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Overview

What Is Head and Neck Cancer?

Head and neck cancer is a group of malignant tumors that can develop in the mouth, throat, nose, sinuses, voice box, salivary glands, or nearby tissues. Most begin in the surface-lining cells, called squamous cells. These cancers can affect people of different ages, although risk varies with factors such as tobacco, alcohol, HPV, age, and other health or environmental exposures. A cancer in the neck may also begin in a nearby head or throat structure and spread to neck lymph nodes.

Symptoms

Head and Neck Cancer Symptoms

Head and neck cancer symptoms vary depending on where the tumor starts. Many of these changes have noncancerous causes, but symptoms that persist, worsen, or occur without a clear explanation should be assessed by a healthcare professional.

  • A lump or swelling in the neck that does not go away (persistent neck mass).
  • A sore in the mouth that does not heal.
  • Ongoing throat pain.
  • Trouble swallowing (dysphagia).
  • Hoarseness or a lasting change in the voice.
  • Unexplained bleeding from the mouth, throat, or nose.
  • Nasal blockage or repeated nosebleeds.
  • Pain in one ear without an obvious ear infection, especially when it occurs on one side.
  • Jaw pain or difficulty opening the mouth.
  • Numbness of the face, mouth, or neck.
  • Loose teeth without a clear dental cause.
  • Unexplained weight loss.

Important

Persistent symptoms need attention

A neck lump, throat symptom, or ear or jaw pain does not by itself diagnose cancer. However, symptoms lasting more than a couple of weeks should be evaluated, particularly if they are worsening.

Causes

Causes of Head and Neck Cancer

Head and neck cancer begins when accumulated changes in a cell’s DNA disrupt the normal controls on growth and repair. Abnormal cells may grow, divide, and survive when they should not, eventually forming a tumor that can invade nearby tissues or spread. In many individuals, the exact cause of these changes cannot be identified.

The role of HPV and other exposures

High-risk types of human papillomavirus (HPV) can contribute to some cancers of the throat, including parts of the tonsils and base of the tongue. Tobacco smoke, smokeless tobacco, heavy alcohol use, and other carcinogenic exposures can damage cells and increase the chance of cancerous changes. No single exposure is required in every case, and some people develop a malignant tumour in the neck without an obvious cause.

Risk Factors

Risk Factors for Head and Neck Cancer

Modifiable and non-modifiable risk factors

  • Modifiable: Using cigarettes, cigars, pipes, smokeless tobacco, or other tobacco products increases risk.
  • Modifiable: Heavy alcohol use raises risk, especially when combined with tobacco.
  • Modifiable: Certain workplace or environmental exposures, including some dusts, fumes, and chemicals, may increase risk.
  • Less modifiable: Persistent infection with a high-risk type of HPV is linked with some throat cancers.
  • Non-modifiable: Increasing age is associated with a higher likelihood of developing these cancers.
  • Non-modifiable: Sex and biological differences may affect risk for particular head and neck cancer sites.
  • Non-modifiable: A previous head and neck cancer can increase the chance of another cancer.
  • Less modifiable: A weakened immune system may reduce the body’s ability to control abnormal or infected cells.
  • Non-modifiable: Inherited susceptibility and certain genetic conditions can contribute to risk.

Side Effects & Complications

Complications and Treatment Side Effects

Complications depend on the tumor’s site, extent, and treatment. The cancer or its treatment may cause airway or swallowing problems, spread to lymph nodes or distant organs, pain, bleeding, and nutritional difficulties. Treatment effects can be temporary or long-lasting and may affect speech, swallowing, appearance, and daily activities.

  • Dry mouth, especially after radiation therapy.
  • Mouth sores or irritation of the lining of the mouth and throat.
  • Dental problems requiring ongoing dental care.
  • Changes in taste or smell.
  • Fatigue that affects daily activities.
  • Skin changes in areas treated with radiation.
  • Difficulty swallowing food or liquids.
  • Changes in speech or voice.
  • Reduced shoulder or neck movement after surgery or radiation.
  • Nutrition problems or unintentional weight loss.

Get help promptly

Know when to contact your oncology team

Contact your oncology team promptly for breathing trouble, inability to swallow fluids, uncontrolled bleeding, dehydration, fever during treatment, or rapidly worsening symptoms.

