If you or someone you love has just heard the words “head and neck cancer,” you may have more questions than answers. That’s completely normal. Head and neck cancer isn’t one single disease. It’s a group of cancers that can start in several places, from the mouth and throat to the voice box and sinuses.
The good news: many head and neck cancers can be treated successfully, especially when they’re found early. This guide walks through the basics in plain language so you can feel more prepared for conversations with your care team.
What is head and neck cancer?
“Head and neck cancer” is an umbrella term for cancers that begin in the mouth, throat, voice box, nose, sinuses, or salivary glands. About 9 in 10 start in squamous cells, the thin, flat cells that line the moist inner surfaces of these areas. That’s why you may hear your doctor call it squamous cell carcinoma of the head and neck, or HNSCC for short.
Head and neck cancer makes up nearly 4% of all cancers diagnosed in the United States. In 2024, about 71,000 people in the U.S. were diagnosed with it. It’s more than twice as common in men as in women and is diagnosed most often in people over 50.
A few cancers in the same part of the body are usually not grouped with head and neck cancer, including cancers of the brain, eye, thyroid, esophagus, and skin. These are diagnosed and treated differently.
Where head and neck cancer starts
Head and neck cancers are named for the place they begin. Knowing your exact type matters, because it shapes your treatment options.
Area | What it includes | How common |
Oral cavity (mouth) | Lips, front two-thirds of the tongue, gums, inner cheeks, floor and roof of the mouth | Common |
Oropharynx (middle throat) | Back of the tongue, tonsils, soft palate | Common, and rising due to HPV |
Larynx (voice box) | Vocal cords and the flap (epiglottis) that keeps food out of the airway | Common |
Hypopharynx (lower throat) | The bottom of the throat, just above the esophagus | Less common |
Nasopharynx (upper throat) | The space behind the nose | Less common in the U.S. |
Nasal cavity and paranasal sinuses | Inside the nose and the hollow spaces around it | Rare |
Salivary glands | Glands near the jaw and in the floor of the mouth that make saliva | Rare |
Sometimes cancer is first found in a lymph node in the neck before doctors can find where it started. This is called cancer of unknown primary in the head and neck, and it is often still very treatable.
What causes it?
There’s rarely a single cause, but a few risk factors stand out. Having a risk factor doesn’t mean you caused your cancer, and many people with these risk factors never develop it.
- Tobacco and alcohol. These are the two biggest risk factors, especially for cancers of the mouth, lower throat, and voice box. That includes cigarettes, cigars, pipes, chewing tobacco, snuff, and secondhand smoke. Using both tobacco and alcohol raises risk more than either one alone.
- HPV (human papillomavirus). Certain types of this common virus, especially HPV16, cause about three out of four cancers of the oropharynx (tonsils and back of the tongue). HPV-related throat cancer is becoming more common and often affects people who have never smoked.
- Other factors. These include chewing betel quid (paan), Epstein-Barr virus (linked to nasopharyngeal cancer), on-the-job exposure to wood dust, nickel dust, or formaldehyde, past radiation to the head and neck, and some inherited conditions such as Fanconi anemia.
The HPV vaccine (Gardasil 9) is FDA-approved to help prevent HPV-related head and neck cancers in people ages 9 to 45.
Signs and symptoms to watch for
The most common early signs are easy to mistake for everyday problems like a cold or a canker sore. The key difference is that they don’t go away. See a doctor or dentist if any of these last more than two to three weeks:
- A lump or swelling in the neck (often painless, especially in HPV-related cancer)
- A sore in the mouth or throat that doesn’t heal
- A sore throat that won’t go away
- Trouble or pain when swallowing
- Hoarseness or a change in your voice
- A white or red patch on the gums, tongue, or lining of the mouth
- Ear pain, especially on one side
- Blocked sinuses, nosebleeds, or sinus infections that don’t respond to antibiotics
- Swelling near the jaw, or dentures that suddenly fit poorly
- Numbness or weakness in part of the face
Most of the time, these symptoms are caused by something less serious. But getting them checked early is the best way to catch cancer when it’s most treatable.
