Head and Neck Cancers
Overview
You may be reading this because you or someone you care about learned they have head and neck cancer. Maybe you need to learn about head and neck cancer treatments. Or maybe you’re curious about your risk of getting head and neck cancer. We want to help you find answers.
This is a good place to start. This information will help you understand the best next steps for you or your loved one.
Our Thyroid Nodule Assessment Program is for people who need a fast, precise diagnosis for a lump (growth) in their thyroid. You do not need a referral from your doctor, or tests before your visit.
Types of head and neck cancers
Speech therapy can be an important part of head and neck cancer treatment.
What are head and neck cancers?
Head and neck cancer are a group of cancers. They happen when cells grow out of control in the head and neck area. This can include the mouth and tongue, throat and voice box, nose and sinuses, salivary gland, and thyroid.
Anyone can get head and neck cancer, but there are some things that raise your chances.
Being exposed to any kind of tobacco product can raise your risk of head and neck cancer. Drinking alcohol is also a major risk factor. If you drink a lot of alcohol, you have a higher chance of getting a head and neck cancer.
Research shows a strong link between HPV (human papillomavirus) and head and neck cancer. HPV is a virus that can infect the skin and the mucosa (lining) of your mouth and throat. Not all HPV infections lead to cancer.
Treatments for head and neck cancer can include:
- Surgery
- Radiation
- Systemic therapies, such as chemotherapy, targeted therapy, and immunotherapy
Parts of the head and neck, including tongue, throat, sinuses, nasal cavity, and salivary glands.
What are the types of head and neck cancers?
- Mouth (oral) cancer
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Mouth cancer, including tongue cancer, starts in the mouth. Another name for mouth cancer is oral cavity cancer. The main causes of mouth cancer are using tobacco and alcohol, but anyone can get oral cavity cancer.
- Throat cancer
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Throat cancer most often starts in the pharynx (throat) and the larynx (voice box). Pharynx cancers start in the oropharynx (tonsils) and hypopharynx. A main cause of throat cancer is HPV (human papillomavirus virus). Your chances of getting throat cancer also are higher if you use tobacco and alcohol.
- Nasal cavity and sinus cancer
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Nasal cavity and sinus cancers are caused by abnormal (not normal) cell growth in and around the nose. Symptoms can include nasal congestion (stuffy nose), nose bleeds, and headaches. Nasal cavity and sinus cancers are rare.
- Salivary gland cancer
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Salivary gland cancer is a rare type of cancer. It starts when the cells in the major or minor salivary glands grow fast.
Tumors that are benign (not cancer) can also form in the salivary glands. These are more common. Around 7 out of 10 salivary gland tumors are benign.
- Tongue cancer
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Tongue cancer starts when cells in the tongue grow too much and form lesions (LEE-zhuns) or tumors. Lesions are tissue that’s abnormal (not normal) or harmed because of injury, infection, or illness.
Anyone can get tongue cancer. Your chances of getting it are higher if you use tobacco and alcohol.
- Thyroid cancer
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The thyroid is a small gland that’s below the voice box, in front of the neck. When cells in the thyroid gland grow without stopping, they form a nodule or tumor. Almost all thyroid nodules are benign (not cancer). Only 1 out of 10 thyroid nodules are cancer and need treatment.
- Primary hyperparathyroidism and parathyroid tumors
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Hyperparathyroidism (HY-per-PAYR-uh-THY-roy-dih-zum) is when the neck’s parathyroid gland makes too much hormone. It can be caused by a tumor, known as primary hyperparathyroidism. Parathyroid tumors are growths inside the parathyroid gland. Most parathyroid tumors are not cancer and do not spread.
Talk with an MSK Care Advisor. We're here 24 hours a day, 7 days a week.
Innovations at MSK
Our experts are always exploring new ways to treat head and neck cancers and manage side effects. Explore the latest head and neck cancer news from MSK.
A new approach to radiation treatment given after surgery to remove HPV-positive head and neck tumors may now help some people avoid surgery.
Risk factors and prevention
What causes head and neck cancers?
A risk factor is anything that raises your chance of getting a disease, such as cancer. Risk factors depend on the type of cancer.
Not everyone who has head and neck cancer has a known risk factor. Sometimes, there’s no clear reason what causes head and neck cancer.
You cannot change some head and neck cancer risk factors. Examples are your age, race, health history, and your genes.
You can influence other risk factors. For example, you can stop using tobacco. If you’re a heavy smoker now or in the past, you’re at higher risk for head and neck cancers.
If you drink alcohol, limit the amount. If you drink a lot of alcohol now or in the past, you’re at higher risk for head and neck cancers.
