Head and Neck Cancers – Causes, Signs and symptoms

Head Neck Cancers

Reviewed By:
Carol Kornmehl, MD, F.A.C.R.O
Martin E. Liebling, M.D., FACP
Mark Oren, M.D., FACP

Summary

Head and neck cancers occur in various tissues and cavities in the head and neck region. Most head and neck cancers begin in the squamous or scale-like cells that line the mucous membranes in the head and neck. These surfaces include the lining of the nose, mouth and throat.

Head and neck cancers comprise about 3 to 5 percent of all cancers that occur in the United States and are more common in men, according to the National Cancer Institute. They are identified by the area in which they begin. For example, if the cancer begins in the mouth, it is diagnosedas oral cancer, and if it begins in the larynx, it is identified as laryngeal cancer.Head and neck cancer can be located in the:

  • Oral cavity (mouth)
  • Nose and sinuses
  • Pharynx (tube that is part of the digestive tract, running behind the nasal cavities, mouth and larynx)
  • Larynx (voice box). Cartilage in the throat that houses the vocal cords; rests below the pharynx and above the trachea (windpipe)
  • Lymph nodes in the neck, if the cancer has spread
  • Salivary glands

Head and neck cancers are strongly linked to tobacco and alcohol use, although there are other risk factors as well. The symptoms vary with the location and type of cancer and often go undetected in early cancer. The most common symptoms associated with head and neck cancer include:

  • Lump or sore that does not heal  (e.g., in the mouth or throat)
  • Sore throat that does not go away
  • White or red patch that remains
  • Problems swallowing
  • Change in the voice (hoarse or raspy)

The treatment for head and neck cancers depends on the type of cancer, the location, the stage of cancer and the patient’s age and general health. Treatment may include surgery, radiation and chemotherapy.

When detected early, many head and neck cancers can be cured. Knowing the signs and symptoms, along with early diagnosis and treatment, can improve cure rates. Patients who have had head and neck cancers have an increased risk of developing cancer in the same or surrounding area later in life. Eliminating or reducing the risk factors, especially tobacco and alcohol use, decreases the chances of developing a second cancer.

About head and neck cancer

Cancer develops when there is a growth of abnormal, malignant cells in part of the body. When these abnormal cells grow out of control in the head and neck region, it is diagnosed as head and neck cancer.

The areas of the head and neck have some of the largest surfaces where the inside of the body is exposed to the outside environment, providing access for breathing and eating. As a result, these areas have mucosal surfaces that line body cavities and are designed to move substances smoothly while protecting body tissues from foreign substances. In the head and neck area, these cavities include the mouth, nose, throat and sinuses. Most head and neck cancers begin in the squamous cells that line these mucosal surfaces. 

Normal mucosal cells look like flat, platelike scales (squamous) under the microscope. Because head and neck cancer usually starts in these cells, it is often called squamous cell carcinoma. A small percentage of head and neck cancers develop in other types of cells. For example, adenocarcinomas start in glandular cells, such as those in the salivary glands, rather than squamous cells.

In addition to the type of cell affected by the cancer, head and neck cancer is identified by the location in which it originates. Head and neck cancers can be located in the following areas:

  • Oral cavity
  • Salivary glands
  • Nasal and sinus cavities
  • Pharynx
  • Larynx
  • Lymph nodes in the upper part of the neck (if the cancer has spread)

Some cancers are not grouped with head and neck cancers even though they are in this area of the body. They include:

  • Brain cancer
  • Eye cancer
  • Thyroid cancer
  • Esophageal cancer
  • Cancers of the scalp, skin, muscles and bones of the head and neck

According the National Cancer Institute(NCI), head and neck cancers account for approximately 3 to 5 percent of all the cancers in the United States. The American Cancer Society (ACS) estimated that more than 45,000 Americans will develop some form of head and neck cancer in 2007. Of that number, more than 34,000 cases will be oral or oropharyngeal cancer, while about 11,000 will be laryngeal cancer. The ACS estimates that more than 7,500 deaths from oral and pharyngeal cancer will occur in 2007.

The prognosis of head and neck cancers varies because they vary greatly in their stages. Staging determines whether a cancer is contained in the place where it first developed or has spread (and, if so, how far it has spread). It also indicates the size of the tumor and other information vital to diagnosis, treatment and prognosis. Head and neck cancers have a number of different ways they are staged based on the type of cancer cells involved, the area affected by cancer and other factors. Local cancers are confined to the area of origin. Regional cancer has extended to surrounding organs and tissues and may involve regional Lymph nodes. Metastatic cancer has spread to distant parts of the body. 

