Head and Neck Cancer

Finding It Early Increases Chance of Cure

Tobacco is the most common risk factor for head and neck cancer, also known as “throat cancer.” In the United States, up to 200,000 people die each year from smoking-related illnesses. The good news is that this figure has decreased due to the increasing number of Americans who have quit smoking. The bad news is that some of these smokers switched to chewing tobacco, assuming it is a safe alternative. This is untrue – they are merely changing the site of the cancer risk from their lungs to their mouth. While lung cancer cases are down, cancers in the head and neck appear to be increasing. Cancer of the head and neck is often curable if caught early. Fortunately, most head and neck cancers produce early symptoms. You should know the warning signs so you can alert your doctor. Remember – successful treatment of head and neck cancer depends on early detection. Knowing and recognizing the signs of head and neck cancer can save your life.

Here’s What You Should Watch for:

A lump in the neck: Cancers that begin in the head or neck usually spread to lymph nodes in the neck before they spread elsewhere. A lump in the neck that lasts more than two weeks should be seen by a physician. Of course, not all lumps are cancer. But a lump (or lumps) in the neck can be the first sign of cancer of the mouth, throat, voicebox (larynx), thyroid gland, or of certain lymphomas or blood cancers. Such lumps are generally painless and continue to slowly enlarge.

Change in the voice: Most cancers in the larynx cause a change in voice. Any hoarseness or voice change lasting more than two weeks should alert you to see your physician. An otolaryngologist is a head and neck specialist who can examine your vocal cords easily and painlessly. While most voice changes are not caused by cancer, you shouldn’t take chances. If you are hoarse more than two weeks, make sure you don’t have cancer of the larynx. See your doctor.

A growth in the mouth: Most cancers of the mouth or tongue cause a sore or swelling that doesn’t go away. These sores and swellings may be painless unless they become infected. Bleeding may occur, but often not until late in the disease. One should be concerned if an ulcer is accompanied by lumps in the neck. Your dentist or doctor can determine if a biopsy is needed and can refer you to a head and neck surgeon to perform this procedure.

Coughing up blood: This is often caused by something other than cancer. However, tumors in the nose, mouth, throat or lungs can cause bleeding. If blood appears in your saliva or phlegm for more than a few days, you should see your physician.

Swallowing problems: Cancer of the throat or esophagus (swallowing tube) may make swallowing solid foods difficult. The food may “stick” at a certain point and then either go through to the stomach or come back up. If you have trouble almost every time you try to swallow something, you should be examined by a physician. Usually a barium swallow test or an esophagoscopy (examination of the swallowing tube with a telescope) will be performed to find the cause.

Changes in the skin: The most common head and neck cancer is skin cancer, usually basal cell carcinoma. Fortunately, this is rarely a major problem if treated early. Basal cell cancers appear most often on sun-exposed areas like the forehead, face, or ears. Basal cell cancer often begins as a small, pale patch that enlarges slowly, producing a central “dimple” and eventually an ulcer. Parts of the ulcer may heal, but the major portion remains ulcerated. Some basal cell cancers show color changes. Other kinds of cancer, including squamous cell cancer and malignant melanoma, also occur on the skin of the head and neck. Most squamous cell cancers occur on the lower lip and ear. They may look like basal cell cancers and, if caught early and properly treated, can be cured. If there is a sore on the lip, lower face, or ear that does not heal, consult a physician. Malignant melanoma classically produces dense blue-black discoloration of the skin. However, any mole that changes size, color, or begins to bleed may be trouble. A black or blue-black spot on the face or neck, particularly if it changes size or shape, should be seen by a dermatologist or other physician.

Persistent Earache: Constant pain in or around the ear when you swallow can be a sign of infection or tumor growth in the throat. This is particularly serious if it is associated with difficulty in swallowing, hoarseness or a lump in the neck. These symptoms are best evaluated by an otolaryngologist.

Identifying High Risk of Head and Neck Cancer

Use of tobacco (cigarettes, cigars, chewing tobacco or snuff) and alcoholic beverages are closely linked with cancers of the mouth, throat, voice box and tongue. Prolonged exposure to sunlight is a major cause of skin cancer.