Sussex ENT: Ear, Nose and Throat Surgery
Brighton and Sussex University Hospitals Trust
Worthing and Southlands Hospital

Head and Neck Cancer

Definition - Risk Factors - Symptoms - Types - Diagnosis - Staging - Treatment

 

Definition

Head and neck cancers is a term used to describe metatastatic tumours that develop in the:

Other cancers dealt with include skin cancers (Basal cell carcinoma, Squamous cell carcinoma and Malignant melanoma) of the head and neck, neck lymph nodes, thyroid and parathyroid tumours.

Risk Factors

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The main factors that increase the risk of head and neck cancers are smoking and excess alcohol consumption.

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Symptoms

The following symptoms are associated with head and neck malignancy BUT can be also associated with less serious conditions of the head and neck:

Anybody with any of these symptoms for more than two weeks should see their GP

Diagnosis

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Types

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Following referral from your general practioner to the ENT department for any of the above symptoms you will be seen in the ENT Clinic.We will take a careful medical history with emphasis on head and neck symptoms.This will be followed by a comprehensive head and neck examination.

This includes examining:

  • Oral cavity (mouth)
  • Nasal cavity
  • Ears
  • Neck
  • Pharynx and larynx (throat) using a fibreoptic nasendoscope

Depending on the findings in the history and examination several investigations may be arranged:

  • Fine needle aspiration and cytology
  • Blood tests
  • Chest x-ray
  • CT scans
  • Further examination and biopsy under anaesthetic

If the results of your history, examination and investigations are suspicious of cancer, your case will be discussed in a weekly multidisciplinary meeting with; head and neck surgeons (ENT and maxillofacial), oncologists, radiologists, pathologists, clinical nurse specialists and other members of the team.

Following this meeting you will be seen in a joint clinic, with the oncologist and surgeons, to discuss your diagnosis and what the best treatment options are.

Staging

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Staging is a important step in the management of head and neck cancer. It is determined by the size and spread of the cancer to local tissues and the rest of the body. This information allows the medical team to decide upon the most appropriate form of treatment.

The letter T, N and M are used to describe the Tumour, Lymph Nodes and distant Metastases. Following the letter a number from 0-4 is used, 0 for no spread and 4 being the worse prognosis.

The staging is used to decide which treatment option is most appropriate a T1,N0,M0 will need less treatment than a T3,N1,M0 for a cancer of the same type.

 

Treatment

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Head and neck cancers are a complex subject with many different sites and types of tumour.

The three main forms of treatment are:

Most treatment of head and neck cancer uses a combination of the various surgical, radiotherapy and chemotherapy treatments. These will be discussed with you in the joint oncological/surgical clinic.

There is more information available from a variety of sites on our Links page.