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Head and Neck Cancer

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These cancers (carcinomas) start in the cells that line all parts of the nose, sinuses, mouth, throat and larynx.

  • Other types of cancer can also be located in the head and neck region, but the diagnosis and treatment are much different. Specific information about brain tumors, esophageal cancer, eye cancer, parathyroid cancer, sarcoma, and thyroid cancer is available in other guides on Cancer.Net.
  • Cancer begins when healthy cells change and grow out of control, forming a mass called a tumor. A tumor can be cancerous or benign. A cancerous tumor is malignant, meaning it can grow and spread to other parts of the body. A benign tumor means the tumor can grow but will not spread.

Cancers that are known collectively as head and neck cancers usually begin in the squamous cells that line the moist, mucosal surfaces inside the head and neck (for example, inside the mouth, the nose, and the throat). These squamous cell cancers are often referred to as squamous cell carcinomas of the head and neck.

  • Head and neck cancers can also begin in the salivary glands, but salivary gland cancers are relatively uncommon. Salivary glands contain many different types of cells that can become cancerous, so there are many different types of salivary gland cancer.
  • Cancer cells can spread to other parts of the body. Cancer cells in the head or neck can sometimes travel to the lungs and grow there. When cancer cells do this, it’s called metastasis.
  • Cancers of the head and neck are further categorized by the area of the head or neck in which they begin. These areas are described below and labeled in the image of head and neck cancer regions. 
    • Oral cavity: Includes the lips, the front two-thirds of the tongue, the gums, the lining inside the cheeks and lips, the floor (bottom) of the mouth under the tongue, the hard palate (bony top of the mouth), and the small area of the gum behind the wisdom teeth.
    • Pharynx: The pharynx (throat) is a hollow tube about 5 inches long that starts behind the nose and leads to the esophagus. It has three parts:
      • the nasopharynx (the upper part of the pharynx, behind the nose);
      • the oropharynx (the middle part of the pharynx, including the soft palate [the back of the mouth], the base of the tongue, and the tonsils);
      • the hypopharynx (the lower part of the pharynx).
    • Larynx: The larynx, also called the voicebox, is a short passageway formed by cartilage just below the pharynx in the neck. The larynx contains the vocal cords. It also has a small piece of tissue, called the epiglottis, which moves to cover the larynx to prevent food from entering the air passages.
    • Paranasal sinuses and nasal cavity: The paranasal sinuses are small hollow spaces in the bones of the head surrounding the nose. The nasal cavity is the hollow space inside the nose.
    • Salivary glands: The major salivary glands are in the floor of the mouth and near the jawbone. The salivary glands produce saliva.

What causes cancers of the head and neck?

  • Alcohol and tobacco use (including smokeless tobacco, sometimes called “chewing tobacco” or “snuff”) are the two most important risk factors for head and neck cancers, especially cancers of the oral cavity, oropharynx, hypopharynx, and larynx. At least 75% of head and neck cancers are caused by tobacco and alcohol use. People who use both tobacco and alcohol are at greater risk of developing these cancers than people who use either tobacco or alcohol alone. Tobacco and alcohol use are not risk factors for salivary gland cancers.
  • Infection with cancer-causing types of human papillomavirus (HPV), especially HPV type 16, is a risk factor for some types of head and neck cancers, particularly oropharyngeal cancers that involve the tonsils or the base of the tongue. In the United States, the incidence of oropharyngeal cancers caused by HPV infection is increasing, while the incidence of oropharyngeal cancers related to other causes is falling. More information is available in the HPV and Cancer fact sheet.
  • Other risk factors for cancers of the head and neck include the following:
    • Paan (betel quid). Immigrants from Southeast Asia who use paan (betel quid) in the mouth should be aware that this habit has been strongly associated with an increased risk of oral cancer. Betel nut chewing is associated with an increased risk of squamous cell cancer of the head and neck
    • Diet. Excessive consumption of eggs, processed meats, and red meat were associated with increased rates of cancer of the head and neck in one study, while consumption of raw and cooked vegetables seemed to be protective.
      • Preserved or salted foods. Consumption of certain preserved or salted foods during childhood is a risk factor for nasopharyngeal cancer.
      • Vitamin E was not found to prevent the development of leukoplakia, the white plaques that are the precursor for carcinomas of the mucosal surfaces, in adult smokers. Another study examined a combination of Vitamin E and beta carotene in smokers with early-stage cancer of the oropharynx, and found a worse prognosis in the vitamin users.
    • Oral health. Poor oral hygiene and missing teeth may be weak risk factors for cancers of the oral cavity. Use of mouthwash that has a high alcohol content is a possible, but not proven, risk factor for cancers of the oral cavity.
    • Occupational exposure. Occupational exposure to wood dust is a risk factor for nasopharyngeal cancer. Certain industrial exposures, including exposures to asbestos and synthetic fibers, have been associated with cancer of the larynx, but the increase in risk remains controversial. People working in certain jobs in the construction, metal, textile, ceramic, logging, and food industries may have an increased risk of cancer of the larynx. Industrial exposure to wood or nickel dust or formaldehyde is a risk factor for cancers of the paranasal sinuses and nasal cavity.
    • Radiation exposure. Radiation to the head and neck, for noncancerous conditions or cancer, is a risk factor for cancer of the salivary glands.
    • Epstein-Barr virus infection. Infection with the Epstein-Barr virus is a risk factor for nasopharyngeal cancer and cancer of the salivary glands.
    • Ancestry. Asian ancestry, particularly Chinese ancestry, is a risk factor for nasopharyngeal cancer.

