Head & Neck Cancers Symptoms, Risks & Treatments | MedStar Health
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What is head and neck cancer?

Head and neck cancers are a broad group of malignant tumors that can develop in the head and neck region, such as the:

  • Nasal cavity and sinuses

  • Oral cavity (lip, mouth, and tongue)

  • Salivary glands

  • Throat (oropharynx and hypopharynx)

  • Voice box (larynx)

Learn more about the different types of head and neck cancer

MedStar Health is one of the area's largest treatment centers for head and neck cancers, with particular expertise in salivary gland tumors and cancer associated with the human papillomavirus (HPV). Our nationally recognized specialists work closely together, meeting in a multidisciplinary tumor conference to discuss new cases and make the best recommendations. As a patient, you'll benefit from access to the latest tools and techniques to treat your cancer based on your individual needs. In addition, our head and neck cancer experts are focused on your quality of life and work hard to maintain your natural appearance and daily functions, like swallowing, breathing, eating, and talking.

Symptoms and risk factors

What are the signs of head and neck cancer?

Some people with these types of cancer don't have any symptoms. In other cases, symptoms of head and neck cancers may include:

  • Lump or a sore that does not heal
  • Sore throat that does not go away
  • Difficulty swallowing
  • Change or hoarseness in the voice
  • Ear pain
  • Unintentional weight loss

These symptoms may vary based on the location of the cancer. Other symptoms for specific areas of the head and neck as they progress may include the following:

  • Mouth cancer

    • Non-healing ulcers

    • Jaw swelling that causes dentures to fit poorly or become uncomfortable

    • Spasms of the jaw muscles

    • Pain in one ear

    • Red or white patches on the gums, tongue, or lining of the mouth

    • Unusual bleeding or pain in the mouth.

    Learn More About Mouth Cancer

  • Nose and sinus cancer

    • Discharge from the nose
    • Persistent congestion
    • Facial pain
    • Double vision
    • Sinuses that are blocked and do not clear
    • Chronic sinus infections that do not respond to treatment with antibiotics
    • Bleeding through the nose
    • Frequent headaches
    • Swelling or other trouble with the eyes
    • Pain in the upper teeth
    • Problems with dentures
  • Upper throat (nasopharynx) cancer

    • Sore throat
    • Jaw spasm
    • Pain in the ear
    • Spitting up blood
    • Pain and difficulty swallowing
    • Trouble breathing or speaking
    • Pain when swallowing
    • Pain in the neck or the throat that does not go away
    • Frequent headaches

    Learn More About Throat Cancer

  • Voice box (laryngeal) cancer

    • Coughing
    • Hoarse voice
    • Difficulty breathing
  • Salivary gland cancer

    • Swelling under the chin or around the cheek
    • Numbness or paralysis of the muscles in the face
    • Pain in the face, the chin, or the neck that does not go away

These symptoms may also be signs of other health conditions. If you experience any of these symptoms, it's always best to talk to a doctor.

What causes head and neck cancers?

Not everyone diagnosed with head and neck cancer has a known risk factor. However, chewing or smoking tobacco, drinking alcohol, and being infected with human papillomavirus (HPV) are the most common risk factors associated with these cancers. Learn more below.

  • Tobacco use: Both smoking and using smokeless tobacco (such as chewing tobacco) increases your risk of head and neck cancer. Exposure to secondhand smoke can also elevate your risk.
  • Alcohol: Consuming alcohol is a major risk factor, especially if you also use tobacco.
  • HPV-16 infections: Infection with cancer-causing types of HPV, especially HPV-16, is a risk factor for oropharyngeal cancers that involve the tonsils or the base of the tongue.

Other risk factors for cancers of the head and neck include the following:

  • Gender and age: Males over 50 are typically the most likely to develop certain forms of these cancers, although anyone can get them.
  • Paan (betel quid): People 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.
  • Maté: Consumption of maté, a tea-like beverage habitually consumed by South Americans, has been associated with an increased risk of cancers of the mouth, throat, and larynx.
  • Occupational exposure: Wood and nickel dust, formaldehyde, asbestos, and synthetic fiber exposures have been associated with cancer of the larynx and sinuses, and some jobs in the construction, metal, textile, ceramic, logging, and food industries may have an increased risk of cancer of laryngeal cancer.
  • Radiation exposure: Radiation to the head and neck, for noncancerous conditions or cancer, is a risk factor for cancer of the salivary glands and thyroid.
  • Epstein-Barr virus infection: Infection with the Epstein-Barr virus is a risk factor for nasopharyngeal cancer.
  • Ancestry: Individuals from Southeast Asia are at higher risk for developing nasopharyngeal cancer.

