What Is Head and Neck Cancer?

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The term "head and neck cancers" includes a variety of cancers that originate in the head or neck region. Thyroid and skin cancers are not counted among this group. However, it does include some cancers of the mouth, nose, and throat, like laryngeal cancer or tumors in your nasal sinuses.

Because there are different kinds of head and neck cancers, there also are different causes and symptoms as well as treatments. This article offers a general look at some of these common head and neck cancers, including those linked to the human papillomavirus (HPV).

Patient discussing neck problems with doctor
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Symptoms

Symptoms of head and neck cancer vary, depending on the specific cancer. A broad spectrum of symptoms may include:

  • Chronic sinus infections that do not respond to treatment
  • Difficulty or pain when swallowing
  • Voice changes or hoarseness
  • Pain in the neck, throat, jaw, or chin that does not go away
  • Ear pain, ringing in the ears, or trouble hearing
  • A sore, blister, or other lesion of the mouth that does not heal
  • Bloody sputum
  • Difficulty opening mouth or chewing
  • Unusually foul breath
  • Double vision
  • Lump(s) in the neck

Types of Cancers

The following are some of the main types of head and neck cancers.

Salivary Gland Cancer

Cancers of the salivary glands are rare. These cancers are found in the three main salivary glands responsible for producing the saliva in your mouth. These are called the parotid glandssubmandibular glands, and sublingual glands.

Symptoms of this cancer include difficulty swallowing, facial pain, bleeding or a sore in your mouth, and a lump either in your mouth or neck.

Laryngeal Cancer

This type of cancer affects your vocal cords, and changes in your voice may be an early symptom. People with laryngeal cancer also may experience ear and throat pain, difficulty swallowing, and the sense that their airways are obstructed, or closed off.

Smoking, excessive alcohol use, and HPV are the strongest risk factors for cancers of the larynx.

Tumors of the Oropharynx

Oropharynx cancers affect the back of your throat and tongue, as well as your tonsils. Smoking, alcohol use, and HPV infection are the common risk factors in this type of head and neck cancer.

There's some evidence that HPV-related cases begin with a neck lump as the first sign of cancer, while tobacco-related cases start with a sore throat, trouble swallowing, or unexplained weight loss.

Hypopharyngeal Cancer

These cancers are found in the lowest part of your pharynx. This part of the pharynx also is called the laryngopharynx. It's a part of your throat behind your voicebox, or larynx. Common symptoms include pain, difficulty swallowing, and bleeding.

Hypopharynx cancer is one of the most common head and neck cancers. It tends to have a poor prognosis, in part because of high rates of spread, or metastasis, to distant parts of the body.

Nasopharyngeal Cancer

These cancers affect the part of the pharynx found behind your nose. Nasopharyngeal cancer presents with some different symptoms, including chronic congestion, hearing and vision changes, and headaches.

The Epstein-Barr virus is implicated in the development of most nasopharyngeal cancers, despite the fact that by early adolescence, more than 95% of the global population has been exposed without any symptoms. Researchers are still working to understand why there is such a strong correlation between these cancers and the Epstein-Barr virus.

What Is the Epstein Barr Virus?

The Epstein-Barr virus (EBV) is a common virus that affects nearly everyone and stays in your system forever. EBV may be best known for its link to chronic fatigue syndrome, but scientific advances are demonstrating the role that it may play in the development of certain cancers, including most nasopharyngeal cancers and some gastric (stomach) cancers.

Causes and Risk Factors

Risk factors for head and neck cancer vary among the different types, but tobacco and alcohol use are among the most significant risks.

Other risk factors for head and neck cancer include:

Exposure to ultraviolet (UV) rays through the sun or tanning beds is commonly associated with skin cancers, but it also is linked to cancer of the lips, considered an oral cancer too.

HPV

In recent years, HPV has increasingly been linked to cancers of the mouth and head, especially cancers of the oropharynx. Some HPV-linked cancers are on the rise, especially in young people and those who never used tobacco.

However, many people are not aware that HPV is a risk factor. A 2021 survey of more than 1,000 people in Poland found the majority knew that smoking was a risk factor, but only about a third of them correctly identified HPV and alcohol use as risk factors too.

Diagnosis

How head and neck cancer is diagnosed depends on what type of cancer is suspected. Lab tests, imaging tests, biopsies, and endoscopies are all methods of diagnosing many types of cancer.

Some of the more common imaging tests used to diagnose head and neck cancers include the PET-CT imaging tests. That means a positron emission tomography (PET) scan and a computerized tomography (CT) scan are done at the same time.

The CT scan also may be done alone. Both the CT scan and magnetic resonance imaging (MRI) can offer more detailed views than X-rays do to identify head and neck tumors and their spread.

An endoscopy procedure is done by using a flexible, lighted tube with an attached camera into the area where a head and neck cancer may be suspected. This allows a healthcare provider to directly visualize any tissues that are involved.

A biopsy, or tissue sample of a suspected tumor, may be removed to confirm a diagnosis. A pathologist reviews the cells under a microscope in order to identify a cancer and its type.

Once cancer is confirmed, the cancer stage is then determined and a treatment plan is created.

Treatment

Treatment for head and neck cancer depends on the type of cancer, how far the cancer's growth has advanced, and other general health factors.

