Head and Neck Cancer

There are a number of symptoms you should look out for, including:

• headache
• pain in your mouth, upper teeth, throat, neck, face, or chin
• a lump, sore and/or a mouth ulcer that does not go away
• unusual bleeding in your mouth, blood in your spit, or coughing up blood
• a sore throat with earache especially just on one side
• any changes to your voice especially a hoarse voice, or a constant cough

• white or red patch inside your mouth, lumps in the neck or near glands that are there for longer than 2 weeks
• trouble or pain talking, swallowing, seeing, smelling things normally or breathing
• losing weight without trying.

Having these symptoms may not mean you have cancer, but it is really important to check. 

If you have any of these problems, or are worried about something else, yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker.

You won’t know if you have head and neck cancer until your doctor has talked to you, completed an examination and done some tests.

The tests might include:

• an ultrasound, which uses soundwaves to build a picture of the inside of your head or neck
• a biopsy, when a tiny bit of tissue is taken with a needle, and this is looked at using a microscope.

You might then be sent to see an ear, nose and throat doctor who is a specialist. The ear, nose and throat doctor may:

• take a look inside your mouth, feel your neck and then use a small thin tube with a light on its end to look inside your nose and throat
• arrange for you to have a CT scan, a PET scan or an MRI scan to have a closer look
• test your eyesight and hearing. 

Most people who have these tests find out they don’t have cancer, but it’s important to check.

If you are diagnosed with head and neck cancer, you might have more tests to find out the stage of the disease and whether the cancer has spread to other parts of your body.

Knowing the stage of the disease helps your medical team plan the best treatment for you.

Most types of head and neck cancer have 4 stages. The stage depends on the size of the tumour and which other tissues it has spread to.

Usually, Stage 1 and 2 the cancer is small and has not spread to surrounding organs or lymph nodes. In Stages 3 and 4, the cancer may have spread to nearby lymph nodes, surrounding organs and even distant organs, e.g. lungs, liver. The stage of cancer will be discussed by your doctor when planning the best treatment for you.

There are many ways to treat head and neck cancer. The main ones are surgery, radiotherapy, chemotherapy and targeted therapies. If you have head and neck cancer, you might need one of these, or a combination of them.

Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker about which treatment you might have and how you might like to include any traditional healing or cultural practices during your cancer journey.

Surgery

Surgery is done to take out the cancer and stop it from spreading. Surgery involves staying in hospital and having an anaesthetic and an operation.

Depending on what type of cancer it is and where it is located, part of your treatment plan will include removing either a small or large area around the cancer.

Some people have one operation, while others might need more than one.

If you do have surgery first, you will have about 5-6 weeks between surgery and starting radiation treatment or radiation and chemo to let your body heal a little before starting the next part of your treatment plan.

Undergoing surgery can affect your whole family. Yarn with your doctor, nurse, Aboriginal and/or Torres Strait Islander health worker or social worker about what support you and your family need.

Read more about surgery.

Radiotherapy

Radiotherapy is also called radiation therapy. It uses X-rays to destroy cancer cells in one part of your body. Each treatment is called a “dose” or a “fraction”.

Most people who have radiotherapy for head and neck cancer have it 5 days a week (Monday to Friday) for up to 7 weeks, and each session takes a about 30 minutes. But it might be different for you. Some days may take a little longer as you need to check in with the doctor or nurse weekly.

Because the rays of the x-ray machine need to be exact and in the same spot every time so they don't damage things like your eyes and ears you will need to have a radiotherapy mask made just for you. It's made of plastic and once warmed will meld and set to the shape of your head and neck.

Your radiotherapy mask will be waiting for you every day you go to your session. The radiation technician will place it on you, and you will wear it for about 8-10 mins each time while the radiotherapy beam whizzes around you.

You may not feel anything each day, but effects such as tiredness and skin changes may build up over the weeks and it is really important to yarn to your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker if you are feeling any effects.

