Symptoms Of Head And Neck Cancer 

Head and neck cancers can cause different symptoms depending on where they start, but some warning signs are common across areas. General symptoms can include:

• A lump in the neck or a sore in the mouth/throat that doesn’t heal and may be painful

• A sore throat that doesn’t go away

• Difficulty swallowing

• Voice changes, like hoarseness.

Symptoms by specific area

Oral cavity (mouth)

• White or red patch on the gums, tongue, or lining of the mouth

• Swelling or growth in the jaw, making dentures loose or uncomfortable

• Unusual bleeding or pain in the mouth.

Throat (pharynx)

• Pain when swallowing or ongoing neck pain

• Sore throat

• Ear pain

• Tinnitus (ringing in the ears)

• Hearing trouble.

Larynx (voice box)

• Trouble speaking or breathing

• Pain when swallowing or ear pain.

Paranasal sinuses and nasal cavity

• Blocked sinuses that don’t clear

• Sinusitis that is unresponsive to antibiotics

• Nose bleeding

• Headache

• Swelling around the eyes

• Pain in the upper teeth or issues with dentures.

Salivary glands

• Swelling under the chin or jaw

• Numbness or weakness in the face

• Persistent pain in the face, chin, or neck.

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Types Of Head And Neck Cancer

Head and neck cancers, based on their site of origin and types of cells involve,d include;

• Hypopharyngeal cancer: This type of cancer starts in the lower throat, behind the voice box.

• Nasopharyngeal cancer: It develops in the upper throat, behind the nose.

• Oropharyngeal cancer: This cancer affects the back of the middle part of the throat.

• Paranasal sinus & nasal cavity cancer: Cancer cells grow in the hollow spaces around and just behind the nose.

• Salivary gland cancer: This is a type of head and neck cancer that begins in glands under the tongue, jaw, and near the ears that produce saliva.

• Oral cavity cancer: Involves the lips, tongue (front two-thirds), gums, roof of the mouth, and inner cheeks.

• Laryngeal cancer: Arises in the voice box also known as the larynx, most often as squamous cell carcinoma.

• Skin cancer: Forms in the surface tissues of the skin on the head or neck.

• Melanoma: A skin cancer from pigment-producing cells called the melanocytes in the head and neck region.

• Basal cell carcinoma: A non-melanoma skin cancer from abnormal calles at the base of the skin.

• Squamous cell carcinoma (skin): A more aggressive non-melanoma cancer that can spread and may need extensive surgery.

• Sarcoma: Originates in soft tissues like muscle, fat, blood vessels, or connective tissue of the head and neck.

• Cancer of unknown primary: Found as a neck lump, usually cancer that has spread to lymph nodes without a known starting site.

Causes Of Head And Neck Cancer

Head and neck cancers usually start when the cells lining the mouth, throat, nose, or larynx undergo genetic changes called mutations. Normally, cells grow and die in an orderly way. But when these mutations happen, the cells begin to grow uncontrollably and form a lump or tumor.

The most common type, squamous cell carcinoma, starts in the thin, flat cells that line these areas. As cancer grows, it may invade nearby tissues like the tongue, jawbone, or lymph nodes. In advanced stages, it can spread (metastasize) to distant organs such as the lungs.

Several risk factors can damage the DNA of these cells, making them more likely to turn cancerous.

Risk Factors For Head And Neck Cancer

Head and neck cancers arise from a combination of factors that include:

• Tobacco use: Smoking cigarettes, cigars, pipes, or chewing tobacco and betel quid (areca nut) is the leading cause. 

• Alcohol consumption: Long-term heavy alcohol use increases risk. When combined with tobacco, the effect is greater than additives.

• Human papillomavirus (HPV): Persistent infection with high-risk HPV (especially HPV-16) is a major cause of oropharyngeal cancers, particularly in younger adults.
  
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• Epstein–Barr virus (EBV): This virus is strongly linked to nasopharyngeal carcinoma.

• Age: Most cases occur in people over 50 years, but HPV-related cancers are increasingly diagnosed in younger adults.

• Gender: Men have a higher risk than women, largely due to higher rates of tobacco and alcohol use.

• Poor oral hygiene: Chronic gum disease and poor dental care raise the risk.
  
  Learn the right way to brush and take care of your oral hygiene.
  
  
  

• Dietary factors: Consumption of preserved or salted foods increases nasopharyngeal cancer risk.

