Head and Neck Cancers
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Head and Neck Cancers
What are head and neck cancers?
Head and neck cancer is a general term for a range of cancers that start in the head and neck region. About 9 out of 10 head and neck cancers start in the moist lining of the mouth, nose or throat. The lining is called the squamous epithelium, and these cancers are called mucosal squamous cell carcinomas (SCCs). Some head and neck cancers start in glandular cells, and many of these cancers are called adenocarcinomas. SCCs and adenocarcinomas can also occur in other parts of the body.
Recently, skin cancers (cutaneous carcinoma) that start in the head and neck area have been classified as a type of head and neck cancer. To learn more about these, see our Understanding Skin Cancer booklet.
Other cancers in the head and neck area
Cancer can start in the brain, eye, oesophagus, trachea and thyroid, or in bone or muscle of the head and neck. These cancers are not usually classified as head and neck cancers.
The first sign of cancer is often a lump under the skin of the neck or cheek. This can happen when cancer has spread to a lymph node. Your doctors will run tests to work out what type of cancer it is. It might be a head and neck cancer or it might be a cancer that has spread from elsewhere in the body (e.g. stomach cancer can spread to a lymph node in the neck and will still be considered stomach cancer).
Occasionally, tests show that a cancer in the head and neck started in another part of the body, but it is unclear where it started. This is called cancer of unknown primary (CUP).
Cancer that starts in the mouth is known as oral cancer. The mouth is made up of the lips and the oral cavity. The oral cavity includes the:
- lining of the cheeks and lips
- front two-thirds of the tongue (oral or mobile tongue)
- floor of the mouth under the tongue
- bony roof of the mouth (hard palate)
- small area behind the wisdom teeth (retromolar trigone).
The area at the back of the mouth is called the oropharnyx. It includes the base of the tongue, the tonsils, the uvula and the soft palate, as well as the middle section of the throat. Cancer of the oropharynx is known as oropharyngeal cancer.
The throat, also called the pharynx, is a hollow tube that starts behind the nose and leads to the food pipe (oesophagus) and the windpipe (trachea). The pharynx has three main parts:
- nasopharynx – the upper part behind the nose and above the soft palate; cancer starting in this area is called nasopharyngeal cancer
- oropharynx – the middle part, the area from the soft palate and base of the tongue to the back of the mouth, including the tonsils; cancer starting in this area is called oropharyngeal cancer
- hypopharynx – the lower part, around the voice box (larynx); cancer starting in this area is called hypopharyngeal cancer.
Cancers in the three parts of the pharynx are treated differently.
The voice box, also called the larynx, is the entry point to the windpipe (trachea). It contains the vocal cords and protects the lungs. Cancer that starts in the larynx is called laryngeal cancer.
The larynx has three main parts:
- supraglottis – the area above the vocal cords; includes the epiglottis, a small flap of tissue that covers the larynx when you swallow and prevents food and fluids going into the trachea and lungs
- glottis – the area containing the vocal cords, which vibrate when air passes through them to produce the sound of your voice
- subglottis – the area below the vocal cords leading to the trachea.
The thyroid gland is in front of the trachea under the voice box, but thyroid cancer is not considered head and neck cancer.
The nasal cavity is the large, hollow space behind the nose. It is separated into two main cavities by the nasal septum, a thin wall of bone and cartilage in the centre of the nose.
The paranasal sinuses are small, air-filled spaces in the side walls of the nose. They help to warm and moisten air passing to the lungs. They also influence the sound and tone of your voice. There are four pairs of paranasal sinuses:
- maxillary sinuses – under the eyes and in the cheek area
- frontal sinuses – behind the forehead
- ethmoid sinuses – above the nose and between the eyes
- sphenoid sinuses – behind the nose and between the eyes.
The salivary glands make the watery substance known as saliva. This keeps the mouth moist to help with swallowing and talking and also protects the mouth and teeth.
There are three pairs of major salivary glands:
- parotid glands – in front of the ears
- submandibular glands – under the lower jaw
- sublingual glands – under the tongue.
There are also hundreds of smaller glands throughout the lining of the mouth, nose and throat. These are known as the minor salivary glands.
Cancers can start in the major or minor salivary glands. When cancer is found in one of the parotid glands, it has often spread from a skin cancer on the head or neck.
How common are head and neck cancers?
More than 5100 people in Australia are diagnosed with a head and neck cancer each year (excluding skin cancers). This includes about 1900 people with cancer in the mouth or tongue; 690 with lip cancer; 1300 with pharyngeal cancer; 570 with laryngeal cancer; 210 with nasal or paranasal sinus cancer; and 360 with salivary gland cancer.
Head and neck cancers are more common after the age of 40. Men are about three times more likely than women to develop a head and neck cancer, mainly because of men’s higher smoking and drinking rates. Aboriginal and Torres Strait Islander people are more likely to develop head and neck cancer than other Australians.
This information is reviewed by
This information was last updated September 2021 by the following expert content reviewers: A/Prof Richard Gallagher, Head and Neck Surgeon, Director of Cancer Services and Head and Neck Cancer Services, St Vincent’s Health Network, NSW; Dr Sophie Beaumont, Head of Dental Oncology, Dental Practitioner, Peter MacCallum Cancer Centre, VIC; Dr Bena Brown, Speech Pathologist, Princess Alexandra Hospital, and Senior Research Fellow, Menzies School of Health Research, QLD; Dr Teresa Brown, Assistant Director, Nutrition and Dietetics, Royal Brisbane and Women’s Hospital, QLD; Lisa Castle-Burns, Head and Neck Cancer Specialist Nurse, Canberra Region Cancer Centre, The Canberra Hospital, ACT; A/Prof Ben Chua, Radiation Oncologist, Royal Brisbane and Women’s Hospital, GenesisCare Rockhampton and Brisbane, QLD; Elaine Cook, 13 11 20 Consultant, Cancer Council Victoria; Dr Andrew Foreman, Specialist Ear, Nose and Throat Surgeon, Royal Adelaide Hospital, SA; Tony Houey, Consumer; Dr Annette Lim, Medical Oncologist and Clinician Researcher – Head and Neck and Non-melanoma Skin Cancer, Peter MacCallum Cancer Centre and The University of Melbourne, VIC; Paula Macleod, Head, Neck and Thyroid Cancer Nurse Coordinator, Northern Sydney Cancer Centre, Royal North Shore Hospital, NSW; Dr Aoife McGarvey, Physiotherapist and Accredited Lymphoedema Practitioner, Physio Living, Newcastle, NSW; Rick Pointon, Consumer; Teresa Simpson, Senior Clinician, Psycho-Oncology Social Work Service, Cancer Therapy Centre, Liverpool Hospital, NSW.