Head and Neck Cancer

Head and neck cancer includes any cancer arising from the lining of the sinuses, mouth, throat and voice box. Skin cancers of the scalp, face and neck are also considered head and neck cancers, and tumors can also form on the thyroid, parathyroid, and salivary glands. Traditional risk factors include the use of tobacco or alcohol, but increasingly the human papillomavirus is being implicated in the formation of certain cancers in the tonsils and the back of the tongue. Sun exposure is a risk factor for skin cancer and prior neck radiation can predispose to thyroid cancer.

Common presenting signs and symptoms include sores in your mouth or throat that do not go away, often with pain radiating up to the ear, difficulty swallowing, and change in voice or speech. Sometimes, the first sign is a lump or swelling in the neck that does not resolve, representing either a primary tumor or cancer that has spread to a lymph node in the neck. Advanced cancers may present with coughing up blood, or difficulty breathing.

When you are undergoing an initial evaluation for a suspected head and neck cancer, your doctor will perform a history and physical exam, which often will also include an office endoscopy, where a small fiberoptic scope is passed through your nose to look at the back of your throat and voice box. If an area of concern is identified, additional studies may include imaging tests such as a CT scan or MRI, and it may be necessary to perform a biopsy of any areas in the mouth or throat, either in the clinic or under general anesthesia in the operating room. For masses in the neck or thyroid, an ultrasound may be used in the office to better see the lesion and a biopsy can be obtained using a small needle to aspirate cells that can be looked at under the microscope to determine a diagnosis.

Once it is established the type of tumor that is present and the extent of disease (stage), the members of your team will discuss your case at our multidisciplinary tumor board to determine the most appropriate treatment option for you. Based on feedback from the group and their discussion with you, a treatment plan will be developed. Typical treatment options include surgery or radiation therapy for early stage cancers. More advances tumors are managed with either upfront surgery with radiation or chemotherapy and radiation after surgery, or with definitive chemotherapy and radiation therapy, using surgery only if cancer remains at the end of treatment. Factors to consider when making the decision on what option to pursue include what will give the best chance of getting rid of the cancer and what will provide the best function and quality of life after treatment. The members of our team will help guide you through this challenging process.

At UC Davis, there are many ongoing research trials available to our patients. These studies provide opportunities to enroll in diagnostic and treatment approaches that are on the cutting edge and are helping shape the way we manage head and neck cancer for years to come. Ask us if you qualify for any clinical trials.