• Occupational exposures: Metal smelting, textile production, exposure to wood dust, and some industrial chemicals increase risk.

• Other lifestyle factors: Marijuana smoking and frequent intake of very hot beverages have been implicated in increasing the risk.

• Genetic susceptibility: Family history increases nasopharyngeal cancer risk to a greater extent.

Diagnosis Of Head And Neck Cancer

The diagnosis of head and neck cancer (HNC) requires a multidisciplinary approach to confirm malignancy and determine disease stage. It consists of the following:

1. History and physical exam

A detailed assessment of risk factors and presenting symptoms, including non-healing ulcers, hoarseness, unexplained weight loss, and a neck mass, is conducted.

2. Imaging studies

• Endoscopy: A flexible or rigid tube is passed through the throat or nose to visualize mucosal lesions and guide biopsy directly.

• CT (computed tomography): It detects bone involvement and tumor extent, particularly useful for oral cavity, larynx, and oropharynx lesions.

• MRI (magnetic resonance imaging): It is performed with superior soft-tissue contrast, making it ideal to detect tumor spread into surrounding soft tissues, the base of the tongue, nasopharynx, and skull base.

• PET-CT (positron emission tomography with CT): This test is used to detect primary tumors, assess if the lymph nodes are involved, and identify distant metastases (spread).

3. Tissue diagnosis

• Biopsy: This is the gold standard for diagnosis. In this test, the doctor removes a small piece of the lump or sore (either by cutting out a part of it or the whole lesion) and sends it to the lab to check for cancer cells.

• Fine-needle aspiration cytology (FNAC): It is commonly used for suspicious cervical lymph nodes. This is a minimally invasive procedure and is accurate.

• Histopathology: It determines the tumor type, grade, and invasion characteristics. 

4. Molecular and biomarker testing

• HPV testing: This is an important test as throat cancers caused by HPV usually behave differently and often have a better outcome compared to those not linked to HPV.

• EBV testing: For cancers that start in the nasopharynx (the area behind the nose), doctors often test for the Epstein–Barr virus (EBV). This virus is strongly linked to this type of cancer, and finding it helps confirm the diagnosis and guide treatment.

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Staging of the cancer

Once cancer is confirmed, doctors need to know how advanced it is. They use an international system called TNM:

• T: Size of the main tumor and how far it has spread in nearby tissues.

• N: Whether lymph nodes in the neck are affected.

• M: Whether cancer has spread (metastasized) to distant organs.

Specialists To Visit

Head and neck cancer care often needs a multidisciplinary approach. Various specialists work together as a team to give you the best possible treatment. They include: 

• ENT (ear, nose and throat) surgeon

• Medical oncologist

• Radiation oncologist

• Pathologist

• Dentist

• Nutritionist

• Rehabilitation specialist

An ENT surgeon removes tumors and helps restore breathing, swallowing, or speech.

A medical oncologist plans and monitors chemotherapy, immunotherapy, or targeted drug treatments.

A radiation oncologist provides detailed imaging to diagnose, stage, and track cancer.

A pathologist studies tissue samples under the microscope to confirm cancer type and guide treatment.

A dentist manages oral health before, during, and after treatment to prevent complications.

A nutritionist supports strength and recovery by managing diet and eating difficulties.

A rehabilitation specialist helps with speech therapy, swallowing exercises, and overall physical recovery.

When to see a doctor?

See a doctor right away if you notice any of these:

• A lump or swelling in the neck, mouth, or throat that doesn’t go away

• Persistent sore throat or hoarseness

• Difficulty swallowing or breathing

• Non-healing ulcers or white/red patches in the mouth

• Unexplained ear pain or nosebleeds

• Sudden weight loss or fatigue

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Prevention Of Head And Neck Cancer

Most head and neck cancers are preventable, as many causes are linked to lifestyle, environment, or infections. Simple changes can lower your risk significantly. They include:

Don’t use tobacco

• If you smoke, quit as stopping lowers your risk at any age

• Avoid smokeless tobacco products like gutka, khaini, and betel quid.

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Cut down on alcohol

• Heavy drinking increases cancer risk, especially when combined with smoking

• Cutting down or avoiding alcohol protects your mouth, throat, and voice box.

Consider vaccination

• HPV vaccination is recommended for preteens at ages 11–12 years, but it can be started as early as 9 years.

