Head and Neck cancer is a term used to describe cancers that arise from the cells that line the mouth, tongue, throat, larynx, nose, and sinuses. These cancers are usually squamous cell carcinomas. 

Occasionally, cancers may start from the salivary glands of the head and neck area. These are called salivary carcinomas and these cancers are usually adenocarcinomas. These may include adenoid cystic carcinoma and mucoepidermoid carcinoma.

Head & Neck Cancer Statistics 

Squamous cell carcinoma of the head and neck (SCCHN) comprises the 6th leading cancer in the US. About 62,000 Americans develop head and neck cancer every year and 13,000 die from the disease. Worldwide, about 550,000 people are affected every year.

What causes Head & Neck Cancer? 

The main risk of developing head and neck squamous cell cancer include:

• Smoking
• alcohol consumption

Among never-smokers or light smokers, viral infections including human papillomavirus (HPV) infection and Epstein-Barr virus (EBV) infection are common. HPV- related head and neck cancers often arise in the oropharyngeal area, whereas EBV-related head and neck cancers commonly arise  in the nasopharynx

What are Early Symptoms of Head & Neck Cancer? 

Head and Neck cancer presents in a variety of ways. Sometimes a painless lump in the neck from an enlarged lymph node is felt. Other times, a non-healing ulcer or a mass is seen or felt on the lip, inside the mouth, on the cheek. Difficulty swallowing or a hoarse voice that does not go away may be another way head and neck cancers present.

How does my doctor know I have Head & Neck Cancer? 

A biopsy (usually a fine needle aspiration or a core needle biopsy) is needed to determine the type of head and neck cancer. The biopsy can be taken from the neck lymph node under ultrasound guidance. Often a head and neck surgeon will directly exam your nose and throat with a scope to identify any  masses. The surgeon can also do a biopsy. For cancers that arise in the oropharynx, p16 staining is often requested.

What does Classification and Staging of my Head & Neck Cancer mean? 

Squamous cell Head and neck cancers are classified by the site where the tumor first arose.  Some common sites are:

• nasopharynx
• lip and oral cavity
• oropharynx
• hypopharynx
• larynx
• sinuses

Staging of Head and neck cancers follows the Tumor/Node/Metastasis (TNM) staging criteria by the American Joint Committee on Cancer (AJCC) or the International Union for Cancer Control (UICC) and are classified according to the primary site of the tumor: Nasopharynx, oral cavity, oropharynx, hypopharynx, larynx, and sinuses.

What are treatments for Head & Neck Cancer? 

Treatment depends on the location of the tumor and how extensive it is. If the cancer is localized to the head and neck area, treatment may involve

• Surgery
• Radiation
• Chemotherapy

Treatment often requires a multi-disciplinary team of doctors and health care providers from various specialties including:

• Head and neck surgeon
• Radiation Oncologist
• Medical Oncologist
• Plastic surgeon for reconstruction
• Maxillofacial prosthodontist
• Dentists or oral oncologists – who specialize in taking care of patients with head and neck cancer
• Speech and Swallowing therapist
• Audiologist
• Nutrition specialist
• Mind-Body Medicine

If head and neck cancer has spread outside the head and neck area, usually the primary mode of treatment is with medication treatment such as chemotherapy or targeted therapy.  Common chemotherapy agents used to treat head and neck cancer include 5-fluorouracil (5FU), cisplatin or carboplatin, docetaxel, paclitaxel.  A commonly used targeted or biologic treatment is cetuximab, an antibody that targets EGFR, a protein that is overexpressed in many head and neck cancers.  In addition, many clinical trials are currently available, evaluating new types of drugs or combinations of drugs.