For oral and oropharyngeal cancers, the five-year survival rate for all stages is 60 percent. For laryngeal cancers, the five-year survival rates range from 36 to 83 percent, depending on the stage.

Types and differences of head and neck cancer

The different types of head and neck cancer are primarily based on the site of origin. The most common types of head and neck cancer are classified into the following groups.

  • Oral cavity. This area includes the lips, front and middle of the tongue, gums, lining of the cheeks, floor of the mouth, the hard palate and the area behind the wisdom teeth.
  • Salivary glands. The major salivary glands are located on the floor of the mouth and near the jawbone. These glands produce saliva, the fluid that keeps the mouth and throat moist. Saliva is necessary to swallow and digest food. These cancers are often adenocarcinomas and not squamous cell cancer.
  • Nasal cavity and sinuses. The nasal cavity is the space inside the nose. The sinuses are the small hollow spaces in the bones of the head surrounding the nose.
  • Pharynx. The pharynx is a tube that is runs between the back of the nose and the esophagus, the tube that goes to the stomach. The pharynx is divided into three parts:
    • Nasopharynx. The upper part of the pharynx that is located behind the nose.
    • Oropharynx. The middle part of the pharynx that includes the soft palate (back upper roof of the mouth), the base of the tongue and the tonsils.
    • Hypopharynx. The lower part of the pharynx that is closest to the esophagus.
  • Larynx. The larynx is commonly called the voice box. It is largely composed of cartilage and is located below the pharynx in the neck. The larynx is divided into three regions:
    • Supraglottis. This upper section contains cartilage and the epiglottis, a piece of tissue that moves to protect the airway from food.
    • Glottis. This middle section contains the vocal cords, which are used to produce the voice.
    • Subglottis. This lower section is the cartilage that connects to the windpipe (trachea).
  • Lymph nodes in the upper neck region. In some instances, cancer is found in these lymph nodes with no obvious cancer in other parts of the head and neck. This cancer is called metastatic cancer with unknown primary.

Risk factors and causes of head & neck cancer

The exact causes of the different types of head and neck cancer are unclear. The cancer appears to be the result of damage to the DNA of the cells in the head and neck region, which causes them to become malignant and rapidly reproduce as cancer cells.

However, a number of risk factors are linked to the growth of cancerous cells. Tobacco use has the strongest link to head and neck cancer. In addition to cigarettes, tobacco use includes cigar and pipe smoking and smokeless tobacco (e.g., chewing tobacco, snuff).

Research has shown that tobacco causes damage to cells in the lining of the mouth, pharynx and larynx. Cells must grow more rapidly to repair this damage. Many of the chemicals found in tobacco cause damage to DNA, which tells the cells how to grow and repair the damage. In essence, tobacco both damages cells and inhibits the ability to grow new ones.

The National Institutes of Health (NIH) estimates that approximately 85 percent of head and neck cancers are linked to some form of tobacco use. Smokers are 6 times more likely to develop oral or upper throat cancers than nonsmokers. The risk of developing head and neck cancers increases with the amount of tobacco smoked, chewed or sucked and the duration of use.

Secondhand smoke, also known as environmental tobacco smoke (ETS), may contribute to the development of head and neck cancers. When nonsmokers are exposed to secondhand smoke, they can absorb nicotine and other chemicals similar to the way smokers do. The greater the exposure to secondhand smoker, the greater the level of compounds in the body.  There are no specific statistics as to the risk of head and neck cancer due to secondhand smoke exposure.

Alcohol use has the second strongest link to head and neck cancers. Drinking alcohol significantly increases the chances of developing oral, oropharyngeal and laryngeal cancers. The American Cancer Society (ACS) estimates that 75 to 80 percent of all patients with oral cancer drink excessive amounts of alcohol. Head and neck cancers are about 6 times more common in drinkers than nondrinkers.

Scientists are unsure if alcohol directly damages the DNA, but they have shown that alcohol increases the penetration of many DNA-damaging chemicals into the cells. This is one reason why tobacco and alcohol use together cause such a large amount of DNA damage.

The risk factors for head and neck cancer change according to the amount, types, and length of use for both alcohol and tobacco use. In addition, the combination of smoking and drinking also increases the risk.