How serious is the cancer?

  • Although early-stage head and neck cancers (especially laryngeal and oral cavity) have high cure rates, up to 50% of people with head and neck cancer present with advanced disease. Cure rates decrease in locally advanced cases, whose probability of cure is inversely related to tumor size and even more so to the extent of regional node involvement.
  • Consensus panels in America (AJCC) and Europe (UICC) have established staging systems for head and neck squamous-cell cancers.
    • Cancer can be stage 0, 1, 2, 3, or 4. The stage describes the growth or spread of the cancer in the place it started. It also tells if the cancer has spread to other organs of your body that are close by or farther away. The lower the number, the less the cancer has spread. A higher number, like stage 4, means a more serious cancer that has spread from where it started.

What kind of treatment will be needed?

  • There are many ways to treat head or neck cancer, but the main types of treatment are local or systemic.
    • Surgery and radiation are used to treat only the cancer. They do not affect the rest of the body. This is called local treatment.
    • Chemo and targeted therapy drugs go through the whole body. They can reach cancer cells anywhere in the body. They are called systemic treatment.
  • The treatment plan that’s best for you will depend on:
    • Where the cancer is
    • The stage of the cancer
    • The chance that a type of treatment will cure the cancer or help in some way
    • How treatment will affect the way you talk, breathe, and eat
    • Your age
    • Other health problems you have
    • Your feelings about the treatment and the side effects that come with it

How common are head and neck cancers?

  • The number of new cases of head and neck cancers in the United States was 40,490 in 2006, accounting for about 3% of adult malignancies. 11,170 people died of their disease in 2006.
  • The worldwide incidence exceeds half a million cases annually.
  • In North America and Europe, the tumors usually arise from the oral cavity, oropharynx, or larynx, whereas nasopharyngeal cancer is more common in the Mediterranean countries and in the Far East.
  • In Southeast China and Taiwan, head and neck cancer, specifically nasopharyngeal cancer is the most common cause of death in young men.
  • In 2008, there were 22,900 cases of oral cavity cancer, 12,250 cases of laryngeal cancer, and 12,410 cases of pharyngeal cancer in the United States.
  • In 2002, 7,400 Americans were projected to die of these cancers.
  • More than 70% of throat cancers are at an advanced stage when discovered.
  • Men are 89% more likely than women to be diagnosed with, and are almost twice as likely to die of, these cancers.
  • African Americans are disproportionately affected by head and neck cancer, with younger ages of incidence, increased mortality, and more advanced disease at presentation. Laryngeal cancer incidence is higher in African Americans relative to white, Asian and Hispanic populations. There is a lower survival rate for similar tumor states in African Americans with head and neck cancer
  • Head and neck cancers account for approximately 3-4% of all cancers in the United States.
  • Head and neck cancer increases with age, especially after 50 years. Most people are between 50 and 70 years old.
  • Researchers estimated that more than 65,000 men and women in this country would be diagnosed with head and neck cancers in 2017.
  • In 2015, head and neck cancers globally affected more than 5.5 million people (mouth 2.4 million, throat 1.7 million, and larynx 1.4 million), and it has caused over 379,000 deaths (mouth 146,000, throat 127,400, larynx 105,900).
    • Together, they are the seventh most frequent cancer and the ninth-most-frequent cause of death from cancer.
    • In the United States, about 1% of people are affected at some point in their life, and males are affected twice as often as females.
    • The average 5 year survival following diagnosis in the developed world is 42-64%.
  • From: UpToDate - Epidemiology and risk factors for head and neck cancer. By: Kerstin M Stenson, MD, FACS
    • The incidence rate in males exceeds 20 per 100,000 in regions of France, Hong Kong, the Indian subcontinent, Central and Eastern Europe, Spain, Italy, and Brazil, and among African Americans in the United States.
    • Mouth and tongue cancers are more common in the Indian subcontinent, nasopharyngeal cancer is more common in Hong Kong, and pharyngeal and/or laryngeal cancers are more common in other populations; these factors contribute disproportionately to the overall cancer burden in these Asian countries.
  • From: Cancer.Net - Head and Neck Cancer: Statistics 8/2017
    • This year (2017), an estimated 64,690 people (47,650 men and 17,040 women) will develop head and neck cancer. While younger people can develop the disease, most people are older than 50 when they are diagnosed.
    • It is estimated that 13,740 deaths (10,250 men and 3,490 women) from head and neck cancer will occur this year.
  • About 4400 people in Australia (approximately 3170 men and 1230 women) are diagnosed with a head and neck cancer each year. 4 This includes about 1370 people diagnosed with cancer in the mouth and tongue; 1000 with lip cancer; 890 with pharyngeal cancer; 590 with laryngeal cancer; 320 with salivary gland cancer; and 170 with nasal or paranasal sinus cancer.