Your chance of getting head and neck cancer is even higher if you use both tobacco and alcohol.
Talk with your healthcare provider about your drinking and smoking habits, now and in the past.
HPV can be another risk factor. The best way to protect yourself is by getting the HPV vaccine.
Other risk factors for head and neck cancers
- You chew betel quid or gutka, which is more common in parts of Asia.
- You had radiation in the head and neck area, which raises your risk for salivary gland and thyroid cancers.
- Your age. Most people are over age 40 when they’re diagnosed with mouth cancer. The average age of diagnosis is 60.
- You have Asian ancestry (risk factor for nasopharynx cancer).
- You do not eat a lot of fruits and vegetables.
- You eat a lot of salt-cured fish and meat.
- You drink yerba mate, a South American drink.
- You have poor oral hygiene (do not take good care of your mouth).
- You were exposed at work to asbestos, wood dust, nickel alloy dust, or silica dust.
- Epstein-Barr virus.
- Gastroesophageal reflux disease (GERD).
- A weakened immune system.
- Graft versus host disease.
- Lichen planus.
- Some genetic syndromes, such as dyskeratosis congenital.
You may have a higher risk for head and neck cancers if you had any of these health issues:
- Head and neck squamous cell carcinoma (HNSCC).
- Dysplastic oral leukoplakia, which is a precancer lesion in the mouth.
- Fanconi anemia.
- Li-Fraumeni syndrome, which is linked to thyroid cancer.
- Plummer-Vinson syndrome, which makes it hard to swallow.
- Papillomas, which are small growths or tumors in your mouth or throat caused by HPV.
Learn about the different types of head and neck cancers
Our Tobacco Treatment Program has experts who can help you quit smoking. It’s open to people who never had cancer or a disease linked to tobacco. It also welcomes anyone who has cancer, and cancer survivors. Our program offers treatment options to help you quit, such as counseling and medicine.
Talk with an MSK Care Advisor. We're here 24 hours a day, 7 days a week.
Can I lower my risk for head and neck cancers?
There’s no sure way to prevent head and neck cancer. There are many risk factors that you cannot control. But research shows that healthy habits can lower your risk.
- Do not smoke or use tobacco products. Need help quitting?
- Limit the amount of alcohol you drink.
- Protect yourself against HPV by getting the HPV vaccine and practicing safe sex. Condoms can offer some protection from HPV infection.
- Wear a protective face mask if you’re exposed to toxic fumes and dust at work.
- Get regular check-ups with your healthcare provider, including your dentist. Many oral cancers are found during routine dental appointments.
The HPV (human papillomavirus) vaccine can prevent a few cancers. MSK recommends that both females and males get vaccinated up to age 26. But you can even get your shots up to age 45. People aged 26 to 45 should talk with their healthcare provider about whether the HPV vaccine is right for you.
Screening for head and neck cancers
What is screening?
Cancer screening is checking for cancer in people who do not have symptoms. Screenings can help find cancer early, when it’s easier to treat.
Treating cancer early often means there’s a better chance of curing it. Screening also can save lives by lowering the chance of dying from cancer.
There are different types of cancer screening tests, including physical exams, blood tests, and imaging tests. These tests help doctors look for signs of cancer in your body, like lumps or growths that are not normal.
Cancer screenings have benefits and risks. Experts agree that for most people, screenings help more than hurt.
How are head and neck cancers screened?
Right now, there are no tests to screen for head and neck cancer. It’s not clear if screening can prevent deaths from this type of cancer. Researchers are studying this in clinical trials.
It’s still important to have your primary care provider and dentist check for signs of head and neck cancer. They can do this during your regular check-ups each year.
MSK experts recommend they examine your neck and mouth. They also should inspect your oropharynx (OR-oh-FAYR-inx), the middle part of the throat that’s behind the mouth.
When should I be screened?
Here are MSK’s latest screening guidelines for head and neck cancer. They may be different from those of other groups of experts.
If you’re at average risk for head and neck cancer:
MSK recommends you get an exam of your head, neck, and oropharynx from your primary care provider each year.
We also recommend your dentist checks for signs of head and neck cancer every year during your dental exam. Your dentist should check your oropharynx, mouth, and neck. Many oral cancers are found during routine dental exams.
If you’re at higher risk for head and neck cancer:
Talk with your healthcare provider about getting screened.
Signs and symptoms
What are the head and neck cancer signs and symptoms?
Symptoms depend on the type of head and neck cancer and where it started.
- A lump on the back of the neck, jaw, or mouth.
- An ulcer (a broken area of skin) in the mouth that does not heal.
- Pain or weakness in the face that does not go away.
