A cancer diagnosis can be overwhelming and devastating to experience. But it’s easier to have hope when you understand just what you’re facing. In fact, in the complex category of head and neck cancers — those found in the mouth, nose, throat, glands, voice box, ear, thyroid and skin — you have an excellent chance of healing, especially if caught early.
“The good news is that in people with the most common type of head and neck cancer, there’s an 85 percent cure rate,” says Henry N. Ho, MD, FACS, a specialist in head and neck cancers at The Ear, Nose, Throat and Plastic Surgery Associates and the Florida Hospital Cancer Institute (FHCI).
Awareness can be empowering: We don’t want you to live in fear of developing a condition, but rather be armed with knowledge that could help you detect or be prepared for any symptoms. Understanding the risk factors and common signs of these cancers could help you identify them early and ultimately make your recovery journey easier.
What increases head and neck cancer risk?
Each cancer case is unique and may have one or several contributing factors. But a few key causes have been identified:
- Tobacco and alcohol usage: According to the National Cancer Institute, at least 75% of all aerodigestive tract (the organs and tissues of the respiratory tract and upper digestive tract) cancer cases are caused by use of tobacco and alcohol, with the exception of cancer of the salivary glands.
- HPV: The human papillomavirus 16 is a rapidly increasing cause of oropharyngeal cancers.
- Oral hygiene: Bad oral health and missing teeth may increase the risk for oral cancer.
- Occupational exposure: Certain jobs in the metal, construction, ceramic, textile, logging or food industries may increase the risk for larynx cancer, while exposure to wood dust has been associated with an increased risk for nasopharyngeal cancer.
- Ancestry: South Asian ancestry in particular is associated with an increased risk for nasopharyngeal cancer.
- Radiation: Exposure poses a risk to develop certain types of head and neck cancer, especially thyroid cancer.
What are the symptoms?
Since there are many different head and neck cancers, the symptoms vary. The most common symptom is a sore in the mouth that doesn’t heal, but others include:
- Red or white patches in the mouth
- An unexplained lump in the head or neck area (usually not painful)
- An unrelenting sore throat, hoarseness or a change in the voice
- Difficulty breathing, nasal obstruction or persistent congestion
- Frequent nosebleeds or unusual nasal discharge
- Pain or trouble swallowing
- Ear or jaw pain
- Saliva or phlegm with blood
There are, however, illnesses and conditions that may mimic the symptoms of head and neck cancers and cause concern. Dr. Ho explained that an infection, a sore throat, neck swelling or lumps in the neck are all common issues that can be present in a patient but not at all related to cancer.
One situation in which you should always see a physician: “There’s a new guideline that says we should be suspicious of any lump that has been present for a week and a half to two weeks,” Dr. Ho said.
How are head and neck cancers diagnosed?
“Because of availability, most people would see their primary care doctor or dentist first,” says Dr. Ho, depending on your area of pain or swelling. Then you may be referred to an otolaryngologist, a physician trained in the medical and surgical management and treatment of head and neck issues.
Here are a few common ways your doctor can begin to diagnose your condition:
- Exam: A physical is done and medical history is discussed.
- Biopsy: A small sample of tissue is taken for testing.
- Endoscopy: A flexible fiber-optic instrument can be inserted to view much of the internal head and neck right in the doctor’s office.
- Ultrasound: An ultrasound image is produced without radiation to evaluate thyroid nodules or neck lymph nodes.
“Everyone needs to have a medical history and a physical exam, and there are certain clues within the history and physical that make us suspicious or not,” said Dr. Ho. “We look at risk factors like smoking, history of prior cancers, radiation exposure, if a lump has been there for a length of time, its size, if it’s causing problems with nerve function, swallowing or breathing; those kinds of connections make us highly suspicious.”
If a physician believes there should be more investigation, there are a few more steps that can be taken relatively easily right inside the office.
“We have to make sure we can see all the mucous membranes in the throat very carefully, as these may show a source of where cancer could be coming from, so that may include not only a physical exam but also a fiber-optic telescope we can pass through the nostril to see all the anatomy.”
Advanced diagnostic tools may include CT scans, MRIs and a biopsy of the area.
How do you heal these cancers?
Dr. Ho explained that surgery is the primary treatment for most head and neck cancers. Radiation may be involved for more advanced cases, or if it’s too risky to operate on the patient. In some cases, plastic surgery may be recommended to reconstruct the area and improve quality of life.
“You shouldn’t be afraid,” says Dr. Ho. “People can be afraid or in denial and don’t want to go, but fortunately if they come in early, the majority of them are curable.”
For your best treatment options and chances of recovery, it’s important to be aware of the signs and symptoms of these cancers. Rest assured that the Florida Hospital Cancer Institute treats not just head and neck cancer, but your whole health with the expertise of a multidisciplinary team of otolaryngologists, radiation oncologists, medical oncologists, specialists and researchers.
Dr. Ho is part of the official surgical team for FHCI. If you have questions about head and neck cancer symptoms present in you or a loved one, or would like to make an appointment, please call (888) 343-1731.