Head and neck cancer refers to cancers that develop in the mouth, throat, larynx (voice box), sinuses, and salivary glands. These cancers usually begin in the cells that line the mucosal surfaces of these areas. The most common type of head and neck cancer is squamous cell carcinoma, which arises from the flat cells lining the affected areas.

Head and neck cancer is often categorized based on the area of origin, including:

• Oral cancer, affecting the mouth or lips
• Pharyngeal cancer, affecting the throat
• Laryngeal cancer, affecting the voice box
• Sinus cancer, affecting the sinuses and nasal passages
• Salivary gland cancer, affecting the salivary glands

Although head and neck cancers can occur in anyone, they are more frequently diagnosed in people with certain risk factors—particularly tobacco use and alcohol consumption, which together significantly increase risk. At OncoClinic, we support you with accurate diagnostics, clear explanations, and coordinated care planning tailored to your specific cancer and overall health.

Signs and symptoms

• Persistent sore throat or a sensation of something stuck in the throat
• Difficulty swallowing (dysphagia)
• Hoarseness or other voice changes
• Persistent pain or tenderness in the mouth, throat, or jaw
• Sores or ulcers in the mouth that do not heal
• Red or white patches in the mouth
• Lumps or swelling in the neck, jaw, or mouth

Other symptoms may include ear pain, hearing problems, nasal congestion, frequent nosebleeds, bleeding from the mouth or nose, loose teeth, jaw stiffness, facial numbness or weakness, chronic cough, coughing up blood, and unexplained weight loss

If any of these symptoms persist for more than two weeks, consult a healthcare provider promptly as early diagnosis greatly improves treatment outcomes.

Risk factors

• Age: Head and neck cancers are more common in individuals over the age of 50, reflecting cumulative exposure to risk factors
• Gender: Men are more likely to develop head and neck cancers than women, largely due to higher exposure to tobacco and alcohol
• Tobacco use: Smoking or using smokeless tobacco is the strongest risk factor for head and neck cancers, particularly cancers of the oral cavity, pharynx, and larynx
• Alcohol consumption: Heavy alcohol use significantly increases the risk of head and neck cancer
• Combined tobacco and alcohol use: Using tobacco and alcohol together dramatically increases the risk, with studies showing a 20- to 40-fold higher risk compared with individuals who neither smoke nor drink. This synergistic effect accounts for the majority of head and neck cancer cases worldwide
• Human papillomavirus (HPV): Infection with high-risk HPV types, particularly HPV-16, is a major risk factor for oropharyngeal cancers
• Areca nut (betel nut) chewing: Chewing areca nut, commonly consumed alone or in betel quid (often with lime and sometimes tobacco) and widely used in South Asia, including India, is a well-established risk factor for oral and oropharyngeal cancers. It is strongly associated with oral submucous fibrosis and significantly increases cancer risk, even in the absence of tobacco
• Sun exposure: Prolonged sun exposure increases the risk of cancers of the lip and skin of the head and neck
• Occupational exposure: Exposure to substances such as wood dust, asbestos, and certain industrial chemicals increases the risk of specific head and neck cancers
• Poor oral hygiene: Poor oral health, including chronic gum disease, tooth loss, and inadequate oral hygiene, has been associated with an increased risk of oral and oropharyngeal cancers, likely due to chronic inflammation and microbial imbalance

Screening

There is no formal population-based screening program for head and neck cancer. However, early detection is often possible through awareness of symptoms and routine clinical examinations, as visible and palpable lesions in the mouth, throat, and neck can be identified during medical or dental visits.

Diagnosis

Head and neck cancer is often suspected based on persistent symptoms or abnormal findings during a clinical or dental examination.

Diagnostic evaluation typically includes:

• Clinical examination: Careful inspection and palpation of the oral cavity, throat, and neck, including assessment of cranial nerve function
• Endoscopic evaluation: Flexible nasopharyngolaryngoscopy allows direct visualization of the nasal cavity, pharynx, and larynx

Imaging and pathologic evaluation

In some cases, the following tests may be ordered to further evaluate the tumour:

• CT scan or MRI of the head and neck to assess tumor extent and involvement of surrounding structures
• Ultrasound may be used to evaluate cervical lymph nodes
• A biopsy of the tissue is required to confirm the diagnosis and determine the histologic type, most commonly squamous cell carcinoma
• Pathology and molecular testing: HPV testing is routinely performed for oropharyngeal cancers, as it has prognostic and therapeutic implications

Early and accurate diagnosis is essential for appropriate staging and treatment planning.

Staging

Staging of head and neck cancer determines the extent of disease and helps guide treatment and prognosis. It is performed after diagnosis using clinical findings, imaging, and pathology.

Staging evaluation typically includes imaging studies:

• CT scan and/or MRI of the head and neck to assess the primary tumor and regional lymph nodes
• CT of the chest to evaluate for distant spread, particularly to the lungs
• PET/CT: Not routinely required for all patients. Often used in locally advanced disease to evaluate lymph nodes or distant metastases, or when findings on conventional imaging are unclear
• Endoscopic assessment: May be used to evaluate the primary tumor and identify additional lesions
• HPV status: For oropharyngeal cancers, HPV status is incorporated into staging because it significantly affects prognosis

Treatment and procedures

At OncoClinic, we provide comprehensive care for patients with head and neck cancer. Due to the complexity of these tumors and their impact on vital functions such as speech, swallowing, breathing, and appearance, a multidisciplinary approach is essential.

Our team works collaboratively to ensure that each patient receives a personalized, evidence-based treatment plan, tailored to the specific tumor characteristics and individual needs, with a strong focus on both cancer control and quality of life. Our services include:

Surgery: Surgery may be used to remove the tumor and, when necessary, nearby lymph nodes in the neck. It is commonly used for early-stage cancers and selected advanced cases, sometimes followed by additional treatment.

Systemic therapy: Systemic treatments work throughout the body and include Chemotherapy, often combined with radiation for locally advanced disease, Targeted therapy and immunotherapy, used in selected patients, particularly in recurrent or metastatic disease.

Radiation therapy: Radiation uses high-energy beams to destroy cancer cells. It can be used alone for early-stage disease or combined with surgery and/or chemotherapy in more advanced stages. Radiation is also an important option when surgery is not appropriate.

Combined (Multimodal) Treatment: Many patients with advanced head and neck cancer receive a combination of treatments, such as surgery followed by radiation or chemoradiation, to improve cancer control.

Supportive and rehabilitative care: Supportinve care is an essential part of treatment and may include nutritional support, dental care, speech and swallowing therapy, pain management, psychological and social support.

The goal of treatment is not only to control or cure the cancer, but also to preserve speech, swallowing, appearance, and quality of life whenever possible. Your healthcare team will explain the recommended treatment plan and discuss potential benefits and side effects.

References

NCCN clinical practice guidelines in oncology: head and neck cancers
National Comprehensive Cancer Network (NCCN), latest version

ESMO–EURACAN clinical practice guidelines for squamous cell carcinoma of the head and neck
European Society for Medical Oncology (ESMO), 2022

EHNS–ESMO–ESTRO clinical practice guidelines for head and neck cancer
European Head and Neck Society (EHNS), 2022

Squamous cell carcinoma of the head and neck: ESMO–EHNS–ESTRO clinical practice guidelines
Machiels J-P et al. – Annals of Oncology, 2022

Impact of late treatment-related toxicity on quality of life among patients with head and neck cancer
Langendijk JA et al. – Journal of Clinical Oncology, 2008

Dysphagia in head and neck cancer patients treated with radiation
Murphy BA, Gilbert J – Journal of Clinical Oncology, 2009