What causes cancers of the head and neck?

Alcohol and tobacco use (including second-hand smoke and smokeless tobacco, sometimes called “chewing tobacco” or “snuff”) are the two most important risk factors for head and neck cancers, especially cancers of the oral cavity, hypopharynx. People who use both tobacco and alcohol are at greater risk of developing these cancers than people who use either tobacco or alcohol alone. Most head and neck squamous cell carcinomas of the mouth and voice box are caused by tobacco and alcohol use.

Symptoms of cancers in specific areas of the head and neck include:

Head and neck cancer symptoms may include a lump in the neck or a sore in the mouth or the throat that does not heal and may be painful, a sore throat that does not go away, difficulty in swallowing, and a change or hoarseness in the voice. These symptoms may also be caused by other, less serious conditions. It is important to check with a doctor or dentist about any of these symptoms.

Oral Cavity: A white or red patch on the gums, the tongue, or the lining of the mouth; a growth or swelling of the jaw that causes dentures to fit poorly or become uncomfortable; and unusual bleeding or pain in the mouth.

Throat (pharynx): Pain when swallowing; pain in the neck or the throat that does not go away; pain or ringing in the ears; or trouble hearing.

Voice box (larynx): Trouble breathing or speaking, pain when swallowing, or ear pain.

Paranasal sinuses and nasal cavity: Sinuses that are blocked and do not clear; chronic sinus infections that do not respond to treatment with antibiotics; bleeding through the nose; frequent headaches, swelling, or other trouble with the eyes; pain in the upper teeth; or problems with dentures.

Salivary glands: Swelling under the chin or around the jawbone, numbness or paralysis of the muscles in the face, or pain in the face, the chin, or the neck that does not go away.

How are head and neck cancers treated?

Head and neck cancer treatment can include surgery, radiation therapy, chemotherapy, targeted therapy, immunotherapy, or a combination of treatments. The treatment plan for an individual patient depends on a number of factors, including the location of the tumour, the stage of cancer, and the person’s age and general health.

What are the side effects of head and neck cancer treatment?

Surgery for head and neck cancers may affect the patient’s ability to chew, swallow, or talk. The patient may look different after surgery, and the face and neck may be swollen. The swelling usually improves with time. However, if lymph nodes are removed, the flow of lymph in the area where they were removed may be slower and lymph could collect in the tissues (a condition called lymphedema), causing additional swelling that may last for a long time.

Head and neck lymphedema may be visible or internal. In most cases, it can be reversed, improved, or reduced if treated promptly. Patients with untreated lymphedema may be more at risk of complications such as cellulitis, or an infection of the tissues. Untreated cellulitis, if severe, can be dangerous and could lead to further swallowing or breathing difficulties.

After a laryngectomy (surgery to remove the voice box) or other surgery in the neck, parts of the neck and throat may feel numb because nerves have been cut. If lymph nodes in the neck were removed, the shoulder and neck may become weak and stiff.