Head and Neck Cancer

Head and neck cancer refers to any cancers arising in the head and neck region. Cancers can arise from any structure in this area and are categorised according to the structure of origin. These include:

• Mouth/oral cavity - tongue, cheek, lip, palate
• Oropharynx - tonsil, soft palate, base of tongue
• Nasopharynx and nasal cavity
• Voice box/Larynx
• Hypopharynx/upper oesophagus (throat)
• Salivary glands
• Thyroid
• Skin of head and neck

Symptoms of these cancers depend on which structures are affected. Red flag head and neck cancer symptoms include persistent hoarseness, difficult swallowing, bleeding in mouth/throat, ear pain, ulceration, neck lump, etc.

In the outpatient clinic assessment for a head and neck cancer involves a clinical history to enquire about symptoms and risk factors. Physical examination includes inspection of all skin and mucosal surfaces in the head and neck, and palpation of the salivary glands and neck for masses. Flexible nasendoscopy/laryngoscopy is commonly performed to inspect the nasal cavity, pharynx and larynx.

Further management depends on findings in the outpatient clinic and is patient specific.  Neck, thyroid and salivary gland lumps are often further assessed by ultrasound scanning with or without a biopsy. If an abnormality is found on the skin or mucosa a biopsy is usually performed to obtain a diagnosis.