Other risk factors are also associated with developing head and neck cancers. These include:

  • Age. The likelihood of developing head and neck cancer increases with age. Approximately 50 percent of all the cases are over the age of 65.
  • Gender. Head and neck cancers are twice as common in men as women. The highest occurrence is in men over age 50. This statistic may be related to the higher incidence of alcohol and tobacco use by men.
  • Sunlight. Prolonged exposure to sunlight can damage the cells on the lips. The ACS estimates that more than 30 percent of people with cancer of the lip have occupations associated with outdoor exposure.
  • Mouth irritation. Poorly fitting dentures that cause long-term irritation of the mouth’s lining is thought to be a risk factor for oral cancer. Poorly fitting dentures may allow causative cancer agents, such as alcohol and tobacco particles, to be trapped under them. However, many research studies have not shown any difference in the occurrence of oral cancer between denture wearers and non-denture wearers.
  • Poor nutrition. A diet that is low in fruits and vegetables is associated with an increased risk of developing cancer in the oral cavity and oropharynx. Without fruits and vegetables, the cells are deprived of the nutrients that help keep them healthy and antioxidants that are protective.
  • Human papillomavirus (HPV) infection. Papillomaviruses are a large group of related viruses (e.g., herpes), some of which have a role in causing cancer. HPV is one of the most common causes of sexually transmitted diseases. One type of HPV (HPV-16) is thought to be linked to oral and oropharyngeal cancers. The links have been inconclusive at times, but a recent study made a strong link between HPV-16 infection and oropharyngeal cancer.
  • Immune system suppression. For reasons that are not clear, individuals who are taking immunosuppressive drugsare more at risk for oral and oropharyngeal cancers. These drugs are taken to treat immune system diseases or to prevent the rejection of a transplanted organ.
  • Industrial exposures. Inhalation of certain industrial elements, such as wood and nickel dust, may contribute to the development of head and neck cancers. It is most strongly linked to cancer of the sinuses, nasal cavity and pharynx. Exposure to airborne particles of asbestos is linked to cancer of the larynx.
  • Radiation. Radiation to the head and neck can increase the risk of head and neck cancer, particularly for the salivary glands. The radiation exposure can come from diagnostic x-rays or radiation therapy for medical conditions, such as an earlier case of cancer.
  • Epstein-Barr virus. This common virus is present in most of the cancer cells associated with nasopharyngeal cancer, an uncommon cancer in the United States. The relationship between the virus and the cancer is unclear. The virus is extremely common, but the cancer is not. 

Although there are no hereditary factors clearly identified with most forms of head and neck cancers, a recent study has identified genetic alterations in the tissues around certain head and neck tumors. These tissues were associated with the aggressiveness of the tumors.

Signs and symptoms of head and neck cancer

Signs and symptoms of head and neck cancer vary depending on the location of the cancer. The onset and severity of the symptoms also vary with the cancer site. The majority of these cancer symptoms appear gradually over time as the cancer cells grow at the site of origin and spread.  Many oral and throat cancers are not detected until the cancer becomes more advanced. When detected early, head and neck cancers can be successfully treated.

The most common symptoms of several head and neck cancer sites include:

  • A lump or sore that does not heal
  • Sore throat or pain in the mouth that does not go away
  • Difficulty swallowing
  • Change in voice quality (usually hoarseness)

Symptoms that pertain to specific site areas include:

  • Oral cavity (mouth)
    • White or red patch on gums, tongue or lining of the mouth
    • Swelling of the jaw that causes poor fitting dentures
    • Unusual bleeding or pain in the mouth
    • Loosening of teeth or pain around the teeth and jaw
    • Persistent bad breath
    • Numbness or pain in the tongue or jaw

  • Nasal cavity and sinuses
    • Sinuses that are blocked and do not clear
    • Chronic sinus infections that do not respond to antibiotics
    • Bleeding through the nose
    • Frequent headaches
    • Swelling or trouble with the eyes
    • Pain in the upper teeth or denture problems

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

  • Pharynx
    • Ear pain or ringing in the ears
    • Trouble breathing or speaking
    • Difficulty hearing
    • Swallowing problems due to tissue growing across the esophagus

  • Larynx
    • Pain or difficulty swallowing
    • Voice changes (hoarseness, scratchiness)
    • Ear pain
    • Lump or mass in the throat

  • Metastatic squamous neck cancer
    • Pain in the throat or neck that does not go away
    • Enlarged lymph nodes in the neck that can be seen or felt

Many of these symptoms are not specific to cancer and can indicate a less serious condition. It is important for individuals to see a physician or dentist if any of these symptoms last more than two weeks.

