Head and Neck Cancer


By: Helen Goldberg, MD

Head and neck cancers usually begin in the cells that line the moist surfaces of the nose, mouth, and throat. This includes the tongue, sinuses, and larynx (voice box) to name a few.
They can also be found in salivary glands. As there are a number of similarities in treatment and risk factors, these cancers are often put into one category.

Alcohol and tobacco use (including chewing tobacco) are the two major risk factors and this is significantly additive if you use both. At least 75% of head and neck cancers are caused by tobacco and alcohol. In the United States, we are seeing an increase in cancers of the tonsils and base of the tongue. This is because of infection with one of the HPV (human papillomavirus) is associated with oral cancers Of note- HPV is also associated with cervical, anal, vaginal and penile cancers. HPV is transmitted by direct sexual contact. It takes between 10 and 30 years from the time of infection to development of cancer. In terms of HPV infection, it is recommended to begin vaccination against HPV before becoming sexually active. There are several vaccines available.

Symptoms of head and neck cancers include a lump or sore in the mouth that does not go away. Persistent hoarseness or change in voice or difficulty swallowing may be seen. Other symptoms include bleeding, pain, numbness, and drainage. For those who wear dentures, it is very important to seek medical attention for areas of irritation that don't heal.

It is important to have thorough regular dental exams.

Head and neck cancers account for around 5% of all cancers in the USA.

They are treated based on their location and how advanced the cancer is. Treatment may consist of surgery, radiation, and chemotherapy. With treatment, a number of these cancers may be cured. The treatment is often quite intense but with good supportive care and attention to nutrition, patients can do well.

In the past, many patients with cancer of the larynx would lose the ability to speak. Fortunately, with advances in chemotherapy, surgery, and radiation, a number of patients are able to preserve their function of the larynx. Rehabilitation therapy is very important for patients with head and neck cancers. For survivors of head and neck cancers, it is crucial to change any high-risk behaviors such as cessation of alcohol and tobacco. People with cancers of the head and neck are at risk for other cancers such as lung cancer and need careful follow-up.

DCMH offers Behavioral Health Specialists at DCMH Family Medicine, Internal Medicine Associates and the West Elk Hotchkiss Clinic to assist when habits, behaviors, stress, worry or emotional concerns about your physical health or other life problems interfere with your daily life and/or overall health.