Key Questions

Below are some key questions and answers that may help people affected by head and neck cancer understand their disease, and their care and treatment options:

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How common are head and neck cancers?

About 4400 people in Australia (approximately 3170 men and 1230 women) are diagnosed with a head and neck cancer each year.4 This includes about 1370 people diagnosed with cancer in the mouth and tongue; 1000 with lip cancer; 890 with pharyngeal cancer; 590 with laryngeal cancer; 320 with salivary gland cancer; and 170 with nasal or paranasal sinus cancer.

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What are the risk factors?

Head and neck cancers are associated with a number of major risk factors. Two of the main risk factors are alcohol and tobacco, and the combined effect of drinking and smoking is significantly greater than the risk of just drinking or just smoking. Research shows that the risk is 35 times higher for people who are both heavy smokers and heavy drinkers.

The main risk factors include:

• drinking alcohol – compared to non-drinkers, drinkers have about 6 times the risk
• smoking tobacco (including cigarettes, cigars and pipes) – compared to nonsmokers, smokers have about 7 times the risk
• viruses – the human papillomavirus (HPV), especially HPV 16, has been linked to cancers of the oropharynx, and may play a role in other head and neck cancers. Exposure to the Epstein-Barr virus (EBV) may also be linked to the development of some head and neck cancers.

Other risk factors include:

• older age – head and neck cancers are more common in people aged 40 years and older
• being male – men are about three times more likely than women to develop head and neck cancer
• family history – people with a parent, brother, sister or child with head and neck cancer have double the risk of developing some types of head and neck cancer
• being from southern China or South-East Asia – people from some cultural backgrounds may be more likely to develop some types of head and neck cancers. This is because of cultural practices such as chewing tobacco or eating salty fish (salty fish is high in nitrates that react with protein to form chemicals that damage DNA)
• chemical exposure at work – breathing in asbestos fibres, wood dust, dry-cleaning solvents or certain types of paint or chemicals is associated with an increased risk of some types of head and neck cancer
• low immunity – people with low immunity conditions, such as those who have had a kidney transplant, have a higher risk of developing oral and oropharyngeal cancers
• sun exposure – ultraviolet (UV) radiation may cause skin cancer on the lip
• areca nut, betel nut, pan or gutka – chewing or smoking these products may cause oral cancer.

Eating adequate amounts of fruit and vegetables may help decrease the risk of oral and oropharyngeal cancers. Talk to your doctor if you are worried about any of these risk factors.

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What are the symptoms?

There are many possible symptoms of head and neck cancer. However, these symptoms can also occur with other illnesses, so they don’t necessarily mean you have cancer – only tests can confirm the diagnosis. If you are concerned about any of these symptoms, make an appointment with your general practitioner (GP) without delay.

Mouth (oral) cancer

• mouth pain or pain when swallowing
• a persistent sore or swelling in the mouth
• unusual bleeding or numbness in the mouth
• red or white patches on the gums, tongue or mouth
• bad breath
• changes in speech or difficulty pronouncing words
• difficulty chewing or swallowing food, difficulty moving the tongue or limited chewing
• weight loss
• a lump in the neck
• loose teeth, or dentures that no longer fit
• ear ache, or ringing in the ears

Pharyngeal cancer

• throat pain or difficulty swallowing
• a persistent sore throat or cough
• coughing up bloody phlegm
• bad breath
• weight loss
• voice changes or hoarseness
• dull pain around the breastbone
• a lump in the neck
• pain in the ear or frequent ear infections
• feeling that your air supply is blocked
• numbness of the face
• nasal congestion
• hearing loss
• headaches

Laryngeal cancer

• swelling or a lump in the neck or throat
• a persistent sore throat
• a persistent change in the sound of your voice, including hoarseness
• difficulty swallowing or pain when swallowing
• constant coughing
• difficulty breathing
• weight loss

Salivary gland cancer

• swelling or a lump near the ear, jaw, lip, or inside the mouth
• different appearance on each side of the face or neck
• difficulty swallowing or opening mouth widely
• drooping, numbness or muscle weakness on one side of the face (palsy)

Nasal or paranasal sinus cancer

• decreased sense of smell
• a persistent blocked nose, particularly in one nostril
• frequent nosebleeds
• excess mucus in the throat or back of the nose
• frequent headaches or sinus pressure
• difficulty swallowing
• loose or painful upper teeth
• a lump on/in the face, nose or mouth
• numbness of the face, upper lip, or within the mouth or upper teeth
• pressure or pain in the earsa bulging or watery eye
• a bulging or watery eye
• double vision
• complete or partial loss of eyesight

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