How it’s diagnosed
Diagnosis usually involves a few steps, often led by an ear, nose, and throat (ENT) specialist:
- Physical exam. Your doctor looks inside your mouth, nose, and throat and feels your neck for lumps.
- Scope exam (endoscopy). A thin, flexible tube with a tiny camera is passed through the nose to see the throat and voice box. It’s usually done in the office.
- Biopsy. A small sample of tissue is removed and checked under a microscope. This is the only way to confirm cancer.
- Imaging. CT, MRI, or PET scans show the size of the tumor and whether it has spread to lymph nodes or other parts of the body.
HPV testing matters. If your cancer is in the oropharynx, your tumor should be tested for HPV, often with a test called p16. HPV-positive throat cancers tend to respond better to treatment, and they’re staged differently.
Staging describes how big the tumor is and how far it has spread, using Roman numerals from Stage I (early) to Stage IV (advanced). Your stage, tumor location, and HPV status together guide your treatment plan.
How it’s treated
Treatment depends on where the cancer started, its stage, HPV status, and your overall health and goals. Early-stage cancer is often treated with surgery or radiation alone. With treatment, about 70% to 90% of people with early-stage head and neck cancer are alive five years later.
More advanced cancers usually need a combination of treatments:
- Surgery removes the tumor and sometimes nearby lymph nodes. Many surgeries today are less invasive, including robotic surgery through the mouth.
- Radiation therapy uses high-energy beams to destroy cancer cells. It’s often given daily for several weeks.
- Chemotherapy uses drugs to kill cancer cells and is often given alongside radiation to make it work better (called chemoradiation).
- Immunotherapy helps your immune system recognize and attack cancer. It’s an important option for cancer that has come back or spread.
- Targeted therapy uses drugs that block specific signals cancer cells need to grow.
Because these cancers affect how you eat, speak, swallow, and breathe, you’ll likely have a team of specialists. This can include a head and neck surgeon, radiation oncologist, medical oncologist, dentist, speech-language pathologist, and dietitian. Clinical trials may also be an option, including studies testing gentler treatment for HPV-positive cancers.
Life during and after treatment
Head and neck cancer treatment can affect everyday things many of us take for granted. Common side effects include dry mouth, mouth sores, changes in taste, trouble swallowing, voice changes, a stiff jaw, and swelling in the face or neck (lymphedema). Many improve over time, but some can become chronic conditions to manage.
The good news is that support is available, and starting early helps:
- Speech and swallowing therapy can protect and restore these functions, sometimes even before treatment begins.
- Nutrition support from a dietitian helps you keep your strength up when eating is hard.
- Dental care before and after radiation lowers the risk of long-term mouth and jaw problems.
- Physical therapy can ease neck and shoulder stiffness and help manage swelling.
Regular follow-up visits are important to check for signs that the cancer has come back. If you smoke, quitting improves how well treatment works and lowers the chance of a new cancer.
Questions to ask your care team
Bringing questions to your appointments can help you feel more in control. Consider asking:
- Where exactly did my cancer start, and what stage is it?
- Has my tumor been tested for HPV (p16)? What does the result mean for me?
- What are my treatment options, and what is the goal of each?
- How might treatment affect my ability to eat, speak, and swallow?
- Should I see a speech-language pathologist, dietitian, or dentist before treatment starts?
- Is my care team experienced in treating head and neck cancer?
- Are there clinical trials I might be eligible for?
You don’t have to navigate this alone
A head and neck cancer diagnosis brings a lot of new information at once. Outcomes4Me can help you understand your diagnosis, explore treatment options, and track symptoms to share with your care team.
Disclaimer: The information provided in this article is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Outcomes4Me is not acting as your caregiver, and any suggestions or guidance offered should not replace the advice of your healthcare provider or qualified medical professional. Always seek the guidance of your physician or other qualified health provider with any questions you may have regarding a medical condition.
