Head and Neck Cancers
Cancer can occur in any of the tissues or organs in the head and neck. There are over 30 different places that cancer can develop in the head and neck area.
Head and neck cancers include cancers of the mouth (oral cancers) and the throat, as well as rarer cancers of the nose, sinuses, salivary glands and middle ear.
Mouth cancers (oral cancers)
The mouth is the most common place for head and neck cancer to develop.
Mouth cancer can develop on the lip, the tongue, the floor of the mouth (under the tongue), the inside of the cheek, the roof of the mouth (the hard palate), the area behind the wisdom teeth or the gum.
Most lip cancers occur on the bottom lip.
Cancer of the oral cavity (inside the mouth)
The most common places for cancer to develop inside the mouth are the side of the tongue and the floor of the mouth.
Diagram of the oral cavity
Doctors use different names to describe different areas of the throat and the cancers that can develop there.
Cancer of the nasopharynx
The nasopharynx is the highest part of the throat behind the nose. Cancers that occur here are called nasopharyngeal cancers.
Cancer of the oropharynx
The oropharynx is the part of the throat directly behind the mouth. It includes the soft part of the roof of the mouth (the soft palate), the base of the tongue (the part you can’t see), the tonsils and the back and side walls of the throat.
The most common places in the oropharynx for cancer to develop are the tonsils and the base of the tongue. We have more information about cancer of the oropharynx.
Cancer of the voice box (larynx)
This is the second most common place for head and neck cancer to develop. We have more information about cancer of the voice box.
Cancer of the thyroid gland
Cancer can also develop in the thyroid gland. It is treated differently from other types of head and neck cancer. We have more information about thyroid cancer.
Diagram showing a cross-section of the head
Rarer cancers of the head and neck
Cancer of the sinuses
There are air spaces called sinuses in the bones of the face alongside the nose. Cancers can develop in the lining of these sinuses.
Cancer of the salivary glands
Salivary glands make saliva, which keeps the mouth moist. There are three major pairs of salivary glands:
- parotid glands - which are found on each side of the face, just in front of the ears
- submandibular glands - which are under each side of the jawbone
- sublingual glands - which are under the floor of the mouth and below either side of the tongue.
Salivary gland cancer is most likely to develop in the parotid glands.
Cancer of the middle ear
Rarely, cancer can develop in the middle ear. The middle ear is made up of the eardrum and a cavity called the tympanum, which contains three little bones (the malleus, incus, and stapes). These bones connect the eardrum to the inner ear. The tympanum is connected to the nasopharynx by a tube called the Eustachian tube.
Types of cancer cells
Squamous cell carcinomas (SCC)
The most common type of head and neck cancer is squamous cell carcinoma (SCC). Most head and neck cancers (about 9 out of 10) start in squamous cells, which are the skin cells lining the mouth, nose and throat.
Rare types of head and neck cancers
Rarely, head and neck cancers can develop from other types of cells:
- Lymphomas develop from white blood cells called lymphocytes.
- Adenocarcinomas develop from cells that line the glands in the body.
- Sarcomas develop from the cells that make up muscles, cartilage, bone or blood vessels.
Risk factors and causes of head and neck cancer
The cause of head and neck cancer in most people is still unknown, but research is going on all the time to learn more.
- Smoking cigarettes, cigars or pipes
- Chewing tobacco or betel quid (paan)
- Human papilloma virus (HPV) infection
- Exposure to chemicals
- Pre-cancerous conditions
- Family history
A risk factor is something that increases your chance of developing cancer. But having a risk factor for cancer doesn’t mean you’ll definitely get it. Some people with risk factors never develop cancer, and other people without any known risk factors can still develop it.
The main risk factors for head and neck cancer are using tobacco and drinking alcohol. It is thought that about 3 out of 4 head and neck cancers (75%) are linked to tobacco or alcohol use.
Other risk factors include gender, age and infection with a virus called HPV 16. Head and neck cancer is more common in men than women. It’s most common in people over 50, although younger people can be affected too.
Smoking cigarettes, cigars or pipes
Smoking tobacco increases the risk of developing many types of head and neck cancer, including mouth cancers, throat cancers and cancer of the voice box. The more cigarettes someone smokes, and the more years they smoke for, the higher the risk.
Holding a pipe on your lip, or leaving a cigarette on your lip, when smoking also increases your risk of developing lip cancer.
Chewing tobacco or betel quid (paan)
Chewing tobacco or betel quid increases the risk of developing mouth cancer.
Drinking alcohol is linked to cancers of the mouth and throat. The more alcohol a person drinks, and the greater number of years they drink for, the higher the risk.
Alcohol and tobacco combined greatly increase the risk of head and neck cancer. People who both smoke and drink heavily over several years have the highest risk of developing head and neck cancers.
Human papilloma virus (HPV) infection
Cancers at the back of the tongue and in the tonsils (cancers of the oropharynx) have become more common over the past 20 years.
Many of these cancers are linked to infection with a type of virus called human papilloma virus 16 (HPV 16). It’s thought that one of the main ways this virus spreads to the mouth and throat is through oral sex. The risk of infection goes up with increasing numbers of oral sex partners.
A diet that’s high in animal fats and low in fresh fruit and vegetables may increase the risk of developing head and neck cancer. Some types of salted fish that may be eaten as part of a Chinese diet can increase the risk of developing cancer of the nasopharynx.
Exposure to sunlight over a prolonged period of time increases the risk of developing cancer on the outside of the lip. About 1 in 3 people diagnosed with lip cancer work outdoors.
Exposure to chemicals
Prolonged exposure to some types of dust and certain chemicals increases the risk of developing cancers of the nasopharynx and sinuses. Hardwood dust, leather dust and formaldehyde (found in MDF dust) are linked to some cancers of the nasopharynx and sinuses.
Pre-cancerous conditions of the mouth, such as leukoplakia and erythroplakia (white or red patches in the mouth often linked to tobacco use), increase the risk of a cancer developing in the mouth.
There may be a slightly higher risk of developing a head and neck cancer if you have a close relative (a parent, brother, sister or child) who has had a head and neck cancer.