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Head and Neck Cancer - Introduction

Approved by the Cancer.Net Editorial Board, 09/2022

ON THIS PAGE: You will find some basic information about this disease and the parts of the body it may affect. This is the first page of Cancer.Net’s Guide to Head and Neck Cancer. Use the menu to see other pages. Think of that menu as a roadmap for this entire guide.

Cancer begins when healthy cells change and grow out of control, forming a mass called a tumor. A tumor can be cancerous or benign. A cancerous tumor is malignant, meaning it can grow and spread to other parts of the body. A benign tumor means the tumor can grow but will not spread.

About head and neck cancer

“Head and neck cancer” is a medical term used to describe a number of different malignant tumors that develop in or around the throat, larynx, nose, sinuses, and mouth.

Most head and neck cancers are squamous cell carcinomas. This type of cancer begins in flat squamous cells. These cells make up the thin layer of tissue on the surface of the structures in the head and neck. Beneath this layer, which is called the epithelium, some parts of the head and neck have a layer of moist tissue called the mucosa.

If a cancer is only found in the squamous layer of cells (epithelium), it is called carcinoma in situ. If the cancer has grown beyond this cell layer and moved into the deeper tissue, then it is called invasive squamous cell carcinoma. If doctors cannot identify where the cancer began, it is called a cancer of unknown primary. Read more about squamous cell carcinoma of unknown primary in the head and neck.

If a head and neck cancer starts in the salivary glands (see below), the tumor will usually be classified as an adenocarcinoma, adenoid cystic carcinoma, or mucoepidermoid carcinoma.

Types of head and neck cancer

There are 5 major types of head and neck cancer, each named according to the part of the body where they develop. For more information about a specific type, visit the guide dedicated to that type of head and neck cancer on this same website.

  • Laryngeal and hypopharyngeal cancer. The larynx is commonly called the voice box. This tube-shaped organ in the neck is important for breathing, talking, and swallowing. It is located at the top of the windpipe, or trachea. The hypopharynx is also called the gullet. It is the lower part of the throat that surrounds the larynx. Read more about laryngeal and hypopharyngeal cancer.

  • Nasal cavity and paranasal sinus cancer. The nasal cavity is the space just behind the nose where air passes on its way to the throat. The paranasal sinuses are the air-filled areas that surround the nasal cavity. Read more about nasal cavity and paranasal sinus cancer.

  • Nasopharyngeal cancer. The nasopharynx is the air passageway at the upper part of the throat behind the nose. Read more about nasopharyngeal cancer.

  • Oral and oropharyngeal cancer. The oral cavity includes the mouth and tongue. The oropharynx includes the middle of the throat, from the tonsils to the tip of the voice box. Read more about oral and oropharyngeal cancer.

  • Salivary gland cancer. The salivary gland produces saliva. Saliva is the fluid that is released into the mouth to keep it moist and that contains enzymes that begin breaking down food. Read more about salivary gland cancer.

Other types of cancer can also be located in the head and neck region, but the diagnosis and treatment are much different. Specific information about brain tumors, esophageal cancer, eye cancer, parathyroid cancer, sarcoma, and thyroid cancer is available in other guides on Cancer.Net.

Looking for More of an Introduction?

If you would like more of an introduction, explore these related items. Please note that these links will take you to other sections on Cancer.Net:

  • ASCO Answers Fact Sheet: Read a 1-page fact sheet that offers an introduction to head and neck cancer. This free fact sheet is available as a PDF, so it is easy to print.

  • Cancer.Net Blog: Read an ASCO expert’s opinion about what newly diagnosed patients should know about head and neck cancer.

The next section in this guide is Statistics. It helps explain how many people are diagnosed with head and neck cancer and general survival rates. Use the menu to choose a different section to read in this guide.

Head and Neck Cancer - Statistics

Approved by the Cancer.Net Editorial Board, 03/2023

ON THIS PAGE: You will find information about the estimated number of people who will be diagnosed with head and neck cancer each year. You will also read general information on surviving these diseases. Remember, survival rates depend on several factors, and no 2 people with cancer are the same. Use the menu to see other pages.

