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  • Orthopaedic Subspecialties

    Pediatric and Adult Patients

    The Department of Orthopaedic Surgery at Mass General provides high-quality, personalized care for every orthopaedic condition.

About This Condition

What is head and neck cancer?

Cancer that starts in any part of the head or neck (except the brain or eye) is called head and neck cancer. These are cancers that start in the nose, sinuses, mouth, tongue, throat (pharynx), tonsils, adenoids, glands that make saliva, or the voice box (larynx).

Head and neck cancers are formed by abnormal cells that grow and multiply out of control. The cancer cells replace normal cells and form a lump, or tumor. As the tumor gets bigger, it can grow into nearby tissues and organs. Cancer cells can also spread to other parts of the body through the blood or lymph vessels.

What are the different types of head and neck cancer?

The type of cancer depends on where the tumor is located and the type of tissue involved.

  • squamous cell cancers: cancer in the tissue that lines the spaces of the nose, sinuses, mouth, and throat
  • lymphoma: immune system cancer
  • adenocarcoma: cancer of a gland, such as the salivary gland that makes “spit”
  • sarcoma: cancer of muscle, bone, cartilage, nerve, or blood vessels

What are the symptoms of head and neck cancer?

The symptoms depend on where the tumor is located. Early symptoms may be:

  • a sore or swelling in the mouth (on the tongue, under the tongue, inside the cheeks, along the gums, on the roof of the mouth)
  • a sore throat that doesn’t get better
  • a change in the voice, especially hoarseness that doesn’t come with a cold
  • numbness or tenderness of the face
  • blood in saliva (spit) or phlegm (fluid)
  • swallowing problems
  • ear ache, pain in or around the ear, especially when swallowing, or a change in hearing
  • a lump in the neck, a lump that lasts for more than 2 weeks and/or gets larger. This may be a lymph node.

Any of these symptoms can occur with other common illnesses. If the symptoms seem unusual or last more than two weeks, you should see your doctor.

How is head and neck cancer diagnosed?

  • medical history and physical exam
  • X-rays: X-ray pictures can show abnormal shadows that might be cancer
  • CT scan: a series of X-rays taken in thin cross-sections of the head and neck. These X-rays can show a tumor and whether it has spread to nearby tissues or lymph nodes
  • MRI scan: magnetic resonance imaging is similar to a CT scan, but MRI uses strong magnets instead of X-rays to make the picture
  • Endoscopy: a thin, flexible tube with a tiny camera in it is passed into the patient’s mouth and throat. If an abnormal spot of tissue is seen with the camera, a small clipper at the end of the tube can take a sample of the tissue (a biopsy) to check for cancer cells
  • Biopsy: a small piece of tissue or group of cells is removed from a spot suspected of being abnormal. The biopsy tissue is looked at under a microscope by a pathologist to check for cancer cells

Treatment for head and neck cancer

The goal of cancer treatment is to get rid of cancer cells in the body and to stop more cancer cells from growing. Treatment is determined by the type of cancer and whether it has spread (staging), the age of the patient, patient preference, and any associated medical conditions. Treatment is planned by a team of cancer specialists who review a variety of test results.

There are three main types of cancer treatment. These treatments may be used alone or in combination.

  • Surgery: during surgery the tumor is removed. After surgery, other cancer treatments, such as chemotherapy or radiation, may be used to kill any cancer cells that could be left behind
  • Radiation therapy: uses high energy radioactive beams or particles to kill the cancer cells or stop them from growing
  • Chemotherapy: uses medicine to kill cancer cells or stop them from growing. There are many chemotherapy drugs which can be given in different ways (into a vein or by mouth), given in combination, or given one after the other.