What is head and neck cancer?

Head and neck cancers occur inside the sinuses, nose, mouth and salivary glands down through the throat. Although these cancers are different, they are treated similarly, so are considered as a group.

In 2015, 6254 head and neck cancers were diagnosed in South Africa. These figures include cancers of the tongue, gum, mouth, salivary glands, tonsils, pharynx, nasal cavity and larynx, but not cancers of the lip.

Head and neck cancer symptoms

Symptoms depend on the site but include:

  • pain
  • swelling
  • hoarse voice
  • difficulty swallowing
  • bad breath.

Causes of head and neck cancer

Alcohol and tobacco consumption are the biggest risk factors for head and neck cancers with the exception of salivary gland cancer. Some head and neck cancers are related to human papilloma virus infection. Other risk factors include:

  • age – head and neck cancer is more common in people over 40 years old
  • sex – men are three times more likely than women in Australia to develop head and neck cancer
  • oral hygiene – poor oral health including gum disease have been linked to cancers of the oral cavity
  • nutrition.

Screening for head and neck cancer

No routine screening tests are used. White plaques or patches in the mouth (leukoplakia) may precede the development of the cancer.

Diagnosis for head and neck cancer

Diagnosis is by a biopsy obtained using an endoscope, needle or surgically.

Staging for head and neck cancer

The extent of the tumour is defined by the size of the lump and whether there is spread to lymph nodes or further to the lungs or bones. CT, MRI, bone and PET scans are used. Visual examination using an endoscope may be required.

Treatment for head and neck cancer

The definitive treatment for local disease is surgery to the primary lump and draining the lymph glands. Full dose radiotherapy may be used in sites where functions such as speech can be preserved. Radiotherapy can be given in sequence with chemotherapy (commonly cisplatin, 5 fluorouracil or the taxanes) for more advanced cancer and both can be used for symptom relief with widespread disease.

Prognosis for head and neck cancer

An individual’s prognosis depends on the type and stage of cancer, as well as their age and general health at the time of diagnosis. At most sites, treatment of small, localised cancer results in at least 75% of patients surviving five years after diagnosis. With more advanced disease at diagnosis this drops to 15%.

Preventing head and neck cancer

The risk of head and neck cancers can be reduced by not smoking (or quitting) and reducing alcohol consumption.