Every person is different, with different factors influencing their risk of being diagnosed with these cancers and the chance of recovery after a diagnosis. It is important to talk with your doctor about any questions you have around the general statistics provided below and what they may mean for you individually. The original sources for these statistics are provided at the bottom of this page.

How many people are diagnosed with head and neck cancer?

Head and neck cancer accounts for about 4% of all cancers in the United States. In 2023, an estimated 66,920 people (49,190 men and 17,730 women) will be diagnosed with head and neck cancer. Worldwide, an estimated 562,328 people were diagnosed with head and neck cancer in 2020.

It is estimated that 15,400 deaths (11,210 men and 4,190 women) from head and neck cancer will occur in the United States in 2023. In 2020, an estimated 277,597 people worldwide died from the disease.

What is the survival rate for head and neck cancer?

There are different types of statistics that can help doctors evaluate a person’s chance of recovery from head and neck cancer. These are called survival statistics. A specific type of survival statistic is called the relative survival rate. It is often used to predict how having cancer may affect life expectancy. Relative survival rate looks at how likely people with head and neck cancer are to survive for a certain amount of time after their initial diagnosis or start of treatment compared to the expected survival of similar people without this cancer.

Example: Here is an example to help explain what a relative survival rate means. Please note this is only an example and not specific to this type of cancer.  Let’s assume that the 5-year relative survival rate for a specific type of cancer is 90%. “Percent” means how many out of 100. Imagine there are 1,000 people without cancer, and based on their age and other characteristics, you expect 900 of the 1,000 to be alive in 5 years. Also imagine there are another 1,000 people similar in age and other characteristics as the first 1,000, but they all have the specific type of cancer that has a 5-year survival rate of 90%. This means it is expected that 810 of the people with the specific cancer (90% of 900) will be alive in 5 years.

It is important to remember that statistics on the survival rates for people with head and neck cancer are only an estimate. They cannot tell an individual person if cancer will or will not shorten their life. Instead, these statistics describe trends in groups of people previously diagnosed with the same disease, including specific stages of the disease.

The 5-year relative survival rates for head and neck cancer in the United States vary based on several factors. These include the stage of cancer, a person’s age and general health, and how well the treatment plan works. Visit the individual section for a specific type of head and neck cancer for more information about survival statistics (see the Introduction for a complete list).

Experts measure relative survival rate statistics for head and neck cancer every 5 years. This means the estimate may not reflect the results of advancements in how head and neck cancer is diagnosed or treated from the last 5 years. Talk with your doctor if you have any questions about this information. Learn more about understanding statistics.

Statistics adapted from the American Cancer Society’s publication, Cancer Facts & Figures 2023, and the National Cancer Institute website. (All sources accessed February 2023.)

The next section in this guide is Medical Illustrations. It offers drawings of body parts often affected by head and neck cancer. Use the menu to choose a different section to read in this guide.

Head and Neck Cancer - Medical Illustrations

Approved by the Cancer.Net Editorial Board, 09/2022

ON THIS PAGE: You will find a drawing of the main body parts affected by head and neck cancer. Use the menu to see other pages.

Illustration of the head and neck

This illustration shows areas where head and neck cancer can develop. The oral cavity includes the lips, the front of the tongue, and the hard palate, or roof of the mouth. The oropharynx begins where the oral cavity stops. It includes the soft palate at the back of the mouth, the tonsils, the base of the tongue, and the part of the throat behind the mouth. The lower part of the throat is called the hypopharynx. It surrounds the larynx. The larynx is a tube-shaped organ located in the front of the neck and at the top of the windpipe or trachea. It contains the vocal folds (vocal cords) and is made up of three parts. The middle section, or glottis, contains the vocal folds. The supraglottis is the area above the vocal folds. The subglottis is the area below the vocal folds that connects the larynx to the windpipe, or trachea, a hollow tube that carries air to the lungs. A flap of tissue called the epiglottis helps protect the airway and prevent food from entering the trachea during swallowing.