Diagnosis methods for head and neck cancer

A physician can determine the cause of the symptoms through a variety of methods. First, the physician will obtain a complete medical history, including any family history of cancer, symptoms, risk factors and other related medical information.

Following the history, the physician will conduct a complete physical examination with emphasis on the areas with the symptoms. A thorough examination of the head and neck region will be conducted, searching for any signs of abnormalities in the face and neck region.

Additional tests may be ordered by the physician to clearly diagnose the condition. These tests include:

  • Endoscopy. A thin lighted tube called an endoscope is used to examine areas inside the body, in this case, the mouth, nasal cavities or throat. A laryngoscope is used to view the larynx and an esophagoscope is used to view the esophagus.

  • Laboratory tests. Blood tests are used to gain information about the general physical condition of an individual. The tests may show malnutrition, low red blood cell count (anemia) or chemical abnormalities suggesting organ involvement.

  • X-rays. Images taken of the head and neck on film that allow a physician to view abnormalities such as growths and tumors.

  • CAT scan.  A series of images of inside the head and neck created by a scanner and computer. These pictures allow a physician to view a cross-sectional picture of the region of concern. The test may be done with or without dye contrast material. CAT scans can help determine the size, shape and position of a tumor as well as enlarged lymph nodes.
  • Magnetic resonance imaging (MRI). A machine that uses a powerful magnet, radio waves and a computer to create detailed images of areas inside the head and neck. These pictures allow a physician to view the region in a three-dimensional view for any abnormalities.

  • PET scan. A special radioactive sugar substance is injected into the vein and the body is viewed by a scanner. Cancer cells absorb the substance and the cancer area appears as a dark area on a screen. Recent research has shown that combined use of PET scans with CAT scans can improve detection of head and neck cancers and help determine the cancer’s stage.

  • Barium swallow. This test is a series of x-rays taken after the patient has swallowed a liquid containing the chemical barium. The test allows the physician to view the structures and functioning of the mouth, throat and esophagus. A modified version of this test can be used to diagnose any swallowing difficulties.

  • Biopsy. A removal of tissue from the concerned area. The tissue is examined under a microscope by a pathologist for evidence of cancer cells. A biopsy is the only definitive way to diagnose cancer.

If the individual is diagnosed with cancer, the physician will need to learn the stage of the cancer. This stage provides information as to the extent of the damage and whether the cancer has spread to other areas of the body. Staging for head and neck cancers follows the American Joint Committee on Cancer for criteria.  Staging is different for each of the type of head and neck cancer and may involve additional biopsies or scans.

Treatment options for head and neck cancer

Although the treatment will differ for the specific type of head and neck cancer, a team approach is best for all cancers.  A cancer care team, which includes specialized healthcare professionals, can help plan and implement treatment for the disease. Some of the specialists who may be added to the team for head and neck cancers include:

  • Otolaryngologist
  • Oral surgeon
  • Dentist
  • Prosthodontist
  • Plastic surgeon
  • Speech language pathologist
  • Dietitian

Treatment for head and neck cancers varies depending on a number of factors. Some of these considerations are:

  • Exact location of the tumor
  • Stage of the cancer
  • Person’s ageand general health
  • General health of the patient
  • Ability and motivation to follow a treatment plan
  • Family and peer support
  • Complicating factors

A treatment plan will be established by the patient and healthcare professionals. It is important for patients to discuss their treatment plans with the physicians and carefully consider all of the options.

Although treatment will vary for different head and neck cancers, treatment options may include:

  • Surgery. The type and extent of surgery will depend on the size and location of the tumor. A surgeon may remove the cancer and some of the surrounding healthy tissue. In some cases, the surgeon may have to remove bone tissue from the jaw or roof of the mouth. Lymph nodes in the neck may be removed if the physician suspects the cancer has spread beyond the area.

    Depending on the type of surgery, there may be a number of changes in the person’s appearance and function. Some of the changes may be permanent and some may be temporary. Complications often resulting from head and neck surgery include:

    • Changed appearance of face and neck (e.g., temporary swelling, permanent facial structure changes)
    • Weak or stiff neck shoulder and neck muscles
    • Difficulty chewing and swallowing
    • Numbness in face, throat or neck
    • Loss of voice (if vocal cords removed) or change of voice
    • Breathing changes

  • Radiation therapy. This treatment uses high powered x-rays to kill cancer cells. Radiation may come from machines outside of the body (external radiation therapy). Radioactive materials also may be placed directly into or near the cancer cells (internal radiation therapy). Radiation may be used alone to treat small tumors or combined with chemotherapy to treat large tumors. It also may be used along with surgery to kill any cancer cells that cannot be removed during surgery.

