Head and neck cancer care

Head and neck cancers often begin in squamous cells that line the moist, surfaces inside your mouth, nose and throat.  More uncommon are cancers of the larynx (voice box), lips and salivary glands, also referred to as oral cancer.

Common symptoms include a lump or sore that doesn't heal, trouble swallowing, a sore throat that doesn’t go away and voice changes.

Early signs of throat cancer include:

• a lump in the neck
• a persistent sore throat
• breathing problems
• cough
• difficulty swallowing or the feeling like something is caught in your throat
• ear pain
• hoarseness or changes in your voice
• unexplained weight loss

Signs of oral cancer include:

• a lump in your neck
• a mass or thickening in the face, jaw, cheek, tongue or gums
• a persistent sore or mass in the mouth that causes pain or a poor fit while wearing dentures
• a sore in your mouth that doesn't heal
• difficulty chewing, swallowing or moving the tongue or jaw
• erythroplakia, a red raised area or spot in your mouth that bleeds if scraped.
• leukoplakia, a white patch or spot in your mouth.
• persistent bad breath
• unexpected loose teeth
• unexplained weight loss

Risk factors:

• Age, throat cancer occurs most often over age 60; HPV-related cancer happens more often in your 50s.
• Exposure to certain chemicals, including nickel, asbestos and sulfuric acid fumes.
• Gender: Men are up to five times more likely than women to get throat cancer.
• The human papilloma virus (HPV) spread through sexual contact, including oral sex.
• Tobacco use and tobacco use combined with drinking alcohol

Screening

There is no current screening for head and neck cancer. However, a regular dental exam can help spot problems. You are at higher risk for head and neck cancers if you:

• have been infected with human papillomavirus (HPV)
• have had a history of radiation in the head and neck area, which can increase your risk of salivary gland and thyroid cancer
• routinely drink alcohol
• smoke or use tobacco products or have used in the past
• spend time in the sun or have used tanning beds.

Prevention

Not everyone who is diagnosed with head and neck cancer has a known risk factor. Often there is no clear reason why the disease develops. Some things that may help reduce your risk include:

• protect yourself against HPV by practicing safe sex and getting the HPV vaccine.
• quit smoking and all tobacco products
• use alcohol in moderation.
• use sunscreen and avoid extended time in the sun.
• wear a protective face mask if you are exposed to toxic fumes and dust.

Diagnosis can include:

• barium swallow
• biopsy
• chemiluminescent light
• chest and dental X-rays
• CT scan
• diagnostic imaging
• endoscopy
• endoscopy
• genomic testing
• HPV testing
• laryngeal videostroboscopy
• MRI
• mucosal staining
• PET scan
• physical exam
• thyroid nodule assessment
• video swallow study

Treatments often include surgery, chemotherapy and radiation.