What is head and neck cancer?

Head and neck cancer is a general term to describe different cancers in this area. These cancers start in the tissues in the head and neck area. For example, in the:

  • mouth which includes the tongue, palate, gums and lips
  • throat (the pharynx) which is divided into the nasopharynx, oropharynx and hypopharynx
  • nose and sinuses (air-filled spaces in the bones of the face)
  • salivary glands which make saliva
  • middle ear which contains the ear drum.
 
Cross-section of the head and neck
Image: Cross-section of the head and neck

About 12,200 people are diagnosed with head and neck cancer in the UK every year. This includes cancer of the larynx (voicebox). In the UK, head and neck cancer is the 4th most common cancer in men.

We have separate information about cancer of the larynx.

To make sure you have the right information, it is important to know the type of head and neck cancer you have. If you are not sure, ask your cancer doctor or specialist nurse.

Other types of cancer can start in the head and neck area, but they are not head and neck cancers. We have separate information on these. They include cancers that start in the thyroid, oesophagus (gullet), windpipe (trachea) and brain.

Booklets and resources

Types of head and neck cancer

Head and neck cancers are named after where they start – the area of the head or neck, and the type of cell. The most common type of head and neck cancer is squamous cell carcinoma. About 9 out of 10 head and neck cancers (90%) start in squamous cells. Squamous cells line the surfaces inside the head and neck, such as the mouth, nose and throat.

The most common place for head and neck cancer to spread to is the lymph nodes in the neck. This may cause a swollen lymph node in the neck. Lymph nodes are part of the lymphatic system which helps protect us from infection and disease.

 

Lymph nodes in the head and neck
Image: Lymph nodes in the head and neck
 
  • Mouth cancer (oral cancer)
  • Tongue cancer
  • Nasopharynx cancer
  • Oropharyngeal cancer
  • Hypopharyngeal cancer
  • Cancer of the larynx (voice box)
  • Cancer of the nose and sinuses (paranasal sinuses)
  • Cancer of the salivary glands
  • Cancer of the middle ear
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Symptoms of head and neck cancer

The symptoms depend on where the cancer started in the head or neck. With certain symptoms, you may see a specialist within 2 weeks (called an urgent referral).

Some of these symptoms include having:

  • an ulcer in the mouth for more than 3 weeks
  • red or white patches in the mouth.

Others are symptoms that do not go away, such as:

  • a lump in the neck, on the lip or inside the mouth
  • a sore tongue
  • a sore throat
  • hoarseness
  • problems swallowing.

 

We have more information about the signs and symptoms of head and neck cancer.
Related pages

Causes of head and neck cancer

The main risk factors for head and neck cancer are tobacco and alcohol, especially when combined. Head and neck cancer is also much more common in men than in women.

Certain risk factors depend on the type of head and neck cancer you have. Many cancers of the oropharynx are linked to an infection with a virus called human papilloma virus (HPV) is linked to the Epstein-Barr virus.

We have more information about the causes and risk factors for head and neck cancers.

Diagnosis of head and neck cancer

If your GP or dentist think your symptoms could be linked to cancer, they will refer you to see a specialist doctor within 2 weeks. This is usually an oral and maxillofacial surgeon, or an ear, nose and throat (ENT) specialist surgeon.

Neck lump clinic

If your only symptom is a lump in your neck, you may be referred to a one-stop neck lump clinic. You can have all the tests needed to check for cancer in a neck lump. These may include:

  • an ultrasound neck scan
  • removing a sample of tissue from the lump (a biopsy)
  • nasendoscopy – a test that looks at the back of your mouth, nose and throat.

You may get the results of your tests on the same day, or 7 to 10 days later.

At the hospital

Your specialist doctor will ask you about your symptoms and examine your mouth, throat and neck. They may take blood tests, to check your general health. If you have an abnormal-looking area that can be seen and is easy to reach, they may remove a small piece of tissue or some cells from the area (biopsy). This is checked for cancer cells.

Your doctor and specialist nurse will explain the tests you need. You may have a test using a thin flexible tube with a light and camera on the end (endoscope). Different types of endoscope can be used to examine the mouth, nose, throat and sometimes the gullet (oesophagus) area.

Some people have a general anaesthetic so the doctor can examine the area more closely using a bigger endoscope. This is sometimes called a panendoscopy.

You may have a biopsy on its own or during some of these tests.

We have more information about tests for head and neck cancer.

Further tests for head and neck cancer

If tests show you have a head and neck cancer, your specialist will arrange further tests. These can help find out more about the size and position of the cancer and whether it has spread. This is called staging. These tests could include:

  • X-rays
  • CT scan
  • MRI scan
  • PET-CT scan

Testing for viruses

If you have oropharyngeal cancer, tests are done on the cancer cells to check if it is linked to the human papilloma virus (HPV). The results help your doctor plan the most effective treatments for you. HPV-related head and neck cancers usually have a good outlook.

If you have nasopharyngeal cancer, the cancer cells are tested to see if it is linked to the Epstein-Barr virus (EBV).

Staging and grading of head and neck cancer

The stage of a cancer describes its size and if it has spread from where it started.

