Spotting the Signs of Head and Neck Cancer

For Lynn Smith, it felt like she was getting a cold. “My ear felt plugged, I had sinus congestion, and my glands felt swollen and tender,” she explains. “I thought I was getting sick.” 

For George Barney, it felt like something was stuck in his throat. For weeks, he tried home remedies such as gargling salt water to try to relieve the feeling, but it didn’t go away.

Unfortunately, the odd sensations Lynn and George were experiencing were signs of head and neck cancer. Most times, sensations like these are not indicative of cancer. But knowing the signs of cancer can help a person seek treatment and get a diagnosis sooner if it needs medical attention. If it is cancer, the earlier it’s caught, the easier it is to treat.

Common Types of Head and Neck Cancer

Head and neck cancer is a collection of cancers associated with the head and neck. They account for about 4% of all cancer cases in the United States.

Mucosal Head and Neck Cancer

“Mucosal head and neck cancer is the kind that is found in the section that starts at your lips and goes all the way down to the start of your food pipe or windpipe,” explains Mohamad Issa, MD, a head and neck surgeon with ProMedica Physicians. “It includes your oral cavity, back of the throat and tongue. About 90% to 95% of the cancer found there is squamous cell carcinoma.

Smoking and drinking are the biggest risk factors for this type of cancer because they can damage the cells over time. However, HPV, or human papillomavirus, is large risk factor as well for cancers in the throat. Often associated with cervical cancer, this common sexually transmitted infection is leading to throat cancer among younger, healthier people.

“Nowadays, if you have an HPV-related cancer, it’s more likely to be found in the back of your throat rather than in your cervix,” says Dr. Issa.

Thyroid, Salivary and Skin Cancers

Other types of head and neck cancer include:

Thyroid cancer. The thyroid, which makes and releases hormones, is found near the base of the front of the neck. Papillary thyroid carcinoma is the most common kind of thyroid cancer and can often be felt or seen as a lump in the neck.

Skin cancer. Squamous cell, basal cell carcinoma and melanoma are all forms of cancer that can develop in the skin cells. They are named after the skin cells that are affected by cancer: melanoma (where melanin is produced), basal cell (the deepest layer of skin) and squamous cell (the outer layer of skin).

Salivary gland cancer. Found in front of the ears and below the jaw, salivary glands help produce saliva. While the vast majority of lumps and bumps found on these glands are not cancer, it is one of the issues that can arise.

Head and Neck Cancer Signs

Although head and neck cancer can develop in various areas, there is overlap in the signs they present. Dr. Issa shares these common signs:

• Nonhealing ulcers. Whether it’s in your mouth, on your tongue or on your external skin, any ulcers or wounds that don’t heal should be evaluated by a medical professional.
• Persistent bad breath. If bad breath is persistent despite good oral hygiene, it may be an indicator of an underlying disease.
• Voice changes. This includes hoarseness or any other changes to the sound of your voice.
• Lumps. Lumps in the face, neck or around the ears should be evaluated if they don’t go away after a few weeks.
• Coughing up blood or bleeding through the nose.
• Swallowing problems.
• Unexplained weight loss.
• Persistent fatigue.

“Early detection of head and neck cancer is possible, but it takes a combination of vigilance and awareness,” shares Dr. Issa. “Understand your own risks for developing cancer. If you smoke, use tobacco, drink and have high-risk sexual practices, you need to be vigilant about any changes you notice that could be cancer.”

If your doctor suspects cancer, an endoscopy or CT scan may be recommended. A biopsy is also important to determine if it’s cancer.

Seeking Treatment Early

Routine medical visits are an opportunity for your primary care provider and dentist to catch issues like unusual lumps or nonhealing ulcers, and to talk with you about your risk of cancer. If you have one or more of the signs of cancer above, however, don’t wait for a routine visit. See your primary care provider if it doesn’t resolve in a few weeks.

“Don’t ignore these symptoms. You know your body. If your symptom is not going away, see your doctor to learn what’s going on,” encourages Lynn.

After a couple of weeks of feeling sick and having swollen glands, Lynn noticed a lump developing on her neck. Her primary care physician ordered a CT scan, which showed a branchial cleft cyst. Then, she saw Dr. Issa’s colleague, Andrew Rosko, MD, a ProMedica Physicians head and neck surgeon. 

Dr. Rosko performed a biopsy and scope in the office, suspecting the lump was cancer.

“He said if it’s cancer, it’s treatable and curable. He was going to be aggressive with treatment, and it’s a good thing he moved so quickly and didn’t wait to see what happened,” says Lynn.

Dr. Rosko used single-port robotic surgery to successfully remove the cyst. The device is like a hose with multiple tools at the end. It allows surgeons to perform surgery in hard-to-reach areas like the throat.

Although the initial biopsy was negative for cancer, a biopsy of the removed cyst confirmed that Lynn, in fact, did have cancer. A PET scan showed that Dr. Rosko’s surgery had removed it all. No other treatment was needed, but Lynn does have regular blood tests and follow-up visits to make sure all is well.

George’s cancer was also treatable through surgery alone. He says “the magic started” when he met Dr. Issa, who removed a cancerous tumor on his left tonsil using robotic-assisted surgery. A week later, tests showed that George was cancer-free. (Read more of George’s story.)

Treating Head and Neck Cancer

Hearing you have cancer is a terrifying experience, but Dr. Issa reassures that the field has come a long way with treatment and reconstruction. And your surgeon will be with you for guidance.

“I enjoy head and neck surgery because of the relationship you build with the patient. You get to understand their families and their goals, and you can guide them on which options are best for them,” says Dr. Issa.

From small incisions to jaw reconstructions, he knows the large impact it can have on his patients.

“The head and neck are so personal. It affects how people see themselves and how they interact with the world,” he continues. “I’m honored to help people navigate tough situations and treat them in a way that helps them look in the mirror and identify themselves again.”