The next section in this guide is Risk Factors and PreventionIt describes what factors may increase the chance of developing head and neck cancer and ways to help reduce your risk. Use the menu to choose a different section to read in this guide.

Head and Neck Cancer - Risk Factors and Prevention

Approved by the Cancer.Net Editorial Board, 09/2022

ON THIS PAGE: You will find out more about what factors increase the chance of developing head and neck cancer. Use the menu to see other pages.

A risk factor is anything that increases a person’s chance of developing cancer. Although risk factors often influence the development of cancer, most do not directly cause cancer. Some people with several risk factors never develop the disease, while others with no known risk factors do. Knowing your risk factors and talking about them with your doctor may help you make more informed lifestyle and health care choices.

There are 2 substances that greatly increase the risk of developing a head and neck cancer:

  • Tobacco. Tobacco use includes smoking cigarettes, cigars, or pipes; chewing tobacco; and using snuff. It is the single largest risk factor for head and neck cancer. Researchers estimate that 70% to 80% of head and neck cancers are linked to tobacco use, and the amount of tobacco use may affect prognosis, which is the chance of recovery. In addition, secondhand smoke may increase a person’s risk of developing head and neck cancer.

  • Alcohol. Frequent and heavy alcohol consumption raises the risk of developing cancer in the mouth, pharynx, larynx, and esophagus.

Using alcohol and tobacco together increases this risk even more.

Other factors that can raise a person’s risk of developing head and neck cancer include:

  • Prolonged sun exposure. This is especially linked to cancer in the lip area, as well as skin cancer of the head and neck.

  • Human papillomavirus (HPV). Research shows that infection with HPV is a risk factor for head and neck cancer. Sexual activity with a person who has HPV is the most common way someone gets HPV. There are different types of HPV, called strains. Research links some HPV strains more strongly with certain types of cancers. HPV vaccines can prevent people from developing certain cancers. Learn more about HPV and cancer and see Latest Research for more information about HPV and head and neck cancer.

  • Epstein-Barr virus (EBV). Exposure to EBV, which is more commonly known as the virus that causes mononucleosis or "mono," plays a role in the development of nasopharyngeal cancer.

  • Gender. Men are 2 to 3 times more likely than women to develop head and neck cancer. However, the rate of head and neck cancer in women has been rising for several decades.

  • Age. People over the age of 40 are at higher risk for head and neck cancer.

  • Poor oral and dental hygiene. Poor care of the mouth and teeth may increase the risk of head and neck cancer.

  • Environmental or occupational inhalants. Inhaling asbestos, wood dust, paint fumes, and certain chemicals may increase a person’s risk of head and neck cancer.

  • Marijuana use. Research suggests that people who have used marijuana may be at higher risk for head and neck cancer.

  • Poor nutrition. A diet low in vitamins A and B can raise a person’s risk of head and neck cancer.

  • Gastroesophageal reflux disease (GERD) and laryngopharyngeal reflux disease (LPRD). Reflux of stomach acid into the upper airway and throat may be associated with the development of head and neck cancer.

  • Weakened immune system. A weakened immune system can raise a person’s risk of head and neck cancer.

  • Exposure to radiation. Exposure to radiation is associated with salivary gland cancer.

  • Previous history of head and neck cancer. People who have had 1 head and neck cancer have a higher chance of developing another head and neck cancer in the future.

Prevention

Different factors cause different types of cancer. Researchers continue to look into what factors cause this type of cancer, including ways to prevent it. Although there is no proven way to completely prevent this disease, you may be able to lower your risk. Talk with your health care team for more information about your personal risk of cancer.

Stopping the use of all tobacco products is the most important thing a person can do to reduce their risk, even for people who have been smoking for many years. Other steps that can reduce the risk of head and neck cancer include:

  • Avoiding alcohol

  • Discussing marijuana as a risk factor with your doctor and avoiding marijuana use

  • Using sunscreen regularly, including lip balm with an adequate sun protection factor (SPF)

  • Reducing your risk of HPV infection is also important. Vaccines that protect individuals from cancer-causing HPV subtypes have been approved by the U.S. Food and Drug Administration (FDA). These are effective in preventing infection prior to exposure which occurs during sexual activity. HPV exposure can be limited by reducing your number of sexual partners and using barrier methods of contraception during sex.

