Head and Neck Cancer

Your head and neck house about 25 body parts, including your nose, mouth, sinuses, throat, voice box, thyroid and many others. Cancer that develops in these areas is called head and neck cancer. But specific types are named for the area in which cancer begins.
 

Thyroid Cancer

Thyroid cancer forms in your thyroid gland ― the butterfly-shaped organ at the base of your throat that regulates metabolism and other body processes. Several types of thyroid cancers can develop, with varying degrees of aggressiveness. Learn more about thyroid cancer.
 

Throat Cancer

Throat cancer is the most common head and neck cancer in the U.S., and at Mercy. There are different types of throat cancer, depending on the part of the throat affected:

• the nasopharynx (upper) of the throat
• the oropharynx (middle) of the throat
• the hypopharynx (bottom) of the throat
   

Cancer can also develop in the larynx (voice box), which sits at the top of the trachea (windpipe) and contains the vocal cords. Laryngeal cancer often starts in the cells lining the inside of the voice box. 
 

Nasopharyngeal Cancer

Nasopharyngeal cancer is also known as nasopharyngeal carcinoma or NPC and is a rare type of head and neck cancer. It starts from epithelial cells that line the upper part of the throat. Nasopharyngeal cancer has three main types, based on the types of cells involved, including:

• Non-keratinizing undifferentiated carcinoma (the most common type of nasopharyngeal cancer in the U.S.)
• Non-keratinizing differentiated carcinoma
• Keratinizing squamous-cell carcinoma (this type of nasopharyngeal cancer is associated with the Epstein-Barr virus)
   

NPC treatment depends on the type and stage of cancer and may include radiation therapy, chemotherapy or surgery.
 

Nose Cavity & Paranasal Sinus Cancer

Cancer can develop in the nasal cavity and paranasal sinuses (spaces between the bones around the nose). This type of cancer is often referred to as nasal and sinus cancer. The most common types of nasal and sinus cancer include:

• Squamous carcinoma – cancer that develops in the thin, flat cells that form the top skin layer of the maxillary sinuses (air-filled spaces in the cheek area, below the eyes and on the sides of the nose)
• Salivary gland cancer – a rare disease in which cancer forms in salivary-gland tissues
• Esthesioneuroblastoma (olfactory neuroblastoma) – cancer that starts in the nerves that affect your sense of smell
• Sarcomas - tumors that develop in the soft tissue, cartilage and bone of the nasal cavity or skull base
• Melanoma – cancer that starts in the nasal-cavity mucosa (moist inner lining)
• Lymphomas – cancers that start in immune-system cells of the nasal and sinus cavities

Anyone can get head and neck cancers. But certain risk factors make you more likely to develop them. Head and neck cancer risk factors include the following:
 

Alcohol & Tobacco Use

Using alcohol and tobacco (including smokeless or chewing tobacco and exposure to secondhand smoke) are the top two risk factors for head and neck cancers, especially in the mouth and voice box. Using tobacco and alcohol together makes your risk even higher than using either substance alone.
 

HPV Infection

HPV infection (especially with type 16) is a risk factor for cancers of the tonsils and tongue. U.S. cases of oropharyngeal (throat) cancers caused by HPV infection are rising, and 90% are caused by chronic HPV infection. 
 

Paan (Betel Quid) Use

Paan (or betel quid) is chewing tobacco made with betel leaves that are popular in Southeast Asia. But it’s strongly associated with an increased risk of mouth cancers.
 

Occupational Exposure

Exposure to asbestos and synthetic fibers can raise your risk of voice box cancer. People who work in construction, metals, textiles, ceramics, logging and food manufacturing may be more vulnerable. Risks of paranasal sinus and nasal cavity cancers increase with exposure to wood dust, nickel dust and formaldehyde.
 

Radiation Exposure

Previous radiation therapy to the head and neck for noncancerous or cancerous conditions raises your risk for salivary gland cancer.
 