Notables who died of Head and Neck Cancer:

  1. Ranker - Famous People Who Died of Head and Neck Cancer (8 listed as of 1/16/19)
  2. Famous People Who Died of Throat Cancer (196 listed as of 1/16/19)
  • Sammy Davis, Jr (1925-1990) Actor, dancer, singer and impressionist; throat cancer, died after complication from larynx surgery.
  • Ned Sherrin (1931-2007) English broadcaster, author and stage director; (Wikipedia - Ned Sherrin); He was diagnosed with unilateral vocal cord paralysis in January 2007; this diagnosis was later changed to one of throat cancer.
  • Bobby Hamilton (1957-2007) American stock care racing driver; (Wikipedia - Bobby Hamilton) On March 17, 2006, Hamilton announced that he had been diagnosed with head and neck cancer.
  • Henri Charrière (1906-1973) French criminal and writer; (Wikipedia - Henri Charrière). On 29 July 1973, Charrière died of throat cancer in Madrid, Spain.
  • Don Henderson (1931-1997) English actor; (Wikipedia - Don Henderson). Henderson died of throat cancer.
  • Henry Dudeney (1857-1930) English author and mathematician; (Wikipedia - Henry Dudeney) In April 1930, Dudeney died of throat cancer in Lewes, where he and his wife had moved in 1914 after a period of separation to rekindle their marriage & is buried in the Lewes town cemetery.
  • Humphrey Bogart (1899-1957) American screen actor; (Wikipedia - Humphrey Bogart); A heavy smoker and drinker, Bogart developed esophageal cancer. Bogart's cremated remains were interred in Forest Lawn Memorial Park Cemetery, Glendale, California, in the Garden of Memory, Columbarium of Eternal Light. He was buried with a small, gold whistle once part of a charm bracelet he had given to Lauren Bacall before they had married.
  • Lana Turner (1921-1995) (aka: Julia Jean Turner) American film and TV actress; (Wikipedia - Lana Turner); In the spring of 1992 she was diagnosed with throat cancer. On May 13, 1992, she underwent exploratory surgery at Cedars-Sinai Medical Center to remove the cancer. In June 1992, it was reported that the cancer had metastasized to her jaw and lungs. Turner underwent radiation therapy, and in February 1993, announced that she was in full remission. Despite treatment, the cancer returned in July 1994. She died nine months later at the age of 74 on June 29, 1995, of complications from the cancer at her home in Century City, Los Angeles. Turner's remains were cremated and scattered in Oahu, Hawaii.
  • George Harrison (1943-2001) English musician, multi-Intrumentalist, singer & songwriter, and music and film producer; Lead guitarist of the Beatles; (Wikipedia - George Harrison); In 1997 Harrison was diagnosed with throat cancer, He was treated with radiotherapy, which was thought at the time to be successful. In May 2001, it was revealed that Harrison had undergone an operation to remove a cancerous growth from one of his lungs, and in July, it was reported that he was being treated for a brain tumour at a clinic in Switzerland. On 29 November 2001, Harrison died at a friend's home in Los Angeles, aged 58. He was cremated at Hollywood Forever Cemetery and his funeral was held at the Self-Realization Fellowship Lake Shrine in Pacific Palisades, California.
  • Anthony Quinn (1915-2001) (aka: Antonio Rodolfo Quinn Oaxaca) Mexican American actor, painter and writer; (Wikipedia - Anthony Quinn); He died of respiratory failure, pneumonia and throat cancer on June 3, 2001 in Boston, Massachusetts at the age of 86. He is buried in a family plot in Bristol, Rhode Island.
  • Ed Sullivan (1901-1974) (aka: Edward Vincent "Ed" Sullivan) Television personality, sports and entertainment reporter, and syndicated columnist for the New York Daily News; (Wikipedia - Ed Sullivan) In early September 1974, X-rays revealed that Sullivan had an advanced growth of esophageal cancer. Doctors gave him very little time to live, and the family chose to keep the diagnosis secret from him. Sullivan, still believing his ailment to be yet another complication from a long-standing battle with gastric ulcers, died five weeks later on October 13, 1974, at New York's Lenox Hill Hospital; he was 73 years old. Sullivan is interred in a crypt at the Ferncliff Cemetery in Hartsdale, New York.
  • Sigmund Freud (1856-1939) (aka: Sigismund Schlomo Freud) psychiatre, père de la psychanalyse, Dr. neurologist, founded the psychoanalytic school of psychiatry, Neurologe, Tiefenpsychologe, Kulturrethoriker und Religionskritiker, psychoanalyst; (Wikipedia - Sigmund Freud) In February 1923, Freud detected a leukoplakia, a benign growth associated with heavy smoking, on his mouth. He died on 23 Sept. 1939, probably of an overdose of Morphine related to the severe pain from the cancer. Three days after his death Freud's body was cremated at the Golders Green Crematorium in North London, with Harrods acting as funeral directors.

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