  • Maintaining proper care of dentures. Poorly fitting dentures can trap tobacco and alcohol’s cancer-causing substances. People who wear dentures should have their dentures evaluated by a dentist at least every 5 years to ensure a good fit. Dentures should be removed every night and cleaned and rinsed thoroughly every day.

The next section in this guide is Screening. It explains how tests may find cancer before signs or symptoms appear. Use the menu to choose a different section to read in this guide.

Head and Neck Cancer - Screening

Approved by the Cancer.Net Editorial Board, 09/2022

ON THIS PAGE: You will find out more about screening for head and neck cancer. You will also learn the risks and benefits of screening. Use the menu to see other pages.

Screening is used to look for cancer before you have any symptoms or signs. Scientists have developed, and continue to develop, tests that can be used to screen a person for specific types of cancer. The overall goals of cancer screening are to:

  • Lower the number of people who die from the disease, or eliminate deaths from cancer altogether

  • Lower the number of people who develop the disease

Learn more about the basics of cancer screening.

Screening information for head and neck cancer

People who routinely drink alcohol, currently use tobacco products, or have used tobacco products in the past should receive general health screening examination at least once a year. This is a simple, quick procedure in which the doctor looks in the nose, mouth, and throat for abnormalities and feels for lumps in the neck. If anything unusual is found, the doctor will recommend a more extensive examination using 1 or more of the procedures described in the Diagnosis section.

Regular dental checkups are also important to screen for head and neck cancer. Check in your local community to see if free oral cancer screenings are available.

The next section in this guide is Symptoms and Signs. It explains what changes or medical problems head and neck cancer can cause. Use the menu to choose a different section to read in this guide.

Head and Neck Cancer - Symptoms and Signs

Approved by the Cancer.Net Editorial Board, 09/2022

ON THIS PAGE: You will find out more about body changes and other things that can signal a problem that may need medical care. Use the menu to see other pages.

People with head and neck cancer often experience the following symptoms or signs. Symptoms are changes that you can feel in your body. Signs are changes in something measured, like by taking your blood pressure or doing a lab test. Together, symptoms and signs can help describe a medical problem. Sometimes, people with head and neck cancer do not have any of the symptoms and signs described below. Or, the cause of a symptom or sign may be a medical condition that is not cancer.

  • Swelling or a sore that does not heal; this is the most common symptom

  • Red or white patch in the mouth

  • Lump, bump, or mass in the head or neck area, with or without pain

  • Persistent sore throat

  • Foul mouth odor not explained by hygiene

  • Hoarseness or change in voice

  • Nasal obstruction or persistent nasal congestion

  • Frequent nose bleeds and/or unusual nasal discharge

  • Difficulty breathing

  • Double vision

  • Numbness or weakness of a body part in the head and neck region

  • Pain or difficulty chewing, swallowing, or moving the jaw or tongue

  • Jaw pain

  • Blood in the saliva or phlegm, which is mucus discharged into the mouth from respiratory passages

  • Loosening of teeth

  • Dentures that no longer fit

  • Unexplained weight loss

  • Fatigue

  • Ear pain or infection

If you are concerned about any changes you experience, please talk with your doctor. Your doctor will ask how long and how often you’ve been experiencing the symptom(s), in addition to other questions. This is to help figure out the cause of the problem, called a diagnosis.

If cancer is diagnosed, relieving symptoms remains an important part of cancer care and treatment. Managing symptoms may also be called palliative care or supportive care. It is often started soon after diagnosis and continued throughout treatment. Be sure to talk with your health care team about the symptoms you experience, including any new symptoms or a change in symptoms.

The next section in this guide is Diagnosis. It explains what tests may be needed to learn more about the cause of the symptoms. Use the menu to choose a different section to read in this guide.