    Radiation is effective in killing cancer cells but also causes some complications. Some of the common side effects from radiation include redness, irritation, dry mouth, difficulty in chewing or swallowing and changes to the jaw or skin. Patients should report the side effects to their healthcare team because there are several ways to treat or minimize some of these side effects.

  • Chemotherapy. These anti-cancer drugs are used to kill cancer cells throughout the body. These drugs may be taken orally or intravenously. The type of drugs and schedule of treatment depend on the type and location of the cancer. Chemotherapy may be used in combination with radiation therapy and/or surgery.

  • Targeted therapy. The squamous cells usually affected by these cancers commonly have too many epidermal growth factor receptor (EGFR) cells, which may contribute to the division of cancer cells. New therapies that target these areas have been approved for some head and neck cancers. Targeted therapies such as monoclonal antibodies and tyrosine kinase inhibitors can affect the substances on the EGFR cells that contribute to tumor growth.

Treatment also may include reconstructive surgery and rehabilitation for head and neck cancer surgeries. The goal of reconstructive surgery is to improve the patient’s appearance and ability to function, particularly with chewing, swallowing, breathing and speaking. Depending on the extent of cancer surgery, surgical reconstruction may include:

  • Skin, tissue or bone grafts from other parts of the body to rebuild the jaw, mouth or throat.

  • Implant of a dental prosthesis to replace a part of the jaw.

  • Tracheostomy (hole through the throat into the airway) to help the patient breathe more easily.

  • Gastrostomy (hole in the abdomen into the stomach) in order to receive nutrition directly into the stomach through a feeding tube. This tube may be removed in the future if the patient’s condition improves.

Rehabilitation services can help a patient adjust to changes from the cancer surgery. The following professionals can help the cancer patient specific problems:

  • Dietitian. Provides information for nutritional issues.

  • Speech pathologist. Provides therapy for swallowing problems (dysphagia) and speech difficulties. If the vocal cords have been removed in surgery, the patient must learn a new method to orally communicate. The speech pathologist can teach the patient to speak by forcing air through the esophagus (esophageal speech) or use artificial devices.

  • Physical therapist. Aids the patient in muscle strengthening and flexibility.

  • Occupational therapist. Helps the patient in making adjustments for completing everyday tasks, such as feeding, bathing and dressing.

Treatment for head and neck cancer is a comprehensive and challenging task. In addition to the physical changes, the patient may be experiencing emotional difficulties. It is important that individuals with head and neck cancer use resources to help themselves. Some of the strategies for dealing with head and neck cancer include:

  • Education. Learn as much as possible about the cancer. With a strong knowledge base, people will know what to expect and will be able to take an active role in their treatment plan.

  • Support system.  Maintain a strong support system of family and friends who can help with problems, issues and anxieties. In addition, by joining a formal support group, an individual will be able to share problems and questions with individuals sharing the same difficulties. Individual psychological counseling is strongly recommended.

  • Goals. Set reasonable goals for the cancer condition. Individuals should examine their own situation and determine what can be accomplished in the future.

  • Staying active. Continue active lifestyle as much as possible. A diagnosis of cancer does not mean an individual must completely change lifestyle habits. Staying involved often gives a cancer patient a better outlook in treatment.

Prevention methods for head and neck cancer

The ways to prevent head and neck cancers vary according to the location and type of cancer.  In general, eliminating or reducing the risk factors is the best way to prevent the development or recurrence of head and neck cancer.

Tobacco and alcohol are the most important risk factors for head and neck cancer. An individual can greatly reduce the risk by not smoking and limiting alcohol intake. In addition, people who have been diagnosed and treated for head and neck cancer have an increased risk for developing a new cancer. The most common sites for the new cancer are in the head and neck, esophagus or lungs. For people who smoke and drink, the risk is even higher. Studies by the National Institutes of Health (NIH) have shown that individuals who continue to smoke and/or drink increase their chances of developing a second cancer for up to 20 years after the original cancer.