• Catch-up vaccination up to age 26 if not previously vaccinated

• Both females and males aged 15–45 years can also receive the vaccine, even if sexually active.

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Protect against viruses

• Use condoms to lower HPV transmission
  
  

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• For EBV prevention, reduce preserved/salted food intake to lower nasopharyngeal cancer risk.

Maintain oral health

• Visit the dentist regularly, early detection makes cancers easier to treat

• Daily brushing, flossing, and gum care help lower risk.

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Safeguard yourself outdoors

• Use lip balm with sunscreen, wear a wide-brimmed hat, and avoid tanning to reduce lip cancer risk

• Minimize occupational exposure to wood dust, chemicals, or fumes, use protective equipment when possible.

Eat healthy

• Add plenty of fruits, vegetables, and antioxidants

• Avoid preserved and salted foods that increase cancer risk.

Treatment Of Head And Neck Cancer

Head and neck cancer treatment depends on where the cancer started, how advanced it is, and overall patient health. Here’s an overview of the treatment options:

1. Surgery

Doctors remove the tumor and some nearby tissue. This is the choice of treatment in early-stage cancers of the mouth, throat, or larynx, and when the tumor can be removed safely.

Types of surgeries include:

• Tumor resection: This surgery involves the removal of the cancerous tumor along with some surrounding healthy tissue.

• Neck dissection: It is a surgery to remove lymph nodes in the neck if cancer has spread.

• Laryngectomy: It is removal of part or all of the voice box to treat laryngeal cancer.

• Glossectomy: In this surgery a part or the entire tongue is removed when cancer starts there.

• Maxillectomy: Removal of part or all of the upper jawbone if cancer is in that area.

2. Radiation therapy

High-energy rays like X-rays are used to kill cancer cells or shrink tumors. Used for small tumors as the main treatment, or after surgery to destroy leftover cancer cells. Types of radiation therapy include:

• External beam radiation: A machine outside the body directs high-energy rays at the tumor to kill cancer cells.

• Brachytherapy: Tiny radioactive implants are placed close to or inside the tumor to target cancer directly.

3. Chemotherapy

This is used for advanced cancers, cancers that spread, or along with radiation known as chemoradiation. Commonly used drugs are:

• Cisplatin

• Carboplatin

• 5-fluorouracil (5-FU)

• Paclitaxel

• Docetaxel

4. Targeted therapy

This therapy used drugs that attack specific proteins or pathways cancer cells need to grow. It is used in advanced or recurrent head and neck cancers, often combined with radiation. Cetuximab is most commonly used.

5. Immunotherapy

This therapy helps the body’s immune system recognize and fight cancer cells. It is used for recurrent or metastatic head and neck cancers that don’t respond to standard treatments. Examples of drugs include:

• Pembrolizumab

• Nivolumab

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Reconstructive surgeries for head and neck cancer

Reconstructive surgery helps restore appearance and vital functions like speaking, swallowing, and breathing after tumor removal. The type of reconstruction depends on the size and location of the defect.

• Free flap reconstruction: It restores complex structures and function after major resections using tissue taken from another part of the body and transplanted to the head or neck.

• Local and regional flaps: This option is often used for smaller or moderate defects where tissue near the surgical site is rotated or moved to cover defects. 

• Bone reconstruction: Bone grafts or vascularized bone flaps are used when part of the jaw or facial bones are removed, helping restore chewing and facial contour.

• Dental and oral prosthetics: Custom prosthetic devices like obturators are used to replace missing oral or dental structures. These improve speech, chewing, and swallowing when surgery alone cannot restore them fully.

• Tracheoesophageal prosthesis (TEP): For people undergoing laryngectomy, a TEP is placed to help restore the ability to speak.

Home-care For Head And Neck Cancer

Some home remedies help manage symptoms of head and neck cancer. These are supportive only and they do not replace conventional treatments. Always discuss them with your doctor before trying. Remedies that can help include:

Honey for mouth sores

Applying or swallowing honey may help soothe sore, inflamed mouth tissues caused by radiation or chemotherapy. 

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Herbal and natural products

Compounds like curcumin (turmeric), green tea or black tea extracts may help reduce inflammation or provide antioxidant support, though evidence is limited.

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Diet and texture modifications

Soft, easy-to-swallow foods and modifying food texture can help with swallowing and reduce the risk of choking.