- Swelling or small lumps in the front of the neck.
- It’s hard to move your jaw or open your mouth wide.
- It’s hard to chew or swallow.
- Speech changes, such as a quieter voice or it sounds like you have a cold all the time.
- Ear pain or hearing loss.
- Trouble breathing.
- A sore throat that does not go away.
- White or red patches in the mouth or throat.
- Weight loss because of trouble eating or swallowing.
- A lump or thickness in your lips.
- Bleeding or numbness in your mouth.
- Loose teeth or dentures that no longer fit well.
- Nose bleeds, nasal congestion (stuffy nose), or sinus infections that don’t get better with treatment.
- It’s hard to move your tongue.
- Numbness in your tongue.
- Changes in a mole, including its color.
- A sore that’s crusty or does not heal.
Signs of a head and neck tumor often can look like symptoms caused by other health problems. If you notice any symptoms, do not ignore them. For example, a sore throat, ear pain, or trouble breathing are all signs of throat cancer. Talk with your dentist or healthcare provider right away.
How head and neck cancers are diagnosed
Cancers in the head and neck are very hard to diagnose at early stages. Many people have few symptoms, or none at all.
Having signs or symptoms of head and neck cancers does not mean you have cancer. But if you have symptoms, talk with your healthcare provider.
They may give you a physical exam and learn more about your family history. They may order a routine screening or other tests.
Your care team of head and neck experts work closely together. First, they need a precise diagnosis.
MSK has a team of pathologists who only diagnose cancers of the head and neck. A pathologist is a doctor who uses a microscope to make a diagnosis.
Because our pathologists are head and neck cancer experts, they make a very accurate diagnosis. A precise diagnosis means your care team can choose the best treatments for that cancer type.
- Physical exam of your head and neck area: Your doctor will check for signs of problems, such as a lump.
- Endoscopy: For areas of the head and neck that are harder to reach, your doctor may use an endoscope. It's a thin lighted tube with a camera that goes through your nose or mouth.
- Biopsy: Your doctor may do a biopsy. This is a procedure to take a small piece of tissue from the growth in your head and neck area. They’ll send the tissue sample to a pathologist to look for cancer cells.
- Imaging tests: To get a clearer picture, your doctor may also order imaging tests. They can show how deep the cancer is, or if it has spread. Tests can include a computed tomography (CT) scan or a magnetic resonance imaging (MRI). You may have a Panorex X-ray to get more details about the lesion. This shows your full upper and lower jaw, including your sinuses.
- Genetic tests: A tumor genetic profiling test also is called genomic testing, molecular profiling, or next-generation tumor sequencing. Genomic testing tells us which genetic changes (mutations or variants) caused the cancer and made it grow. The test results let us target those genes to treat the tumor. The tumor’s genetic information also helps us predict the chances cancer will come back.
- Thyroid Nodule Assessment: Our Thyroid Nodule Assessment Program is for people who need a fast, precise diagnosis for a lump (growth) in their thyroid. You do not need a referral from your doctor, or tests before your visit.
We use a testing tool developed at MSK called MSK-IMPACT®. It looks at about 500 genes for genetic changes and other tumor traits. Our test finds genetic changes in the tumor that other tests can miss. MSK-Impact has tested more than 92,000 of our patients to find the best treatments for them.
Coming to the right place is the key to a fast and accurate diagnosis. A correct diagnosis at the start puts you on the best path for treatment. Our Rapid Diagnosis service helps you do just that.
Treatment for head and neck cancers
How are head and neck cancers treated?
Which treatments are right for you depends on a few things. They include the cancer’s stage, where it started, and the cancer type.
Learn about the different types
Treatment for head and neck cancer can include surgery, chemotherapy, and radiation therapy. Immunotherapy and targeted therapies also treat some head and neck cancers.
We’ll base your treatment on the tumor’s genetic profile. You may have 1 treatment, or a few treatments together. Your MSK care team will talk with you about the best therapies for you.
Surgery is the most common treatment for head and neck cancer. Before or after surgery, other treatments may be used to lower the risk of cancer returning. You may also have reconstruction or plastic surgery.
Chemotherapy, targeted therapies, and immunotherapy are called systemic therapies. They spread throughout the body to treat cancer.
Targeted therapies are cancer treatments that target a tumor’s gene changes (mutations or variants).
Immunotherapy is a cancer treatment that boosts your immune system’s natural ability to fight cancer.
How does the MSK team care for people with head and neck cancer?
Your care team will include doctors, nurses, and healthcare providers who are experts in head and neck cancer. They meet often to share treatment ideas, the latest research, and new ways of thinking.