Head and Neck Cancer - Diagnosis

Approved by the Cancer.Net Editorial Board, 09/2022

ON THIS PAGE: You will find a list of common tests, procedures, and scans that doctors use to find the cause of a medical problem. Use the menu to see other pages.

Doctors use many tests to find, or diagnose, cancer. They also do tests to learn if cancer has spread to another part of the body from where it started. If the cancer has spread, it is called metastasis. Doctors may also do tests to learn which treatments could work best.

For most types of cancer, a biopsy is the only sure way for the doctor to know if an area of the body has cancer. In a biopsy, the doctor takes a small sample of tissue for testing in a laboratory. If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis.

How head and neck cancer is diagnosed

There are many tests used for diagnosing head and neck cancer. Not all tests described here will be used for every person. Your doctor may consider these factors when choosing a diagnostic test:

  • The type of cancer suspected

  • Your signs and symptoms

  • Your age and general health

  • The results of earlier medical tests

If a person has symptoms and signs of head and neck cancer, the doctor will take a complete medical history, noting all symptoms and risk factors. In addition, the following tests may be used to diagnose head and neck cancer:

  • Physical examination/blood and urine tests. During a physical examination, the doctor feels for any lumps on the neck, lips, gums, and cheeks. The doctor will also inspect the nose, mouth, throat, and tongue for abnormalities, often using a light and a mirror for a clearer view. Blood and urine tests may be done to help diagnose cancer.

  • Endoscopy. An endoscopy allows the doctor to see inside the body with a thin, lighted, flexible tube called an endoscope. The person may be sedated as the tube is gently inserted through the nose into the throat and down the esophagus to examine inside the head and neck. Sedation is giving a person medication to become more relaxed, calm, or sleepy. The examination has different names depending on the area of the body that is examined, such as laryngoscopy to view the larynx, pharyngoscopy to view the pharynx, or nasopharyngoscopy to view the nasopharynx. When these procedures are combined, they are sometimes referred to as a panendoscopy.

  • Biopsy. A biopsy is the removal of a small amount of tissue for examination under a microscope. A pathologist then analyzes the sample(s) removed during the biopsy. A pathologist is a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease. A common type of biopsy is called a fine needle aspiration. During this procedure, cells are collected using a thin needle inserted directly into the tumor or lymph node. The cells are examined under a microscope for cancer cells, which is called a cytologic examination.

    The biopsy may include testing to see whether the person has HPV. As described in Risk Factors and Prevention, HPV has been linked to a higher risk of some head and neck cancers. In some cases, whether a person has HPV can also be a factor in determining which treatments are likely to be most effective.

  • Biomarker testing of the tumor. Your doctor may recommend running laboratory tests on a tumor sample to identify specific genes, proteins, and other factors unique to the tumor. This may also be called molecular testing of the tumor. Results of these tests can help determine your treatment options, such as immunotherapy.

  • X-ray/barium swallow. An x-ray is a way to create a picture of the structures inside of the body, using a small amount of radiation. A barium swallow may be required to identify abnormalities along the swallowing passage. During a barium swallow, a person swallows a liquid containing barium, and a series of x-rays are taken. Barium coats the lining of the esophagus, stomach, and intestines, so tumors or other abnormalities are easier to see on the x-ray. A special type of barium swallow called a modified barium swallow may be needed to evaluate specific swallowing difficulties. If there are signs of cancer, the doctor may recommend a computed tomography (CT) scan (see below).

  • Panoramic radiograph. A panoramic radiograph is a rotating, or panoramic, x-ray of the upper and lower jawbones to detect cancer or evaluate the teeth before radiation therapy or chemotherapy. This is often called a Panorex.

  • Ultrasound. An ultrasound uses sound waves to create a picture of internal organs.

  • Computed tomography (CT or CAT) scan. A CT scan takes pictures of the inside of the body using x-rays taken from different angles. A computer combines these pictures into a detailed, 3-dimensional image that shows any abnormalities or tumors. A CT scan can be used to measure the tumor’s size. Sometimes, a special dye called a contrast medium is given before the scan to provide better detail on the image. This dye can be injected into a patient’s vein or given as a pill or liquid to swallow.