Screening and prevention

Can head and neck cancer be prevented?

Unlike other cancers, there are no widespread screening guidelines to detect head cancer or neck cancer early. However, regular dental care typically involves an inspection of the oral cavity. In addition, routine primary care visits may involve physical examination of the head and neck.

While they can't always be prevented, there are several things you can do to lower your head and neck cancer risk.

  • Avoid tobacco or quit smoking/chewing. If you need help quitting, we offer several smoking cessation programs throughout the Maryland and Washington, D.C., region. Search for a program near you. 
  • Moderate your alcohol consumption.
  • Get vaccinated against HPV to protect yourself from the infection.
  • Seek regular dental care, as your dentist will examine for early signs of mouth cancer in the oral cavity.

Diagnosis

How are these cancers diagnosed?

Some people are referred to an ear, nose, and throat specialist (also called an ENT doctor or otolaryngologist) after experiencing symptoms. In other instances, suspicious signs of cancer are found incidentally during an exam for an unrelated health condition.

An accurate diagnosis is essential to getting the best possible treatment for your cancer. At MedStar Health, we use sophisticated imaging and pathology to provide your cancer team with information that will allow us to personalize your treatment. We may use several diagnostic tools and tests to learn as much as we can about your disease, including:

  • Physical examination: Your physician will thoroughly evaluate your head and neck region for anything concerning. Depending on your symptoms, they may feel for lumps around the neck or look inside the mouth or nose using a thin lighted tube to help them examine difficult-to-reach areas.
  • Medical history: Your ENT specialist will also ask questions about your symptoms and overall health, including your lifestyle habits, history of other medical conditions, and more.
  • Biopsy: We will need to collect a tissue sample to make an accurate diagnosis. The type of biopsy we use to remove the sample will vary based on the location of your tumor. This tissue is then examined under a microscope by specialized pathologists.
  • Imaging studies: Imaging tests, such as computed tomography (CT) scans, PET scans, or MRIs, may be useful in determining the size and depth of the cancer and if it has spread. This helps to classify the cancer's stage (how advanced it is) and whether or not surgery may be your best treatment option.

 

A doctor, wearing a mask, explains to a patient using an anatomical model of the head.

 

Types of cancer

What are the most common types of head and neck cancers?

This cancer group encompasses a wide range of malignant tumors affecting different parts of the head and neck. Many types of head cancer or neck cancer also have several subtypes based on the cell type where the cancer originates.

We have experience treating all forms of these cancers, including:

  • Laryngeal cancer: Also known as the voice box, the larynx lies within the throat in between the back of the tongue and the windpipe. Cancer can affect any part of the larynx.
  • Nasal and sinus cancer: Rarely, cancer can develop in the nasal cavity or nearby in the paranasal sinuses.
  • Oral (mouth) cancer: This cancer can affect the mouth, lips, or front two-thirds of the tongue.
  • Salivary gland cancer: Although unusual, tumors can develop in the parotid glands, submandibular gland, sublingual gland, and the minor salivary glands.
  • Skin cancers of the head and neck: Squamous cell carcinoma or basal cell carcinoma can develop on the face because it is frequently exposed to the sun.
  • Throat cancer: The throat or pharynx extends from the back of the nose and mouth to your windpipe (trachea). Cancer can develop in any part of the throat and is classified by its precise location:
    • Nasopharyngeal cancer develops at the top of the throat.
    • Oropharyngeal cancer refers to malignancies in the middle of the throat, including the tonsils and the back of the tongue.
    • Hypopharyngeal cancer affects the bottom of the throat.
  • Thyroid cancer: The thyroid is located below your voice box and is part of the endocrine system. When abnormal cells multiply uncontrollably in the thyroid gland, tumors can develop. These can be cancerous or benign.

Treatments

Your head and neck treatment depends on the type and stage of your tumor.

If you are diagnosed with head and neck cancer, your case will be discussed within a multidisciplinary tumor board that involves experts in head and neck surgery, radiation and medical oncology, radiology, pathology, speech therapy, and more. These specialists will collaborate on the appropriate recommendations for your treatment, including how to best preserve your natural appearance and functions, such as breathing, swallowing, and speaking.

