What is head and neck cancer?
Head and neck cancers arise in anatomically close but clinically distinct sites: oral cavity, oropharynx, hypopharynx, larynx, nasopharynx, nasal cavity and sinuses, and salivary glands. Thyroid, brain, eye, and skin cancers are generally categorized separately. Tobacco and alcohol are major risk factors for many squamous cancers. High-risk human papillomavirus, especially HPV-16, drives many oropharyngeal cancers, while Epstein-Barr virus is linked to many nasopharyngeal cancers. Salivary cancers include multiple histologies with different behavior. Patterns of lymph-node spread and the importance of viral testing vary by primary site. Treatment planning emphasizes cancer control and preservation or restoration of breathing, speech, swallowing, hearing, appearance, shoulder function, and dental health. A multidisciplinary team often includes head-and-neck surgery, radiation and medical oncology, pathology, radiology, dentistry, nutrition, speech-language pathology, rehabilitation, and psychosocial support. Follow-up addresses recurrence, late effects, and the ongoing risk of second primary cancers.
Signs and symptoms
Possible signs include a mouth sore or red or white patch that does not heal, a neck lump, persistent sore throat, hoarseness, trouble or pain with swallowing, one-sided ear pain, coughing blood, unexplained weight loss, or difficulty moving the tongue or jaw. Nasal or sinus cancers may cause persistent blockage, nosebleeds, facial numbness, or eye symptoms. Salivary tumors may present as a jaw, cheek, or neck mass, sometimes with facial weakness. Symptoms vary by site and can be caused by noncancer conditions such as infection, reflux, dental disease, benign nodules, or inflammation. A persistent or progressive symptom, especially a neck mass, voice change, bleeding, or swallowing problem, needs examination. Some cancers cause few symptoms until a lymph node enlarges. Breathing difficulty or significant bleeding requires urgent care.
Diagnosis and staging
Evaluation includes examination of the mouth, throat, neck, nose, ears, cranial nerves, and lymph nodes. Flexible endoscopy can inspect areas not directly visible. Imaging with CT, MRI, ultrasound, and sometimes PET-CT defines the primary tumor, nodal disease, and distant spread. Fine-needle aspiration often samples a neck node, while biopsy of the primary site establishes histology. Testing for HPV or p16 is standard for oropharyngeal squamous cancer, and Epstein-Barr virus testing can inform nasopharyngeal cancer care. Dental evaluation may be needed before radiation. Hearing, nutrition, speech, and swallowing baselines can guide treatment selection and rehabilitation. Examination under anesthesia can map a tumor and search for an unknown primary site. TNM staging is site-specific; HPV-associated oropharyngeal cancer has a distinct staging system. Pathology and selected biomarkers, including PD-L1 in recurrent or metastatic disease, may guide therapy. Care depends on site, histology, stage, viral association, biomarkers, function, prior treatment, health, and goals.
Established treatment paths
Early-stage cancers may be treated with surgery or radiation, chosen according to site, expected function, and expertise. More advanced disease often requires combined treatment: surgery with postoperative radiation or chemoradiation for adverse pathology, or definitive radiation with concurrent systemic therapy when organ preservation is appropriate. Surgical procedures range from transoral tumor removal to open resection and neck dissection, sometimes followed by reconstruction. Chemotherapy can enhance radiation or treat recurrent and metastatic disease. Cetuximab has selected roles with radiation or systemic therapy, while immune checkpoint inhibitors are established for some recurrent or metastatic squamous cancers based on treatment setting and biomarkers. Nasopharyngeal, salivary, sinonasal, and other uncommon cancers follow site- and histology-specific protocols. Re-irradiation or salvage surgery may be considered for selected recurrences. Dental extraction, airway protection, or feeding access may be needed before treatment in selected cases. Clinical trials are important, including studies of treatment intensity in HPV-associated disease. Treatment depends on exact site, stage, viral status, pathology, biomarkers, functional impact, health, prior therapy, preferences, goals, function, and treatment tolerance.
Supportive care
Supportive care should start before treatment. Dental assessment, fluoride planning, nutrition review, and baseline speech and swallowing evaluation can prevent or reduce complications. Teams manage pain, dry mouth, thick saliva, mouth sores, taste change, skin reactions, nausea, fatigue, and weight loss. Speech-language therapy and swallowing exercises may preserve function; feeding support is individualized. Physical therapy can address jaw stiffness, neck or shoulder limitation, and lymphedema. Smoking and alcohol cessation support can improve health and reduce additional cancer risk.
Profiles documenting head and neck cancer care
These profiles mention a matching cancer specialty in their published materials. Browse their locations, reported services, and practical details.
Sources
Source information checked: 2026-09-29. The links below identify the public and clinic-provided materials used for this page.
- NCI: Head and Neck Cancers Fact Sheet ↗Checked 2026-09-29
- NCI: Head and Neck Cancer (Professional) ↗Checked 2026-09-29
- NCI: Side Effects of Cancer Treatment ↗Checked 2026-09-29
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