  • Magnetic resonance imaging (MRI). An MRI uses magnetic fields, not x-rays, to produce detailed images of the body, especially images of soft tissue, such as the tonsils and base of the tongue. MRI can be used to measure the tumor’s size. A special dye called a contrast medium is given before the scan to create a clearer picture. This dye can be injected into a patient’s vein or given as a pill or liquid to swallow.

  • Bone scan. A bone scan uses a radioactive tracer to look at the inside of the bones. The amount of radiation in the tracer is too low to be harmful. The tracer is injected into a patient’s vein. It collects in areas of the bone and is detected by a special camera. Healthy bone appears lighter to the camera, and areas of injury, such as those caused by cancer, stand out on the image. This test may be done to see if cancer has spread to the bones.

  • Positron emission tomography (PET) or PET-CT scan. A PET scan is usually combined with a CT scan (see above), called a PET-CT scan. However, you may hear your doctor refer to this procedure just as a PET scan. A PET scan is a way to create pictures of organs and tissues inside the body. A small amount of a radioactive sugar substance is injected into the patient’s body. This sugar substance is taken up by cells that use the most energy. Because cancer tends to use energy actively, it absorbs more of the radioactive substance. However, the amount of radiation in the substance is too low to be harmful. A scanner then detects this substance to produce images of the inside of the body.

After diagnostic tests are done, your doctor will review the results with you. If the diagnosis is cancer, these results also help the doctor describe the cancer. This is called staging.

The next section in this guide is Stages. It explains the system doctors use to describe the extent of the disease. Use the menu to choose a different section to read in this guide.

Head and Neck Cancer - Stages

Approved by the Cancer.Net Editorial Board, 09/2022

ON THIS PAGE: You will learn about how doctors describe a cancer’s growth or spread. This is called the stage. Use the menu to see other pages.

What is cancer staging?

Staging is a way of describing where the cancer is located, if or where it has spread, and whether it is affecting other parts of the body.

Doctors use diagnostic tests to find out the cancer’s stage, so staging may not be complete until all of the tests are finished. Knowing the stage helps the doctor recommend what the best kind of treatment is, and it can help predict a patient’s prognosis, which is the chance of recovery.

TNM staging system

One tool that doctors use to describe the stage is the TNM system. Doctors use the results from diagnostic tests and scans to answer these questions:

  • Tumor (T): How large is the primary tumor? Where is it located?

  • Node (N): Has the tumor spread to the lymph nodes? If so, where and how many?

  • Metastasis (M): Has the cancer spread to other parts of the body? If so, where and how much?

The results are combined to determine the stage of cancer for each person. The stage provides a common way of describing the cancer, so doctors can work together to plan the best treatments.

There is a different staging system for each type of head and neck cancer. Detailed information about these stages can be found in each specific cancer type section. See the Introduction for a complete list of these types of cancer.

Recurrent head and neck cancer

Recurrent cancer is cancer that has come back after treatment. If the cancer does return, there will be another round of tests to learn about the extent of the recurrence. These tests and scans are often similar to those done at the time of the original diagnosis.

Information about the cancer’s stage will help the doctor recommend a specific treatment plan. The next section in this guide is Types of Treatment. Use the menu to choose a different section to read in this guide.

Head and Neck Cancer - Types of Treatment

Approved by the Cancer.Net Editorial Board, 09/2022

ON THIS PAGE: You will learn about the different types of treatments doctors use for people with head and neck cancer. Use the menu to see other pages.

This section explains the types of treatments, also known as therapies, that are the standard of care for head and neck cancer. “Standard of care” means the best treatments known. When making treatment plan decisions, you are encouraged to discuss with your doctor whether clinical trials are an option. A clinical trial is a research study that tests a new approach to treatment. Doctors learn through clinical trials whether a new treatment is safe, effective, and possibly better than the standard treatment. Clinical trials can test a new drug, a new combination of standard treatments, or new doses of standard drugs or other treatments. Clinical trials are an option for all stages of cancer. Your doctor can help you consider all your treatment options. Learn more about clinical trials in the About Clinical Trials and Latest Research sections of this guide.