Treatment will vary depending on the location and stage of your tumor, as well as your overall health and preferences. Your care team will thoroughly review the pros and cons of each of your treatment options, so you can feel confident in making the right decision for your best possible outcome.

Surgery

Dr Stanley Chia stands in an operating room with his arms folded at MedStar Health.Depending on the location and progression of your cancer, surgery is often an effective treatment option, especially in early stages. If your doctors recommend surgery, the type of surgery you will have and the techniques used to perform your surgery will vary based on your unique case. At MedStar Health, our ENT and reconstructive surgeons are skilled at performing a wide range of surgical procedures, including but not limited to:

  • Minimally invasive procedures that may offer faster recovery and shorter hospital stays, when appropriate
  • Transoral Robotic Surgery (TORS), which combines 3D imaging with tiny robotic instruments to remove tumors affecting the oropharynx through the mouth
  • Skull-base surgery which may involve transnasal endoscopy to remove tumors in or around the nose
  • Complex procedures when tumors are in hard-to-reach areas or surrounded by critical structures in the head and neck region.
  • Sophisticated reconstructive surgeries, including the ability to rebuild the tongue, throat, or jaw and restore the voice after larynx surgery

Our head and neck surgeons are dedicated to preserving your quality of life. To do so, they will use state-of-the-art tools and techniques to meticulously protect your ability to swallow, taste, or hear. For example, real-time intraoperative nerve monitoring technology allows them to identify and protect nearby nerves related to daily functions during surgery.

Chemotherapy

Chemotherapy is a powerful medicine given intravenously (through a vein) to destroy cancer cells throughout the body. At MedStar Health, we have medical oncologists who focus solely on treating these types of cancers, making us highly experienced in choosing the right type and dose of drugs at the appropriate time.

Depending on the location and stage of your head and neck tumor, chemotherapy may be used after surgery or in place of surgery alongside radiation therapy for functional preservation. For example, if you have cancer in the larynx, surgery may affect your natural ability to breathe and talk. In this instance, we may want to consider chemotherapy and radiation, which would prevent losing your larynx and preserve your voice.

If your cancer team recommends chemotherapy, they'll work closely with you to minimize and manage any possible side effects.

Learn More About Chemotherapy

Immunotherapy and targeted therapy

Some patients, especially those with recurring head and neck tumors, may benefit from other drug therapies that leverage the body's immune system (immunotherapy) or target genetic markers in tumors (targeted therapy). At times, this may be used alongside chemotherapy. Our head and neck medical oncologists will work with you and your care team to discuss your options, including whether or not you may benefit from an emerging treatment only available through a clinical trial.

Learn More About Immunotherapy

Learn More About Targeted Therapy

Radiation therapy

A patient undergoes treatment in the Proton Center at MedStar Georgetown University Hospital is equipped with state-of-the-art equipment to shrink and eliminate tumors.Radiation therapy uses high-energy waves to kill cancer. A radiation oncologist will be part of the multidisciplinary tumor board that reviews your case to determine if this treatment will be advantageous to treating your cancer and preserving your quality of life. At MedStar Health, our radiation oncologists have exceptional experience in delivering radiation in the most precise manner while limiting the amount of exposure to nearby healthy tissue and critical organs. Our goal is to maximize the effectiveness of radiation on a tumor while limiting potential side effects. To that end, we use the latest advances in radiation therapy, such as proton therapy and other cutting-edge radiation technologies.

Learn More About Radiation Therapy

Looking for expert care?

With multiple locations throughout the region, patients have access to many of the nation’s renowned cancer specialists offering high quality care, second opinions and a chance for better outcomes close to where they live and work. Georgetown Lombardi Comprehensive Cancer Center, one of the nation’s comprehensive cancer centers designated by the National Cancer Institute (NCI), serves as the research engine allowing patients access to clinical trials that often lead to breakthroughs in cancer care.

Our locations

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MedStar Health: Otolaryngology at MedStar Georgetown University Hospital

3800 Reservoir Rd.
1st Fl. Gorman Building
Washington, D.C., 20007

MedStar Health: Otolaryngology at MedStar Washington Hospital Center

106 Irving St., NW
Physicians Office Building
Ste. 2700 North
Washington, DC 20010

Why choose us

At MedStar Health, our goal is to both successfully treat your tumor and also help you to maintain a fulfilling quality of life. Patients choose us for head and neck cancer treatment because:

  • Our doctors and healthcare providers work collaboratively to design the best treatment options personalized to you.