You can only have radiotherapy in cities and some big towns – see this list. If your doctor thinks radiotherapy would help, and you don’t live near a radiotherapy site, there is help to find somewhere to stay, support to keep you connected to family and assistance to cover expenses. Having family with you during radiotherapy treatment is an important support that helps keeps you strong.

Yarn with your doctor, nurse, Aboriginal and/or Torres Strait Islander Health Worker or social worker about your radiotherapy and what support you and your family need before, during and after treatment. Being away from Country and family can be distressing so making sure you have the right support is important.

Read more about radiotherapy

Chemotherapy

Chemotherapy, or ‘chemo’, involves you taking strong drugs to kill the cancer cells, or make the cancer cells ready for the radiation to kill them. That is why radiotherapy and chemotherapy can be given together when you have a head and neck cancer.

Many people have chemo in cycles. Everyone and every chemotherapy centre are a little different. Most of the time the chemo is given during  then same time as your radiation treatment. They will start at the same time. This can be given once, every three weeks or sometimes the doctor will decide that you may need one dose a week for about 6 weeks.

Most chemo comes as injections into your arm or hand that drips in over several hours. If you’re having chemo, your doctor will tell you exactly how it will work for you.

Chemo can make people feel sick for a while, but there are things they can do and take to help. Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker about what support you need and including any traditional healing or cultural practices as part of your treatment plan.

Read more about chemotherapy and side effects.

Targeted therapies

Targeted therapies are newer drugs that try to stop the cancer growing. You can discuss them with your doctor.  Click here for some questions to ask.

It is important for you to understand why you are getting the treatment your doctor chooses and how it is supposed to help you. Different treatments try to do different things. It depends on what cancer you have, and whether it has spread, and where you live, and what you want. Ask your doctor or specialist if the treatment they suggest:

• is meant to cure you, by getting rid of the cancer and stopping it spreading, or

• won’t cure you, but is meant to prolong your life, or make you feel better, and

• how you can include traditional medicine and cultural practices as part of your treatment plan..

They should talk to you and explain this. You can talk to them and tell them what you think, and what you want. Some people will want to try everything possible to stay alive. Others want simpler treatments, or don’t want to leave family or Country for treatment, or don’t want any treatment. It is always your choice. You can also talk to another doctor to help you decide.

It can take time to decide about treatment. There are usually some options to hear about and choices to make.

It can be helpful to write things down, have someone else come to appointments to help remember information. Combining traditional healing and cultural practices are also things for you to consider as part of your cancer journey.

Talk to your doctor, specialist, nurse or Aboriginal and/or Torres Strait Islander health worker.

Read more about treatment.

Always ask about the cost of treatment. Many treatments are free through public hospitals, but some are not. Yarn with your doctor, nurse, Aboriginal and/or Torres Strait Islander health worker or social worker.

Learn more about financial support.

It all depends on the type of treatment you’re having. People will have treatment for different lengths of time. After your treatment is finished, your doctor will keep in touch with you to check on how you’re going. During treatment you will have an opportunity to build trusted relationships with people who care for you, including your doctors, nurses and Aboriginal and/or Torres Strait Islander health workers.

It is not possible to say what causes head and neck cancer in a single person. We do know there are some features that are more common in people who develop head and neck cancer. These features are called ‘risk factors’.

But it is usually hard to be sure whether a risk factor contributed to the development of the cancer in a person. And having one or more risk factors for head and neck cancer does not mean that someone will develop this cancer. In fact, many people with head and neck cancer have no obvious risk factors.

Some factors can lower your risk of developing head and neck cancer.

Risk factors for head and neck cancer you can change:

• smoking or chewing tobacco
• drinking alcohol
• eating a lot of processed or take away foods
• not looking after our teeth or gums
• chewing betel nuts.

Risk factors for head and neck cancer you can’t change:

• previous history of infection with human papilloma virus, or Epstein-Barr virus
• being over 50 years of age
• weakened immune system.

Clinical trials might be an option for you. Talk to your doctor to help you decide if taking part is a good option. Read more about clinical trials.

Read more detail on head and neck here.

Head and Neck Cancer Australia