The cancer care team

Head and neck cancer specialists usually form a multidisciplinary team to care for each patient, and an evaluation should be done by each doctor before any treatment begins. This team often includes these specialists:

  • Medical oncologist: A doctor who treats cancer using medications, such as chemotherapy, immunotherapy, and targeted therapy.

  • Radiation oncologist: A doctor who specializes in treating cancer using radiation therapy.

  • Surgical oncologist: A doctor who treats cancer using an operation.

  • Reconstructive/plastic surgeon: A doctor who specializes in reconstructive surgery, which is done to help repair damage caused by cancer treatment.

  • Maxillofacial prosthodontist: A specialist who performs restorative surgery in the head and neck areas.

  • Otolaryngologist: A doctor who specializes in the ear, nose, and throat.

  • Oncologic dentist or oral oncologist: A dentist experienced in caring for people with head and neck cancer.

  • Oncology nurse: A nurse who specializes in caring for people with cancer.

  • Physical therapist: A health care professional who helps patients improve their physical strength and ability to move.

  • Speech-language pathologist: This health care professional specializes in communication and swallowing disorders. This specialist helps patients regain their speaking, swallowing, and oral motor skills after cancer treatment that affects the head, mouth, and neck.

  • Audiologist: A medical professional who treats and manages hearing problems.

  • Psychologist/psychiatrist: These mental health professionals address the emotional, psychological, and behavioral needs of the person with cancer and the patient's family.

  • Social worker: This health care professional provides counseling for patients, family members, and support groups. A social worker may also arrange family meetings, help with practical issues like transportation, and connect patients with local resources.

  • Registered dietitian nutritionist: A nutrition professional who helps people understand the best ways to eat and what to eat for their specific conditions and recovery, to ensure they get the proper nutrition.

Cancer care teams include a variety of other health care professionals, such as physician assistants, nurse practitioners, pharmacists, counselors, and others. It is extremely important for this team to create a comprehensive treatment plan before treatment begins. People may need to be seen by several specialists before a treatment plan is fully developed.

How head and neck cancer is treated

Many cancers of the head and neck can be cured, especially if they are found early. Although eliminating the cancer is the primary goal of treatment, preserving the function of the nearby nerves, organs, and tissues is also very important. When planning treatment, doctors consider how treatment might affect a person’s quality of life, such as how a person feels, looks, talks, eats, and breathes.

Treatment options and recommendations depend on several factors, including the type and stage of head and neck cancer, possible side effects, and the patient’s preferences and overall health. Take time to learn about all of your treatment options and be sure to ask questions about things that are unclear. Talk with your doctor about the goals of each treatment and what you can expect while receiving the treatment. These types of talks are called “shared decision-making.” Shared decision-making is when you and your doctors work together to choose treatments that fit the goals of your care. Shared decision-making is particularly important for head and neck cancer because there are different treatment options. Learn more about making treatment decisions.

The common types of treatments used for head and neck cancer are described below. Your care plan may also include treatment for symptoms and side effects, an important part of cancer care.

Overall, the main treatment options are surgery, radiation therapy, chemotherapy, and targeted therapy. Surgery or radiation therapy by themselves or a combination of these treatments may be part of the treatment plan. More treatment details can be found each specific cancer type section. See the Introduction for a complete list of different types of head and neck cancer.

Surgery

During surgery, the goal is to remove the cancerous tumor and some surrounding healthy tissue during an operation. Types of surgery for head and neck cancer include:

  • Laser technology. This may be used to treat an early-stage tumor, especially if it was found in the larynx.

  • Excision. This is an operation to remove the cancerous tumor and some surrounding healthy tissue, known as a margin.

  • Lymph node dissection or neck dissection. If the doctor suspects the cancer has spread, the doctor may remove lymph nodes in the neck. This may be done at the same time as an excision.

