Head & Neck Cancers – An Overview

Types of Head & Neck Cancers

• Oral, or mouth cancer, can occur on the tongue, lips, roof or floor of the mouth, gums, salivary glands, the lining of the lips and cheeks, or the area behind the wisdom teeth. These cancers are often first discovered by dentists during a routine checkup.
• Parathyroid disease originates in the parathyroid glands in the neck, near the thyroid gland.
• Pituitary tumors start in the pituitary gland, a pea-sized structure at the base of the brain. While these tumors are rarely malignant, they can create serious medical issues by disrupting hormone production.
• Skin cancers on the head or neck are usually treated by a dermatologist. However, cancer that has spread to deeper tissues may require the additional expertise of an ear, nose, and throat specialist.
• Salivary gland cancer can occur in the mouth, throat, or sinus cavities.
• Skull base tumors can cause serious problems even if they are not malignant because the spinal cord and many nerves and blood vessels pass through openings in the skull base.
• Throat cancers are classified based on their location. Most start in the oropharynx, which encompasses the soft palate, back of the tongue, tonsils, and walls of the throat. Nasopharyngeal cancer starts in the nasopharynx, which sits behind the nasal cavity. Hypopharyngeal cancer originates in the hypopharynx, the area between the throat and the esophagus and trachea. Laryngeal cancer occurs in the larynx (voice box).
• Thyroid cancer, which begins in the thyroid gland, is usually slow-growing and has 5-year survival rate of more than 98%. However, certain subtypes, such as anaplastic thyroid cancer, grow rapidly and require swift treatment.

Symptoms

While the symptoms described below can be due to other conditions, it’s essential to see a doctor to rule out head and neck cancers.

• A lump on the back of neck, jaw, lips, or mouth
• One or more swollen lymph nodes in the neck
• A mouth ulcer that does not heal
• Persistent facial pain or discomfort
• Neck pain
• Ear pain, ringing or sudden hearing loss
• Small, painless lumps or swelling in the front of the neck
• Difficulty moving the jaw
• Difficulty swallowing – you may experience a burning sensation when chewing or swallowing, feel like food is stuck in your throat or going down your windpipe instead of your esophagus
• Changes in your voice or speech – you could sound like you have a cold, slur your words, or have trouble pronouncing certain sounds
• Ear pain or hearing loss
• Nasal congestion, nosebleeds, or chronic sinus infections
• Sore throat that doesn’t go away
• White patches (leukoplakia) or Red Patches (erythroplakia) in the mouth or throat
• Unplanned weight loss
• Dentures no longer fit or loose teeth for no clear reason
• Changes or discoloration in a mole, or sores that won’t heal

Treatment

Depending on the type and stage of the tumor, head and neck cancers may be treated using one or more of the following approaches:

• Surgery to remove the tumor
• Radiotherapy
• Chemotherapy
• Radioactive iodine therapy for thyroid cancer
• Targeted therapy, which uses drugs to target specific cellular abnormalities that drive cancer growth
• Reconstructive surgery may be needed if removing the tumor causes cosmetic issues

The Care Team

Cancer is treated using a multidisciplinary approach and head & neck cancers are no exception. Depending on the diagnosis and prognosis, several of these experts may be involved in your care.

1. An ENT is a physician who specializes in the diagnosis of diseases of the ears, nose, throat, head, and neck.
2. An otolaryngologist is an ENT with additional subspecialty training in pediatric otolaryngology, facial plastic surgery, neurotology (treatment of conditions related to the ear and the temporal bone), or surgery for head and neck cancers.
3. A medical oncologist is the specialist who plans and oversees any necessary chemotherapy or targeted therapy treatments.
4. A radiation oncologist specializes in the use of radiation therapy to treat cancer.
5. Maxillofacial and reconstructive surgeons perform plastic surgery to restore a more normal appearance if cancer surgery created cosmetic issues.
6. Speech and swallow therapists help patients recover their ability to speak and swallow.
7. Dentists and prosthodontists provide prosthetic replacements when cancer surgery results in missing teeth or jaw structures.
8. Dietitians help with dietary planning when surgery or treatments impact eating and swallowing.
9. Genetic counselors may be called in if a cancer has a hereditary component.

El Camino Health has an expert team of specialists treating all types of head and neck cancers. Learn more.

Risk Factors

• Tobacco consumption, including cigarettes, cigars, pipes, and chewing tobacco, is the most common cause of head and neck cancers. The rate of these cancers is declining worldwide as tobacco use decreases.
• Alcohol consumption is a risk factor for throat and oral cancers
• Sex. Men are two to three times more likely to get head and neck cancers than women but this is thought to be due to their greater use of tobacco and alcohol. Women are three to four times more likely to get thyroid cancer than men.
• Viral infection with the human papillomavirus (HPV) or Epstein-Barr Virus (EBV)
• Poor oral hygiene
• Ongoing exposure, usually work-related, to inhalants such as asbestos or wood dust
• A diet low in fruits and vegetables
• Gastroesophageal reflux disease (GERD)
• A weakened immune system
• Sun/ultraviolet light exposure can cause skin cancer, including melanoma, in the head and neck area
• Previous radiation treatment in the head and neck area
• Age – most oral cancers occur in people over 45 while thyroid cancer is more common in those aged 20-55.
• Genetics: Some head and neck cancers are linked to inherited genetic conditions

This article first appeared in the April 2025 edition of the HealthPerks newsletter.