Oral moisturizing

Sipping water often, using natural lubricants, or commercial saliva substitutes can help relieve dry mouth (xerostomia) due to radiation. 

Skin care for radiation effects

Use of gentle creams and moisturizers to soothe skin irritation or burns, generally caused by radiation.

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Complications Of Head And Neck Cancer

Head and neck cancers and their treatments can lead to several complications such as: 

General complications

• Difficulty swallowing (dysphagia): Tumors can block or narrow the throat, making swallowing hard.
• Speech problems: Cancer of the tongue or larynx or the surgery for it can impair speaking.
  
  
• Breathing issues: Tumors in the airway or post-surgery changes may cause breathing difficulties.
  
  
• Weight loss & malnutrition: Trouble eating often leads to weakness and unintended weight loss.
  
  
• Pain: Persistent pain in the mouth, throat, or neck is a common complication of head and neck cancers.
   
• Spread of cancer (metastasis): Cancer may spread to lymph nodes, lungs, or other distant organs.

Complications from treatment

• Dry mouth (xerostomia): Radiation can damage salivary glands, reducing saliva.
• Changes in taste or smell: Both radiation and chemotherapy can alter flavor and smell perception.
  
  
• Skin changes: Radiation may cause burns, redness, or scarring.
  
  
• Dental issues: Radiation can weaken teeth and bones, increasing dental problems.
  
  
• Lymphedema: Surgery or radiation may cause fluid buildup and swelling in the neck.
  
  
• Hearing loss: Certain chemotherapy drugs and radiation can affect hearing.
  
  
• Fatigue (tiredness): A common side effect of radiation, chemo, or long recovery.

Alternative Therapies For Head And Neck Cancer

While alternative therapies cannot cure cancer, they can play an important role in easing symptoms, improving quality of life, and supporting recovery. These approaches are usually used alongside standard treatment with your doctor’s guidance.

Yoga and meditation

Gentle yoga postures, breathing exercises, and meditation can reduce stress, fatigue, and anxiety while improving overall well-being.

Acupuncture

This is a traditional Chinese therapy where very thin needles are gently inserted into specific points on the body. This can help reduce pain, nausea, dry mouth, and difficulty swallowing in people undergoing treatment for head and neck cancer.

Music and art therapy

Music and art therapy use creative expression as a way to heal emotionally and mentally. Listening to or creating music, painting, or drawing helps reduce stress, improve mood, and provide a sense of control. 

Living With Head And Neck Cancer

Head and neck cancer and its treatment can affect daily life, including eating, speaking, breathing, and emotional well-being. Some tips may help you cope better, including:

Prioritize your well-being

• Preparing for treatment can feel overwhelming, but focusing on self-care helps your body recover better

• Maintain a balanced diet with soft, easy-to-swallow foods, rich in fruits, vegetables, and proteins

• Get enough sleep and try stress-relieving activities like meditation, breathing exercises, or gentle yoga.

Don’t exert yourself

• Fatigue is common during treatment, so managing energy is important

• Prioritize essential tasks and ask for help from family or friends when needed

• Take short breaks during the day and pace your activities to avoid overexertion.

Take care of mental health

• Head and neck cancer can impact self-image, speech, and confidence

• Talk openly with friends, family, or a mental health professional

• Join support groups or online communities to connect with others on a similar journey.

Manage the cost 

• Treatment can be expensive, but early financial planning can reduce some stress

• Discuss financial concerns with your healthcare provider

• Explore assistance programs from NGOs or cancer foundations that help with treatment, travel, or living costs.

Prepare for the treatment

• Start with light physical activity, breathing exercises, and counselling. This can improve recovery

• Work with a dietitian or speech therapist to strengthen swallowing and nutrition before treatment

• Try to build mental resilience through mindfulness or relaxation techniques.

Do not skip follow-ups

• Attend regular follow-up appointments to detect recurrence or complications early

• Keep up with dental checkups, as radiation and chemotherapy can affect teeth and gums

• Report new or persistent symptoms to your doctor promptly.

Rehabilitation after head and neck cancer

Rehabilitation helps people recover speech, swallowing, movement, and emotional well-being after treatment.

• Speech and voice therapy: It restores communication with exercises or voice prostheses.

• Swallowing and nutrition support: It focuses on reducing choking risks and ensures proper nutrition.

• Physical therapy: Improves neck, jaw, and shoulder mobility, reducing stiffness and swelling.

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