Your care team has special training in how to diagnose and treat head and neck cancer. Their goal is to support you during and after treatment.
The HPV vaccine has worked well to reduce HPV infections for some 20 years. Still, HPV is very common. When cancer is linked to the human papillomavirus (HPV), some people feel they did something wrong to cause cancer. MSK explains how to talk with people about a cancer diagnosis linked to HPV.
The MSK head and neck cancer team
At MSK, your care is always a team effort. Our care teams reflect the skill and experience of many kinds of head and neck cancer experts. This includes doctors such as surgeons and radiologists, nurse practitioners, physician assistants, nutritionists, and social workers. Our plastic surgery and reconstruction experts can rebuild parts after treatment.
They all work together to give you the best cancer treatment.
MSK’s head and neck cancer team includes surgeon Dr. Jennifer Cracchiolo (L), clinical nurse Angela Maffucci, and manager of advance practice providers Allyson Gillespie.
Continued care
How does MSK provide follow-up and continued care for people with head and neck cancers?
We know you may have questions about what comes next. At MSK, we help you and your loved ones find the support you need.
Your physical, emotional, and mental health are very important to your MSK care team. We have follow-up care and support programs for as long as you need us. These programs and services are for people as soon as you start treatment. They’re here to support you and your loved ones.
Cancer treatment can cause late side effects months or years after treatment. You’ll have a follow-up care plan from a team of MSK head and neck cancer experts. Our focus is to help you have a full and healthy life after cancer treatment.
Your caregivers are a very important part of your care team. They need support, too. We have a Caregivers Clinic to help your loved ones cope with cancer.
MSK speech therapy experts understand how cancer treatment can affect how you talk, eat, and drink. Our speech therapists work closely with your care team.
Many people choose to start speech and swallowing therapy while they’re in the hospital or during treatment. Others see changes to their voice and swallowing after treatment ends. We’re here to help for as long as you need us.
Your speech therapist works with physical and occupational therapists to care for common problems after treatment. They may recommend exercises to improve your range of motion and muscle strength.
Supportive care is an important part of how we improve your quality of life during and after treatment. These therapies can help with side effects that happen months or years later.
Supportive care can also improve your emotional and spiritual health. MSK’s supportive care experts work with all members of your care team. They make a personal plan for you based on your goals and values.
Supportive care can help you with:
- Pain.
- Fatigue (feeling very tired).
- Insomnia (trouble sleeping).
- Nausea (feeling like throwing up) .
- Anxiety.
- Cognitive changes, such as memory loss or trouble focusing.
Managing pain from cancer and its treatment is an important part of cancer care. MSK was the first cancer center in the country to have a program just for treating pain in people with cancer.
Our pain experts will help relieve or manage pain after surgery. They can help while you’re still in the hospital, and after you’re home.
We have experts who manage the symptoms and side effects of cancer treatment, such as nausea during chemotherapy.
Cancer treatment can affect your digestion (how your body breaks down the food you eat). It can change your taste, how you eat, and how hungry you are.
Our clinical dietitian nutritionists can help with:
- Planning healthy meals at home.
- Advice about special diets, such as food that’s easy to chew and swallow.
- Working around food allergies.
- Managing symptoms such as weight loss or gain.
- Managing loss of appetite (not feeling hungry).
- Lowering your risk for other health problems after treatment.
Our Integrative Medicine and Wellness Service offers complementary, natural, and holistic treatments. They include acupuncture, meditation, massage therapy, yoga, and exercise.
Cancer therapies can cause side effects. You may want support to cope with:
- Pain.
- Fatigue (feeling very tired).
- Nerve problems.
- Nausea (feeling like throwing up).
- Insomnia (trouble with sleeping).
- Stress.
Without using prescription drugs, integrative therapies can help improve side effects of treatment.
Integrative medicine services are available in New York City, New Jersey, Westchester, and on Long Island.
We offer counseling and support to help you manage anxiety, depression, anger, or loneliness. There are individual and group counseling sessions, both in person and through telemedicine visits. Counseling is open to you and your family, separately or together.
We also run support groups and programs if you want to talk with other people going through a similar experience. Our social workers can offer information about how to talk about your diagnosis with family members, work colleagues, and friends.
After you finish treatment, your team will include an advanced practice provider (APP). Your APP is a healthcare provider with special training in head and neck cancer and follow-up care. You’ll meet with your APP for up to 2 years after treatment ends.
When you meet with your APP, they’ll monitor (look for) any signs the cancer has come back. They’ll also check for signs of side effects of treatment.
They’ll make a follow-up care plan for you and schedule appointments with other MSK experts to help care for you.