Head and neck cancer

Head and neck cancer refers to laryngeal, lip and tongue cancers. Head and neck cancers occur inside the sinuses, nose, mouth and salivary glands down through the throat. Although the cancers are different, they are treated similarly, so are considered as a group.

Incidence and mortality

In 2009, over 3,800 new cases of head and neck cancer were diagnosed in Australia.

Cancers of the lip, tongue and larynx are the most common cancers in this group. In 2009, 606 people in Australia were diagnosed with laryngeal cancer, 618 with tongue cancer and 865 with lip cancer. All three of these cancers are more common in males.

In 2007 there were 185 tongue cancer deaths and 214 laryngeal cancer deaths.

Screening

No routine screening tests are used. White plaques or patches in the mouth (leukoplakia) may precede the development of the cancer.

Symptoms and diagnosis

Symptoms depend on the site but include:

• pain
• swelling
• hoarse voice
• difficulty swallowing
• bad breath.

Diagnosis is by a biopsy obtained using an endoscope, needle or surgically.

Staging

The extent of the tumour is defined by the size of the lump and whether there is spread to lymph nodes or further to the lungs or bones. CT, MRI, bone and PET scans are used. Visual examination using an endoscope may be required.

Causes

The main causes are alcohol and tobacco consumption. Some head and neck cancers are related to human papilloma virus infection.

Prevention

The risk of head and neck cancers can be reduced by not smoking (or quitting) and reducing alcohol consumption.

Treatment

The definitive treatment for local disease is surgery to the primary lump and draining the lymph glands. Full dose radiotherapy may be used in sites where functions such as speech can be preserved. Radiotherapy can be given in sequence with chemotherapy (commonly cisplatin, 5 fluorouracil or the taxanes) for more advanced cancer and both can be used for symptom relief with widespread disease.

Prognosis

An individual’s prognosis depends on the type and stage of cancer, as well as their age and general health at the time of diagnosis. At most sites, treatment of small, localised cancer results in at least 75% of patients surviving five years after diagnosis. With more advanced disease at diagnosis this drops to 15%.

For further information, contact Cancer Council Helpline  on 13 11 20 (cost of a local call within Australia).

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