Head and neck cancers originate when a cell in the head and neck region undergoes a mutation and begins to divide uncontrollably.
These tumours can form in various locations, including the ears, eyes, mouth, nose, throat, larynx (voice box), thyroid, and the base of the skull. They can also develop in the skin of the head and neck. It is important to note that brain cancers involve different cells and require separate treatment plans, and as such, are not classified as a head and neck cancer.
Due to their critical location, these cancers can significantly affect many aspects of daily life, potentially impacting one's ability to see, hear, chew, swallow, smell, and talk. They may also disrupt hormone levels that regulate key bodily functions, such as digestion and heart rate.
Successful treatment of head and neck cancer requires a team of highly experienced specialists dedicated to managing the tumours while striving to maximise the patient's quality of life.
Head and neck cancer is a broad term encompassing a variety of specific cancer types, including:
Cancers that develop in or around the eye, such as the eyeball, eyelid, and orbit. This includes subtypes like melanoma, lymphoma, sarcoma, and carcinoma. A rare pediatric form is Retinoblastoma.
Often found in the tongue, lips, and floor of the mouth, but can also start in the gums, salivary glands, or the roof of the mouth.
Diseases of the parathyroid glands in the neck that control calcium and phosphorus levels. Both benign (non-cancerous) and malignant (cancerous) types exist.
Tumours starting in the pituitary gland at the base of the brain. These are almost always benign but can cause serious medical issues.
The most common type of cancer, with many cases developing on the head and neck (ears, face, neck, scalp). Types include basal cell carcinoma, squamous cell carcinoma, melanoma, and Merkel cell carcinoma.
Cancers forming in the minor or major salivary glands found in the mouth, throat, and sinus cavities.
Tumours starting in or extending into the base of the skull, which can be malignant or benign.
A general term for cancers classified by their location:
Begins in the butterfly-shaped thyroid gland in the front of the neck. Most cases are slow-growing and treatable.
Factors that may increase the chance of developing head and neck cancer include:
Using tobacco in any form significantly increases the risk for oral and throat cancers.
Drinking alcohol is linked to an increased risk of developing throat and oral cancers.
Skin damage from UV light can cause skin cancer, including melanoma, in the head and neck area.
This is the most significant risk factor for many types of cancer, particularly oropharyngeal cancer. Since HPV is spread through sexual contact, a person's sexual history is a related factor.
Having received radiation to the head and neck area for a prior cancer increases the risk of developing a new one, though the benefits of the initial treatment typically outweigh this risk.
Risk varies by type (e.g., most oral cancers are found in people over 45; most thyroid cancers are diagnosed in people aged 20-55).
Oral and throat cancers are more common in men, while thyroid cancer is more common in women.
Some head and neck cancers are associated with inherited genetic conditions. Genetic counselling may be recommended for you and your family.
The symptoms of head and neck cancer can vary widely depending on the specific disease and the tumour's location (e.g., eye cancer may cause vision issues, while throat cancer can cause difficulty chewing).
A painless lump in the neck
Changes or problems with vision, including double vision
Hearing loss, often limited to one ear
Dizziness or challenges with balance
Changes in voice, such as hoarseness
Difficulty opening the mouth
Trouble breathing and speaking
Difficulty chewing and swallowing
Nasal congestion or a stuffy nose
Nose bleeds
Facial weakness or paralysis
Pain in the head and neck area, including the throat and ear
Additionally, some head and neck cancers can affect hormone levels, leading to symptoms such as:
Unexplained weight gain or weight loss
High blood pressure
Excessive sweating
Constipation
Frequent urination
Bone pain or fractured bones
Kidney stones
Muscle weakness
Fatigue
It is important to remember that these symptoms do not automatically indicate cancer. However, any persistent or concerning symptoms should be discussed promptly with your doctor, as they may signal other health problems.
Early and accurate diagnosis is crucial for increasing the chance of successful treatment and preserving the patient's quality of life, including the ability to hear, speak, and swallow. The experts at SSCHRC possess extensive skill and experience in diagnosing the various types of head and neck cancer.
Doctors at SSCHRC use this high level of expertise, combined with advanced diagnostic tools, to accurately diagnose each cancer type and subtype, which informs the best possible personalised treatment plans.
If you have symptoms that may suggest head and neck cancer, your doctor will conduct a physical examination and ask about your health history and lifestyle. You may then undergo one or more diagnostic tests, which can be used to identify cancer, determine if it has spread, and monitor your response to treatment.
Doctors examine the suspected area, sometimes using special tools like:
A small tissue sample is removed and examined under a microscope for cancer cells. This may be done with a needle and local anaesthesia or require a surgical procedure under general anaesthesia.
These allow doctors to see inside the body without surgery:
These check hormone levels (impacted by thyroid and parathyroid tumours) and monitor treatment response and side effects.
Patients with suspected cancer in the throat, eyes, or ears may be tested for vision, hearing, swallowing, and/or balance.
Identifies the specific molecular features of the cancer to inform treatment selection.
Identifies patients with genetic conditions that may be linked to certain cancers, helping to assess risk for the patient and their family.
At SSCHRC, head and neck cancer patients receive care from a dedicated team of expert doctors, including medical oncologists, radiation oncologists, and surgeons, who specialise exclusively in cancers of the head and neck. This concentrated experience allows them to develop a personalised and coordinated treatment plan for each patient.
Treatment plans may include:
Minimally invasive surgical procedures, often leading to shorter hospital stays and faster recovery.
Advanced radiation therapy techniques that minimise radiation exposure to healthy tissue.
Immunotherapy, which harnesses the body's own immune system to fight cancer.
Targeted therapy, which slows or stops cancer growth at the cellular level.
A primary treatment for many types of head and neck cancer.
Involves making incisions in the skin to remove the tumour and affected tissue, with care taken to protect important nerves and vessels. Plastic surgeons often perform reconstruction to restore function and appearance.
Performed without large incisions, resulting in quicker recovery. This includes:
Uses powerful, focused beams of energy to destroy cancer cells, accurately targeting the tumour while limiting side effects.
Delivers radiation using small pieces of radioactive material placed directly on or inside the tumour site.
Drugs used to kill cancer cells, control their growth, or relieve symptoms. It may involve a single drug or a combination.
Used to adjust hormone levels that might encourage the growth of certain cancers.
Drugs designed to interfere with the specific molecules or cancer-causing genes that cancer cells need to survive and spread.
Treatments that improve the immune system's ability to recognise and eliminate cancer, such as immune checkpoint inhibitors.
A non-invasive procedure that uses extreme cold to freeze and destroy cancerous tissue.
For slow-growing cancers, doctors may recommend closely monitoring the disease without immediate active treatment, initiating therapy only if the disease progresses.
SSCHRC offers an extensive clinical trials programme that provides access to new and emerging treatments, including new immunotherapies, targeted therapies, and advanced radiation techniques.
Head and neck cancer and its treatments can impact a patient's ability to eat, drink, speak, and their appearance. SSCHRC offers comprehensive services to help patients manage and overcome these challenges:
Examination and treatment for the tumour's impact on hearing and balance.
Advanced techniques to help restore speech function after treatment.
Dedicated experts for evaluating and treating patients who experience or may develop difficulty drinking and swallowing.
Specialised dental services, including designing implants and procedures to restore appearance and function of the teeth and jaw.
A dedicated clinic for patients successfully treated for head and neck cancer, providing lifelong follow-up care and screening. Regular follow-up is vital due to the risk of recurrence.
Patients are also strongly advised to avoid smoking and alcohol during and after treatment, as both can hinder treatment success and significantly increase the risk of the cancer returning or a new cancer developing.