. Please see the specific information pages for these other cancers.
- Other information pages have also been created for specific types of head & neck cancer: the larynx, mouth, pharynx, and salivary glands.
What causes it and who gets it?
Listed below are some of the known risk factors for this cancer. Not all of the risk factors below may cause this cancer, but they may be contributing factors.
- Men are at greater risk than women to develop head & neck cancers.
- Risk for getting a head & neck cancer increases with age – cancers primarily occur in people over the age of 40.
- Tobacco use (including chewing tobacco and snuff) is the most important risk factor for developing some head & neck cancers. The longer tobacco has been used, the greater the risk.
- Heavy drinking of alcohol increases the risk for some head & neck cancers.
- People who use both tobacco and alcohol have a greater risk of developing head & neck cancer than people who use only one of the toxins.
- Human papilloma virus (HPV) infection is a risk factor.
- Occupational exposure to inhaled wood dust, paint fumes and certain chemicals may increase the risk of developing head & neck cancers.
- Other risk factors exist for specific types of head & neck cancer – see related pages.
- Statistics:
Can I help to prevent it?
- Tobacco and alcohol use are the major risk factors for developing this type of cancer. Don’t start smoking or chewing tobacco products.
- If you smoke, quit. If you chew tobacco, stop. This will reduce your risk, even after years of use. If you drink alcohol, stop or limit your intake.
- Patients who are cured of head & neck cancer are more likely to develop a second cancer if they continue to use tobacco and alcohol. Even after diagnosis with a head & neck cancer, quitting tobacco and alcohol can reduce the possibility of the cancer happening again.
Screening for this cancer
- If found early, the majority of head & neck cancers are curable. Regular physical and dental checkups, including a full-mouth examination, offer the best method of early detection for many head & neck cancers.
Signs and Symptoms
- Many of the following are also symptoms of non-cancerous conditions. However, any of these symptoms lasting for more than a few weeks should be evaluated by a physician.
- A sore, swelling or ulcer in the mouth that doesn’t go away
- A lump in the neck that lasts more than two weeks
- A white or red patch in the mouth
- Persistent earache or sore throat or nasal congestion
- Pain in the mouth, jaw or ear without obvious cause
- Voice changes or hoarseness lasting longer than two weeks
- Difficulties with swallowing
- Blood appearing in the saliva or phlegm for more than a few days
Diagnosis
Below is a list of some or all of the tests used to diagnose this type of cancer. We have more information on other diagnostic tests for cancer.
- Physical examination with blood and/or urine tests
- Biopsy of the tissue is essential for diagnosis
- Imaging of the tumours using one or more of:
- Computed tomography (CT)
- X-rays
- Magnetic Resonance Imaging (MRI)
- Positron Emission Tomography (PET)
Types & Stages
Staging describes the extent of a cancer. The TNM classification system is used as the standard around the world. In general a lower number in each category means a better prognosis. The stage of the cancer is used to plan the treatment.
- T describes the site and size of the main tumour (primary);
- N describes involvement of lymph nodes;
- M relates to whether the cancer has spread (presence or absence of distant metastases).
- Most head & neck cancers are squamous cell carcinomas, which start in the moist linings of the oral and nasal cavities. These are the cancers most typically found in smokers and alcohol drinkers.
- Adenocarcinomas also occur, particularly in the salivary glands.
- See the staging information for specific types of head & neck cancers for further details.
Treatment
Cancer therapies can be highly individualized – your treatment may differ from what is described below.
- The treatment of head & neck cancer will be handled by a multidisciplinary team of surgeons, radiation oncologists, medical oncologists and dentists.
- Surgery is the preferred option for early stage cancers of the mouth and salivary glands.
- Radiation therapy is the preferred treatment for early stage cancers at other head & neck sites. Types of RT used for head & neck cancers include:
- External beam radiotherapy
- Brachytherapy
- 3-D conformal and stereotactic radiotherapy
- Intensity modulated radiotherapy (IMRT)
- Before beginning radiation therapy, patients should have a thorough dental evaluation. A detailed dental evaluation and treatment plan will be developed.
- Treatment planning for radiation therapy is complex and requires construction of a custom made mask to keep the head and neck from moving during therapy. The treatment planning phase may take 7 to 10 days before treatment can start.
- Radiation therapy in the head and neck region is likely to cause some of the following side effects:
- Dry mouth
- Dental problems
- Mouth sores
- Difficulty swallowing
- Hearing loss
- Chemotherapy may be used with radiation therapy to increase control of the disease.
- Treatment for more advanced stage head & neck cancer usually involves a combination of the available therapies. Patients should be referred to one of the BCCA regional cancer centres for multidisciplinary assessment.
- See the treatment information on the specific types of head & neck cancers for further details.
Followup after Treatment
- Guidelines for follow-up after active treatment has ended have been developed by the BC Cancer Agency and are listed on our website.
- It is essential that patients be followed carefully for at least two years after initial treatment, by a cancer specialists and/or otolaryngologist. A large majority of recurrences are found in the first two years after treatment.
- Following the active treatment phase many patients also require the services of dietitians, physiotherapists and speech therapists.
- Excellent oral hygiene must be maintained. Detailed information about the effects of radiation on teeth is available.
Coping with Cancer
- BC Cancer Agency staff can help with quality of life issues for those living with or affected by cancer. This includes the physical, emotional, psychological and practical aspects of care. Each cancer experience is different, but in one way or another, many cancer patients share the same needs.
- The effects of cancer and its treatment can present unique challenges: from practical concerns like money and housing, to emotional concerns like anxiety and grief. If you need support with the practical and emotional impacts of cancer, or in managing symptoms and side effects you can use the information in Coping with Cancer to connect to these resources.
Search our library catalogue
- The BC Cancer Agency Library has many resources about cancer, coping, talking to children, etc. Please visit the Library in your Centre, call a librarian, or visit the Library online to see the many resources available.
- Automatically get a bibliography of books, videos and other items available through our library.
Recommended websites
The following websites have been selected and evaluated by the BC Cancer Agency.
Can I help with research at BCCA?
BCCA cancer patients are very helpful when it comes to the fight against cancer. Here are a few ways that you can help.
This information has been reviewed and approved by a member of the Head and Neck Tumour Group.
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