Staging is slightly different for each type of head and neck cancer. Oropharyngeal cancer that are HPV-positive have a separate staging system.

A doctor decides the grade of the cancer by how the cancer cells look under the microscope. This gives an idea of how quickly the cancer may develop.

Knowing the stage and grade of head and neck cancer helps you and your doctors decide on the best treatment for you.

Treatment for head and neck cancer

Because head and neck cancer is not common, you are usually treated in a specialist head and neck unit. A team of specialists will meet to discuss the best possible treatment for you. This is called a multidisciplinary team (MDT).

They will also talk to you about preparing for treatment (sometimes called prehabilitation). This may include things like:

  • stopping smoking or drinking to make your treatment more effective
  • dental checks or dental treatment
  • dietary advice to improve your weight
  • certain exercises to reduce the risk of side effects.

We have more information about preparing for head and neck cancer treatment

The aim of treatment is to remove or destroy the cancer and reduce the risk of it coming back. Your treatment depends on:

  • where the cancer is
  • the type and stage of the cancer
  • the best way to maintain appearance, speech and swallowing
  • your general health
  • your preferences.

Your doctor and nurse will explain the benefits and disadvantages of different treatments. They will also talk to you about things to consider when making treatment decisions before you agree (consent) to have treatment. You and your doctor can decide together on the best treatment for you.

Doctors plan your treatment so the effect on your appearance, speech, swallowing and eating is as little as possible. If treatment is likely to affect any of these, your doctor and nurse will talk to you about this. They will explain how long this is likely to last and how they can support you. You may see different specialists such as a dentist, speech or language therapist (SLT), or dietitian during treatment.

Treatment for head and neck cancers may include:

  • Surgery
  • Chemoradiation
  • Radiotherapy
  • Chemotherapy
  • Targeted therapies and immunotherapies

Your treatment depends on the stage of the cancer.

  • Treating early-stage cancer
  • Treating locally advanced cancer
  • Treatment to control the cancer

You may have some treatments as part of a clinical trial.

After head and neck cancer treatment

After your treatment, you will have regular follow-up appointments for several years. Your specialist will regularly examine your head and neck. This is the most important part of your follow-up. You may sometimes have scans.

It can take several months for the side effects of the treatment to improve. Always tell your specialist about:

  • ongoing side effects or symptoms that are not improving
  • any new symptoms that do not get better within 2 weeks.

Your nurse can tell you what to look out for after treatment. For example, this might be a new ulcer or a lump in your neck, pain, or difficulty swallowing or speaking. Contact your doctor or nurse as soon as possible if you notice any symptoms or side effects. You do not need to wait until your next appointment.

Late effects

Treatment side effects may affect how you eat and drink, or your speech. These changes may return to normal, or near normal, as the area recovers from surgery or radiotherapy. Your speech and language therapist (SLT) and dietitian will assess you. They help you learn to cope with any changes.

Late effects are side effects that do not improve, or that develop years after treatment has finished. Your doctor or nurse will explain any likely late effects of your treatment. Not everyone gets late effects. It depends on the treatment you had.

We have more information about managing late effects of head and neck cancer treatments.

Sex life

Head and neck cancer and its treatment can sometimes have an effect on your sex life.

If you are worried about this, talk to your doctor or nurse. You can read about things that may help in our information on cancer and sex.

Fertility

Some cancer treatments can also affect whether you can get pregnant or make someone pregnant. If you are worried about this, it is important to talk with your doctor before you start treatment.

We have more information about:

Body image

If treatment has changed your appearance, voice or how you eat and drink it can also affect your body image. Talk to your nurse if this is a concern for you. There are different things that can help to improve body image changes. There are also organisations below that can help to support you.

Well-being and recovery

Even if you already have a healthy lifestyle, you may choose to make some positive lifestyle changes during and after treatment. For example, if you smoke or drink alcohol, it is best to avoid smoking or reduce the amount of alcohol.

Eating well and keeping active can improve your health and well-being. It can also help your body recover. Your dietitian can help with any difficulties you might have with eating after treatment.

Getting support

It may take several months to recover from treatment. It can be hard if treatment has changed your appearance, how you eat or drink, or your voice. This may also affect your body image but there are ways to help you to manage any changes.

You may still be coping with difficult feelings. Talking to your family and friends or health professionals about how you feel can help them know how to support your well-being.

There are also national support groups that you may find helpful:

  • The Mouth Cancer Foundation
    The Mouth Cancer Foundation
    gives information and support to people affected by head and neck cancers.
  • Changing Faces
    Changing Faces
    offers advice and information to anyone who is affected by a change in their appearance.
  • The Swallows Head and Neck Cancer Support Group
    The Swallows
    offers a 24-hour support line to anyone affected by head and neck cancer.
  • Salivary Gland Cancer UK
    Salivary Gland Cancer UK supports people with rare salivary gland cancers, such as adenoid cystic carcinoma, ACC, and unknown carcinoma.

Macmillan is also here to support you. If you would like to talk, you can:

About our information

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Date reviewed

Reviewed: 01 March 2022
|
Next review: 01 March 2025

This content is currently being reviewed. New information will be coming soon.

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