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Head & Neck Cancer

Head & Neck Cancer

Head & Neck Cancer

Insight into recognizing symptoms for early detection

  • Early detection of head and neck cancer
  • Symptoms of head and neck cancer
  • and more…

More than 55,000 Americans will develop cancer of the head and neck (most of which is preventable) this year; nearly 13,000 of them will die from it.

Early detection of head and neck cancer

Tobacco use is the most preventable cause of these deaths. In the United States, up to 200,000 people die each year from smoking-related illnesses. The good news is that this figure has decreased due to the increasing number of Americans who have quit smoking. The bad news is that some of these smokers switched to smokeless or spit tobacco, assuming it is a safe alternative. This is untrue. By doing this, they are only changing the site of the cancer risk from their lungs to their mouth. While lung cancer cases are down, cancers in the head and neck appear to be increasing. Cancer of the head and neck is curable if caught early. Fortunately, most head and neck cancers produce early symptoms. You should know the potential warning signs so you can alert your doctor as soon as possible. Remember—successful treatment of head and neck cancer depends on early detection. Knowing and recognizing the signs of head and neck cancer can save your life.

Symptoms of head and neck cancer

A lump in the neck... Cancers that begin in the head or neck usually spread to lymph nodes in the neck before they spread elsewhere. A lump in the neck that lasts more than two weeks should be seen by a physician as soon as possible. Of course, not all lumps are cancer. But a lump (or lumps) in the neck can be the first sign of cancer of the mouth, throat, voicebox (larynx), thyroid gland, or of certain lymphomas and blood cancers. Such lumps are generally painless and continue to enlarge steadily.

Change in the voice... Most cancers in the larynx cause some changes in voice. An otolaryngologist is a head and neck specialist who can examine your vocal cords easily and painlessly. While most voice changes are not caused by cancer, you shouldn’t take chances. If you are hoarse or notice voice changes for more than two weeks, see your doctor.

A growth in the mouth... Most cancers of the mouth or tongue cause a sore or swelling that doesn’t go away. These sores and swellings may be painless unless they become infected. Bleeding may occur, but often not until late in the disease. If an ulcer or swelling is accompanied by lumps in the neck, be concerned. Your dentist or doctor can determine if a biopsy (tissue sample test) is needed and can refer you to a head and neck surgeon who can perform this procedure.

Bringing up blood... This is often caused by something other than cancer. However, tumors in the nose, mouth, throat, or lungs can cause bleeding. If blood appears in your saliva or phlegm for more than a few days, you should see your physician.

Swallowing problems... Cancer of the throat or esophagus (swallowing tube) may make swallowing solid foods difficult. Sometimes liquids can also be troublesome. The food may “stick” at a certain point and then either go through to the stomach or come back up. If you have trouble almost every time you try to swallow something, you should be examined by a physician. Usually a barium swallow x-ray or an esophagoscopy (direct examination of the swallowing tube with a scope) will be performed to find the cause.

Changes in the skin... The most common head and neck cancer is basal cell cancer of the skin. Fortunately, this is rarely serious if treated early. Basal cell cancers appear most often on sun- exposed areas like the forehead, face, and ears, but can occur almost anywhere on the skin. Basal cell cancer often begins as a small, pale patch that enlarges slowly, producing a central “dimple” and eventually an ulcer. Parts of the ulcer may heal, but the major portion remains ulcerated.

Some basal cell cancers show color changes. Other kinds of cancer, including squamous cell cancer and malignant melanoma, also occur on the head and neck. Most squamous cell cancers occur on the lower lip and ear. They may look like basal cell cancers and, if caught early and properly treated, usually are not dangerous. If there is a sore on the lip, lower face, or ear that does not heal, consult a physician. Malignant melanoma classically produces dense blue-black or black discolorations of the skin. However, any mole that changes size, color, or begins to bleed may mean trouble. A black or blue-black spot on the face or neck, particularly if it changes size or shape, should be seen as soon as possible by a dermatologist or other physician.

Persistent earache... Constant pain in or around the ear when you swallow can be a sign of infection or tumor growth in the throat. This is particularly serious if it is associated with difficulty in swallowing, hoarseness or a lump in the neck. These symptoms should be evaluated by an otolaryngologist.

Identifying high risk of head and neck cancer

As many as 90 percent of head and neck cancers arise after prolonged exposure to specific risk factors. Use of tobacco (cigarettes, cigars, chewing tobacco, or snuff) and alcoholic beverages are the most common cause of cancers of the mouth, throat, voice box, and tongue. In adults who do not smoke or drink, cancer of the throat can occur as a result of infection with the human papilloma virus (HPV). Prolonged exposure to sunlight is linked with cancer of the lip and is also established as a major cause of skin cancer.

What you should do... All of the symptoms and signs described here can occur with no cancer present. In fact, many times complaints of this type are due to some other condition. But you can’t tell without an examination. So, if they do occur, see your doctor to be sure.

Remember: When found early, most cancers in the head and neck can be cured with little difficulty. Cure rates for these cancers could be greatly improved if people would seek medical advice as soon as possible. Play it safe. If you detect warning signs of head and neck cancer, see your doctor immediately.
Be safe: See your doctor early and practice health habits which help prevent these diseases.

Copyright © 2015 American Academy of Otolaryngology–Head and Neck Surgery. Reproduction or republication strictly prohibited without prior written permission.

Oral Cancer

Oral cancer often appears unnoticed in the mouth as a tiny white or red spot or sore. Because many people do not realize they have oral cancer, a diagnosis may not be made until the problem has become more advanced, making treatment more difficult; currently, fifty percent of patients diagnosed with oral cancer in the U.S. do not survive more than five years. Fortunately, early detection of cancer and pre-cancerous conditions provides a higher probability of cure. Regular dental examinations are an invaluable part of early cancer detection and treatment.

Oral cancer can be caused or exacerbated by heavy alcohol and tobacco use and sun exposure. It may appear on the lips, gums, inner cheeks, tongue, or hard or soft palate.

Signs to watch out for include:

  • A sore that bleeds easily or does not heal
  • Red or white patches
  • A change in color of any parts of the mouth
  • A lump, thickening, rough spot, crust or small eroded area
  • Pain, tenderness, or numbness anywhere in the mouth or on the lips
  • Difficulty chewing, swallowing, speaking or moving the jaw or tongue
  • Sore throat or hoarseness
  • A change in the way the teeth fit together

Nasopharyngeal Cancer

A nasopharyngeal tumor is a growth that forms in the nasopharynx, or the uppermost portion of the throat that is found behind the nasal cavity. The nasopharynx serves as a passageway for air from the nose to the throat and eventually to the lungs. A tumor in the nasopharynx may be either benign or malignant. Nasopharyngeal tumors that are malignant or cancerous, may spread to surrounding tissue and other parts of the body.

While the exact cause of nasopharyngeal tumors is unknown, certain people may be at an increased risk of developing this condition. Some research indicates that there is a link between the Epstein-Barr virus and the formation of nasopharyngeal tumors and that the virus may may cause cells in the nasopharynx to become cancerous.