What is Head and Neck Cancer?

Head and neck cancer is a broad term which covers a diverse number tumour types located in some 30 different sites that include the oral cavity, oropharyngeal, laryngeal, hypopharyngeal, sinus, salivary gland and thyroid cancers. Some head and neck cancers are described according to the type of cell they start in. These are mostly known as squamous cell cancers, which start in the cells lining the mouth, nose and throat.

Head and neck cancers are as complex as other cancers but also present some particular issues. The head and neck area has many critically important and delicate organs in close proximity; treating a tumour in one area will often have serious effects on other surrounding organs. Depending on the type of cancer and treatment given, side effects vary with the most common including difficulties with eating, drinking, speech, hearing and facial disfigurement. Between 29-42% of head and neck patients will suffer from depression, against only 8-24% of general cancer sufferers. (Source CRUK)

Curative treatment is possible in most early head and neck tumours with impressive cure rates of around 80-90% using surgery and/or radiotherapy. As with all cancers, early detection and diagnosis is vital, so it is advisable to visit your dentist or doctor at the first sign of persistent, unexplained signs or symptoms.

Common symptoms include:

  • an ulcer in the mouth that doesn’t heal within a few weeks
  • difficulty swallowing, pain or discomfort when chewing or swallowing
  • red or white patches in the mouth or throat that don’t go away within a few weeks
  • changes to your voice e.g. hoarseness, or sounding like you have a cold
  • a constant sore throat and ear pain on one side
  • a swelling or lump in the face, mouth or neck

Less common symptoms include:

  • unusual bleeding or numbness in the mouth
  • loose teeth for no obvious reason
  • difficulty moving the jaw
  • pain or numbness in the face or jaw
  • weight loss

There are many different structures within the delicate head and neck region. Each cancer type is named and treated according to where it starts in the body. Treatments can vary depending on the type of head and neck cancer.

Mouth cancer

Most lip cancers occur on the bottom lip.

Cancer inside the mouth

Doctors use different names to describe different areas of the throat and the cancers that can develop there.The nasopharynx is the highest part of the throat behind the nose. Cancers that occur here are called nasopharyngeal cancers. The oropharynx is the part of the throat directly behind the mouth. It includes the soft part of the roof of the mouth (the soft palate), the base of the tongue (the part you can’t see), the tonsils and the back and side walls of the throat.The most common places in the oropharynx for cancer to develop are the tonsils and the base of the tongue.

Cancer of the voice box (larynx)

This is the second most common place for head and neck cancer to develop but it is relatively rare with some 2,500 people diagnosed in the UK each year.

Cancer of the thyroid gland

Cancer can also develop in the thyroid gland. It is treated differently from other types of head and neck cancer.

Cancer of the sinuses

There are air spaces called sinuses in the bones of the face alongside the nose. Cancers can develop in the lining of these sinuses.

Cancer of the salivary glands

Salivary glands make saliva, which keeps the mouth moist. Salivary gland cancer is most likely to develop in the parotid glands, which are found on each side of the face, just in front of the ears.

Cancer of the middle ear

Rarely cancer can develop in the middle ear.

Lumps in the neck

If a cancer in the mouth or throat spreads from where it started, the first place it will usually spread to is the lymph nodes in the neck. The cancer may begin to grow in the lymph nodes. This can show up as a painless lump in the neck. Enlarged lymph nodes are much more likely to be due to an infection than to cancer, but if you have a lump on your neck that hasn’t gone away within 3-4 weeks, it should be examined by a doctor.

Causes of head and neck cancer

Drinking alcohol and smoking

Smoking tobacco and drinking a lot of alcohol are high risk factors for cancer of the larynx in the Western world.

HPV infection

HPV stands for human papilloma virus (HPV). The incidence of head and neck cancer caused by the HPV virus has increased over the past two decades. More research is needed to find out how the virus causes cancer.

Throat cancers

The most common places for cancer to develop inside the mouth are the side of the tongue and under the tongue.

Lip cancer

Mouth cancer can develop on the lip, tongue, under the tongue, inside of the cheek, the roof of the mouth (the hard palate), the area behind the wisdom teeth or the gums.

The mouth is the most common place for head and neck cancer to develop.

Treatment

Head and neck cancers often cause problems with eating, speaking or swallowing so treatments aim to eradicate the tumour while minimising damage to the important structures of the throat that are critical for normal speech and swallowing. Recent treatment advances include robotic surgery, robotic radiotherapy and computer-guided radiotherapy techniques that have dramatically reduced side effects such as damage to the salivary glands.

Head and neck cancer treatment is given according to the type of cancer diagnosed and whether or not it has spread. Surgery alone cures some tumours, but others respond better to radiotherapy or combinations of radio and chemotherapy.

Where research is taking place and new treatments have become available we have seen some of the highest survival rates in the world.

See our research pages for more information on the projects that we are currently funding and how to get involved in a trial.