Common methods of treating head and neck cancer include:

  • Chemotherapy, using medications designed to control cancer and its spread
  • Radiation therapy, used to target cancer cells and shrink tumors
  • Surgery, such as tracheostomy to open the airway
  • Immunotherapy, which activates the immune system to fight the cancer

Keep in mind that a personalized treatment plan will be tailored to the type of head and neck cancer you have. Radiation is likely to be used in nearly all cases of head and neck cancer, regardless of the specific type and cause.

Chemotherapy given in conjunction with radiation is standard treatment for more advanced cancers. Surgery is often indicated, although that may not be the case for later-stage cancers that occur in people who, for age or underlying health reasons, may not tolerate a procedure well.

Immunotherapy Drugs: A Treatment Option

Keytruda (pembrolizumab) is an immunotherapy drug approved for use in some cases of recurring or metastatic head and neck cancer. However, researchers warn that more study is needed to understand how these drugs work alongside other treatments and the optimal ways to use them.

Prevention

Many studies suggest a link between HPV infection and some types of head and neck cancer. HPV is most commonly known for causing cervical cancer in women, but there is mounting evidence of its role in other types of cancer.

For example, HPV is thought to cause 70% of oropharyngeal cancers in the United States. It is also associated with some types of nasopharyngeal cancer. Limiting exposure to HPV may decrease the risk of head and neck cancer, and an HPV vaccine is one way to do that. So is using a barrier method of contraception when participating in oral sex.

Tobacco and alcohol use have long been associated with head and neck cancers, and that's a good reason to avoid them. In fact, the risk is greater for people who both drink and use tobacco products.

Poor oral hygiene may also be related to head and neck cancer. Dentures that cause irritation due to improper fit, along with any untreated cavities, may increase your risk of oral cancer.

Summary

There are several different kinds of head and neck cancer, including cancers associated with HPV. The symptoms and treatment depend on the cancer and, among other things, how far it has advanced. Prevention, too, depends on the type of cancer and the specific risk factors for it.

A Word From Verywell

Some of the symptoms linked with head and neck cancers are pretty general, and they could mean nothing more than a cold or an overdue trip to the dentist. But when these symptoms don't go away, or they happen in a context that worries you, call your healthcare provider to discuss your concerns.

Above all, don't hesitate to ask about how you can protect yourself from these cancers, especially any HPV-related cancers. Your doctor also can tell you if an HPV vaccine is a good choice for you.

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13 Sources
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  1. National Cancer Institute. Head and Neck Cancers.

  2. Sturgis E. Oropharyngeal cancer: Clinical implications of the HPV epidemic. Lecture presented at The University of Texas MD Anderson Cancer Center.

  3. Suzuki S, Toyoma S, Abe T, et al. 18F-FDG-PET/CT can be used to predict distant metastasis in hypopharyngeal squamous cell carcinoma. J Otolaryngol Head Neck Surg. 2022 Apr 1;51(1):13. doi:10.1186/s40463-022-00568-8

  4. Abusalah MAH, Irekeola AA, Hanim Shueb R, Jarrar M, Yean Yean C. Prognostic Epstein-Barr Virus (EBV) miRNA biomarkers for survival outcome in EBV-associated epithelial malignancies: Systematic review and meta-analysisPLoS One. 2022;17(4):e0266893. doi:10.1371/journal.pone.0266893

  5. Smatti MK, Al-Sadeq DW, Ali NH, Pintus G, Abou-Saleh H, Nasrallah GK. Epstein–Barr virus epidemiology, serology, and genetic variability of lmp-1 oncogene among healthy population: an updateFront Oncol. 2018;8:211. doi: 10.3389/fonc.2018.00211

  6. Centers for Disease Control and Prevention. Head and Neck Cancers.

  7. Kobayashi K, Hisamatsu K, Suzui N, Hara A, Tomita H, Miyazaki T. A Review of HPV-Related Head and Neck CancerJ Clin Med. 2018;7(9):241. doi:10.3390/jcm7090241

  8. Pinkas W, Jankowski M, Wierzba W. Awareness of head and neck cancers: A 2021 nationwide cross-sectional survey in Poland. J Clin Med. 2022 Jan 21;11(3):538. doi:10.3390/jcm11030538

  9. Corry J, Ng WT, Ma SJ, Singh AK, de Graeff P, Oosting SF. Disadvantaged subgroups within the global head and neck cancer population: How can we optimize care? Am Soc Clin Oncol Educ Book. 2022 Apr;42:1-10. doi: 10.1200/EDBK_359482

  10. Doescher J, von Witzleben A, Boukas K, Weissinger S, Thomas G, Laan S, et al. Changes in gene expression patterns in the tumor microenvironment of head and neck squamous cell carcinoma under chemoradiotherapy depend on responseFront Oncol. 2022;12:862694. doi: 10.3389/fonc.2022.862694

  11. Mei Z, Huang J, Qiao B. Lam AK. Immune checkpoint pathways in immunotherapy for head and neck squamous cell carcinomaInt J Oral Sci. 2020;1:16. doi:10.1038/s41368-020-0084-8

  12. Centers for Disease Control and Prevention. HPV and Oropharyngeal Cancer.

  13. Oji C, Chukwuneke F. Poor oral hygiene may be the sole cause of oral cancerJ Maxillofac Oral Surg. 2012;11(4):379–383. doi:10.1007/s12663-012-0359-5