Epstein-Barr Virus Infection

Infection with the Epstein-Barr virus (more commonly known as the virus that causes mononucleosis) is a risk factor for nasopharyngeal (throat) and salivary gland cancers.
 

Ancestry

People with Asian ancestry (particularly Chinese) have an increased risk of developing nasopharyngeal (upper throat) cancer.
 

Genetic Disorders

Inherited conditions like Fanconi anemia (a rare disease affecting bone marrow) increase the risk of developing head and neck as well as other cancers.

Symptoms of head and neck cancer vary, depending on the kind you have. Signs and symptoms of head and neck cancer commonly include the following:

• A lump in your neck or cheek
• Persistent pain in your mouth
• A red or white patch on your gums or tongue
• Trouble chewing or swallowing
• Voice changes, including hoarseness
• Chronic sinus infections
• Frequent nosebleeds
   

One of these symptoms on its own may not mean you’ve developed cancer, but it’s important to take them seriously. If your symptoms persist, share your concerns with your Mercy doctor.

Mercy cancer specialists are experts at diagnosing head and neck cancers. If you have signs or symptoms of head and neck cancer, your doctor will take a complete medical history and family history. Your oncology team will use also use a range of tests & tools designed for diagnosing head & neck cancer. The types of procedures that may be used to diagnose head and neck cancer include the following.    
 

• Indirect pharyngoscopy and laryngoscopy - These are tests to examine the back of your throat using small mirrors on long, thin handles.
• Endoscopy – An endoscopic procedure uses a scope (thin tube) with a light and lens to examine the head and neck from the inside
• Panendoscopy – In this procedure, multiple types of scopes are used to examine the oral cavity, oropharynx, larynx (voice box), esophagus, trachea (windpipe) and bronchi (breathing passages in the lungs).
• Biopsy – During a biopsy, your doctor removes tissue for a pathologist to determine whether head and neck cancers are present. Types of biopsies include incisional (surgery to collect a small tissue sample) and fine-needle aspiration (using a narrow-gauge needle to collect a tissue sample).
• Diagnostic Imaging - Your doctor may use various diagnostic imaging tests to diagnose head and neck cancers. These tests include CT scans, MRIs and PET scans.

Surgery

Several types of cancer surgery are used to treat head and neck cancer, including:

• Excision - removing tumors and surrounding tissues, possibly using minimally invasive techniques like robotic-assisted surgery or laser
• Lymph node or neck dissection - removing lymph nodes or neck tissues to check for and remove cancer
• Reconstructive surgery - for widespread cancer with extensive tissue removal
   

Radiation Therapy

Depending on the type and stage of head and neck cancer, radiation therapy can be used alone or given after surgery, with or without chemotherapy.

• Intensity-modulated radiation therapy (IMRT) - a commonly used form of radiation for head and neck cancers.
   

Systemic Therapy

Systemic therapies are medicines that travel throughout the body to treat cancer. Types of systemic therapies used to treat head and neck cancers include chemotherapy, targeted therapy and immunotherapy.
 

Chemotherapy

Chemotherapy is a medication that destroys cancer cells to keep them from growing or multiplying. It may be given alone or with other treatments, such as surgery and radiation therapy.
 

Targeted Therapy

Targeted therapy identifies and attacks specific molecules (molecular targets) on cancer cells that help them grow and spread.
 

Immunotherapy

Immunotherapy helps the immune system attack cancer cells by boosting immunity or changing how it functions. FDA-approved drugs are available that work with your immune system to fight head and neck cancers.
 

Head & Neck Cancer Treatment Side Effects

Some treatments for head and neck cancers can affect appearance, speech, swallowing ability, taste or smell. Following cancer treatment, you may need physical, occupational or speech therapy. Mercy offers a wide range of oncology therapy services and support groups to help you strengthen skills such as speaking clearly or swallowing.
 

Rest assured Mercy will be with you every step of the way on your road to recovery. We’ll provide the medical care and emotional support you need to conquer your fears — and your cancer.