    Your care team involves specialists who focus primarily on diagnosing and treating cancers affecting the head and neck. You'll benefit from collaborative treatment recommendations based on the input of a variety of specialists who consider the best treatments for you, including how to minimize short and long-term side effects. These multidisciplinary experts meet weekly to review each case and may include:

    • Ear, nose, and throat (ENT) doctors
    • ENT reconstructive surgeons
    • Radiation oncologists
    • Medical oncologists
    • Pathologists
    • Radiologists
    • Physical medicine & rehabilitation (PM&R) physicians
    • Speech and language pathologists
    • Occupational and physical therapists
    • Dietitians
    • Social workers
    • And others
  • We offer exceptional expertise in surgery, radiation therapy, and medical oncology.

    With specializations in different fields, our doctors and surgeons are at the forefront of their respective specialties. Our surgeons have unmatched expertise in using minimally invasive strategies and state-of-the-art reconstructive techniques to offer the best possible outcomes for patients with these cancers. In addition, we have medical oncologists dedicated to improving cure rates and quality of life for those with head and neck cancers through personalized therapies that target specific tumor profiles. Our renowned radiation oncologists are also exceptionally skilled at using advanced technology to deliver the right radiation dose at the right time, while minimizing long-term toxicity to nearby delicate structures.

  • Studies show that cancer outcomes are better at high volume centers like ours.

    Multiple studies highlight the impact that a cancer team's experience has on patient results, such as long-term side effects and survival rates. Because we see a high number of patients with these cancers every year, our deep experience has prepared us to care for patients with all types and stages of these diseases. Our specialized, comprehensive approach to treatment ensures patients have access to the latest head and neck treatments available today, including clinical trials when appropriate.

Awards and recognition

Recipient of an Accreditation with Commendation, the highest level of approval, from the American College of Surgeons’ Commission on Cancer (CoC)

Numerous surgeons, medical oncologists, and surgical oncologists recognized as "Top Doctors" by both Baltimore Magazine and the Washingtonian

Magnet® designation from the American Nurses Credentialing Center (ANCC)

Clinical trials and research

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Clinical trials

We're proud to offer a wide range of head cancer clinical trials, including those that may be hard to find elsewhere. Through clinical trials, our physicians are leading and participating in research studies that test safer, more effective treatment approaches and strategies for protecting a patient's quality of life during and after treatment for head and neck tumors.

Learn More

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Research

Our head and neck doctors are working relentlessly to find new and improved treatment options for people with these cancers. Through our research engine and the only National Cancer Institute-designated comprehensive cancer center in Washington, D.C., Georgetown Lombardi Comprehensive Cancer Center, patients throughout the MedStar Health system gain access to clinical trials that may offer promising treatment options outside of the standard of care.

Learn More

Support services

We emphasize prioritizing your quality of life from the earliest stages of treatment, often involving other specialists in your care shortly after diagnosis. As a patient, you'll have access to a variety of programs and services that will help you manage possible challenges, including nutritional guidance, rehabilitative therapy, support groups, palliative care, psychosocial support, and more.

Learn More About Cancer Support Services

Genetic counseling

Head cancer is rarely related to inherited conditions. However, in certain instances, patients and their loved ones may benefit from meeting with one of our board-certified genetic counselors. These experts can help patients and family members understand and manage any potential genetic risks associated with certain types of cancers through genetic testing, early screening, and other strategies.

Learn More About Genetic Counseling

Personalized rehabilitation

Treatment for these cancers can affect your breathing, eating, swallowing, and speech, which is why we work proactively to involve speech and language therapists and other rehabilitation experts early in your care. Through personalized therapy, we can help to prevent problems when possible and limit the impact of treatment on your quality of life for as long as necessary.

Learn More About Cancer Rehabilitation

Survivorship

Follow-up care is especially important for head and neck cancer survivors. Your dedicated care team is here to address any concerns or challenges you encounter as you work towards good health. Our survivorship program offers a full range of services, from frequent screenings and guidance for healthy lifestyle changes to counseling and emotional support.

Learn More About the Cancer Survivorship Program