Diagnosis & Staging

How Head and Neck Cancer Is Diagnosed and Staged

  • A medical history and physical examination help identify symptoms, risk factors, and abnormal areas.
  • The mouth and throat are examined directly, sometimes with special instruments or mirrors.
  • A flexible scope may be passed through the nose or mouth to view areas that are difficult to see.
  • Imaging such as CT or MRI can show the tumor, nearby tissues, and lymph nodes.
  • A PET/CT scan may be used in selected cases to look for active cancer or spread.
  • A biopsy removes tissue for laboratory testing to confirm cancer and identify its type and features.

What staging means

Staging describes how extensive the cancer is and helps guide treatment. It commonly considers the primary tumor’s size or invasion into nearby structures, whether nearby lymph nodes are involved, and whether the cancer has spread to distant organs. HPV status and other tumor features may also affect prognosis or treatment. Stages are not identical across every head and neck cancer site, so the staging system must be interpreted for the specific tumor.

Treatment Options

Head and Neck Cancer Treatment Options

Treatment may aim to cure the cancer, control it, or relieve symptoms. A multidisciplinary team may include surgeons, medical and radiation oncologists, dentists, speech and swallowing specialists, dietitians, and other professionals. The best approach depends on the cancer’s site and stage, HPV or other biomarkers, overall health, and personal priorities. Treatments are often combined.

SURGERY

Surgery removes the tumor and sometimes nearby lymph nodes or involved tissues. Reconstruction may help restore appearance or function, and surgery may be combined with radiation or drug treatment.

RADIATION THERAPY

Radiation uses high-energy treatment to destroy cancer cells or reduce a tumor. It may be used alone, after surgery, or with chemotherapy or other medicines.

CHEMOTHERAPY

Chemotherapy uses medicines that travel through the bloodstream to kill or slow cancer cells. It may be given with radiation, before surgery, after surgery, or for advanced disease.

TARGETED THERAPY

Targeted medicines act on specific features that help cancer cells grow. Testing the tumor may show whether this approach is appropriate, often alongside other treatments.

IMMUNOTHERAPY

Immunotherapy helps the immune system recognize and attack cancer cells. It may be offered for some advanced or recurrent cancers based on tumor features and treatment history.

CLINICAL TRIALS

Clinical trials study new treatments or new combinations of existing treatments. The cancer team can explain whether a trial may be suitable and what participation involves.

Prevention

Can Head and Neck Cancer Be Prevented?

  • Do not use tobacco, and seek support if you want to stop.
  • Limit or avoid alcohol, particularly if you use tobacco.
  • Ask a healthcare professional about HPV vaccination according to current recommendations.
  • Use appropriate protective equipment and follow safety guidance for relevant workplace exposures.
  • Maintain oral health with regular dental care and treatment of ongoing mouth problems.

Screening

Know when focused assessment is needed

There is no single routine screening test for all head and neck cancers. People with concerning symptoms or high-risk histories may need a focused examination and prompt assessment.

Outlook and Prognosis

Outlook and Prognosis

Some head and neck cancers can be cured, especially when they are found and treated earlier. Prognosis varies by the cancer’s site and stage, lymph-node or distant spread, HPV status where relevant, overall health, and response to treatment. Whether a throat cancer is curable depends on these individual factors and the treatment plan.

Survivorship & Follow-up

Survivorship and Follow-Up

Follow-up visits commonly include an examination of the original cancer site and neck, a review of symptoms, and tests guided by the findings. The schedule is individualized and is often more frequent soon after treatment. Follow-up helps detect recurrence, a new cancer, and treatment-related problems while supporting recovery.

  • Watch for symptoms that could suggest recurrence or a new cancer and report them promptly.
  • Keep up with dental examinations and daily oral care.
  • Use swallowing and speech rehabilitation when recommended.
  • Monitor nutrition, eating ability, and weight.
  • Receive thyroid or other treatment-related monitoring when relevant.
  • Ask about tobacco and alcohol cessation support.
  • Seek help for anxiety, depression, distress, or other emotional concerns.

Branches

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Tests & Procedure

2 topics

Symptoms

2 topics