Other steps that can be taken to help prevent head and neck cancer include:

  • Well-fitting dentures and good oral hygiene. If dentures are worn, be sure they fit properly. Gaps can allow particles of food and tobacco to be trapped against the gums. Dentures should be cleaned and rinsed regularly. If dentures are not worn, care should be taken to maintain clean teeth and healthy gums.
  • Limiting sun exposure. Sunlight damages the tissues of the lips and increases the risk of oral cancer. Care should be taken to wear sunscreen and protect the face and lips from strong sun exposure.
  • Periodic check of tongue and mouth. Individuals, especially those who smoke and drink, should regularly check the tissues of their tongue and mouth. They should look for changes in color, bumps, tender spots or lumps. Patients should ask their dentists to examine their mouths closely during regular dental visits. If any changes are noted, the individual should schedule an extra visit with their dentist. Oral and throat cancer can be successfully treated but success depends on early detection.
  • To prevent a recurrence of the cancer following treatment, regular checkups are very important. The type of medical checkups depends on the type of cancer and treatment.
  • Vaccines. In 2006, a vaccine was approved for girls and young women to prevent human papillomavirus (HPV), which can cause cervical cancer and is also associated with some head and neck cancers. Reaserch continues into whether or not this vaccine might benefit people at risk for head and neck cancers. Currently, the vaccine is approved only for young women up until age 26 and may be less effective in patients who have already been exposed to HPV.

Individuals who have had some form of head and neck cancer must closely monitor themselves for any changes in their general health. If these individuals are concerned about any symptoms, they should consult their physician for an examination.

Ongoing research on head and neck cancer

Important research is being conducted in the area of head and neck cancer. Scientists continue to study these cancers for information about causes, treatment and prevention of the disease.

The primary focus of research in head and neck cancer involves the following areas:

  • DNA. Scientists are researching which DNA changes are responsible for causing cells in the mouth and throat to become cancerous. They have discovered a mutation of the p53 gene in oral cancer cells. Some tests to detect these p53 mutations may allow very early detection of oral and oropharyngeal tumors. The tests also may be used to determine which tumors are most likely to respond to surgery, chemotherapy or radiation therapy.
  • Gene therapy. Clinical studies are being conducted to determine if abnormal tumor suppressor genes, such as the p53 gene, of oral cancer cells can be replaced with normal genes. Another type of gene therapy being studied adds new genes to the cancer cells to make them more susceptible to being destroyed by certain drugs. Gene therapy discoveries appear to be promising in the treatment and prevention of head and neck cancers.
  • Tumor growth and targeted therapy. Some cancer cells grow especially fast because of a hormone-like substances called growth factors. Epidermal growth factor (EGF) has been linked to head and neck cancers. New drugs are being used in clinical trials that target and block EGF to prevent cancer cells from growing and dividing. These drugs show promise for blocking growth factors and shrinking oral cancers. Research continues into the use of these drugs, which may perform best when combined with another form of treatment, such as chemotherapy or radiation.
  • New chemotherapy methods. Researchers continue to develop new chemotherapy drugs to treat advanced head and neck cancers. In addition to the standard administration of chemotherapy drugs through the veins, researchers are investigating the effectiveness of injecting certain drugs directly into the tumor. Recent changes in the drug solutions have shown a renewed effectiveness with this approach.
  • New radiation therapy methods. Clinical trials have focused on testing the effectiveness of delivering radiation on a twice-a-day schedule for oropharyngeal cancer. Higher cure rates have been reported for several of the studies and clinical trials are continuing to confirm these findings.
  • Vaccines. Vaccines are being studied as a way to treat oral and neck cancer. The vaccines help the immune system recognize and attack the cancer cells. Since some of the head and neck cancers contain DNA from human viruses, vaccines from these viruses are being developed and studied as a possible treatment.

Questions for your doctor

Preparing questions in advance can help patients have more meaningful discussions with their physicians about their condition. Patients may wish to ask their doctors the following questions related to head and neck cancer:

  1. What type of head and neck cancer do I have?
  2. What stage is my cancer?
  3. Has it spread from this site?
  4. Which treatment options are available for my cancer?
  5. Will the treatment affect my ability to eat and drink?
  6. How effective is the treatment for this type of cancer?
  7. How long will this treatment last?
  8. Do I need to make any lifestyle changes because of this cancer?
  9. If I get this cancer treated now, can it recur?
  10. Does this cancer or its treatment put me at risk for any other form of cancer?
  11. Are there any new treatments in development to treat this type of cancer?
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