  • Reconstructive (plastic) surgery. If cancer surgery requires major tissue removal, such as removing the jaw, skin, pharynx, or tongue, reconstructive or plastic surgery may be done to replace the missing tissue. This type of operation helps restore a person’s appearance and the function of the affected area. For example, a prosthodontist may be able to make an artificial dental or facial part to help restore the ability to swallow and speak. A speech-language pathologist may then be needed to help the patient relearn how to swallow and communicate using new techniques or special equipment. Learn more about reconstructive surgery.

Depending on the location, stage, and type of the cancer, some people may need more than 1 operation. Sometimes, it is not possible to completely remove the cancer, and additional treatments may be necessary. For example, surgery may be followed by radiation therapy, chemotherapy, or both to destroy cancer cells that cannot be removed during surgery.

Side effects of surgery

Side effects of surgery depend on the type and location of the surgery. Every patient is encouraged to talk with their doctor about the side effects expected from a specific surgery and how long the side effects are likely to last. Common side effects from head and neck surgery include temporary or permanent loss of normal voice, impaired speech, and hearing loss. People often have difficulty chewing or swallowing after cancer surgery, which may require a tube inserted in the stomach for feeding purposes. If lymph nodes were removed, there may be stiffness in the shoulders afterward. In addition, lymphedema can occur. After a total laryngectomy, which is the removal of the larynx, people may have decreased thyroid gland function that will need to be managed, such as by taking thyroid hormone medication.

Another potential side effect is swelling of the mouth and throat area, making it difficult to breathe. If this side effect develops, patients may receive a temporary tracheostomy, which creates a hole in the windpipe to make breathing easier.

Some people experience facial disfigurement from surgery due to the location of the tumor. Reconstructive surgery (see above) may be recommended to help appearance or maintain important functions, such as chewing, swallowing, and breathing. Patients should meet with different members of the health care team to help them make decisions about their treatment and understand the recovery process. Programs that help patients adjust to changes in body image may be useful both before and after the surgery. Talking with your doctor about what to expect and how recovery will be handled can help you cope.

Before surgery, talk with your health care team about the possible side effects from the specific surgery you will have. Learn more about the basics of cancer surgery.

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Radiation therapy

Radiation therapy is the use of high-energy x-rays or other particles to destroy cancer cells. A radiation therapy regimen, or schedule, usually consists of a specific number of treatments given over a set period of time. Radiation therapy may be used in different ways to treat head and neck cancers, including to help cure the disease or lessen the symptoms of cancer and its treatment. It can be used on its own or in combination or in sequence with other treatments, such as surgery or chemotherapy.

The most common type of radiation therapy is called external-beam radiation therapy, which is radiation given from a machine outside the body. A specific type of external-beam radiation therapy is called intensity-modulated radiation therapy (IMRT). IMRT uses advanced technology to accurately direct the beams of radiation at the tumor. This helps reduce damage to nearby healthy cells, potentially causing fewer side effects.

Proton therapy is another type of external-beam radiation therapy that uses protons rather than x-rays. At this time, proton therapy is not a standard treatment option for most types of head and neck cancer, but it may be used more in the future to treat these types of cancer as technology changes. See the Latest Research section for more information.

When radiation therapy is given using implants, it is called internal radiation therapy or brachytherapy.

Before beginning radiation therapy for any type of head and neck cancer, patients should be examined by a dentist who has expertise in managing the oral problems related to cancer and its treatment. This specialist can coordinate the patient’s dental care with their regular dentist as needed. Because radiation therapy can cause tooth decay, damaged teeth at risk may need to be removed. Often, tooth decay can be prevented with proper treatment from a dentist before beginning cancer treatment. Learn more about dental and oral side effects. People should also receive an evaluation from a speech-language pathologist who has experience treating people with head and neck cancer.

Patients may experience short- and long-term pain or difficulty swallowing, changes in voice because of swelling and scarring, and loss of appetite due to a change in their sense of taste. It is important that patients begin speech and swallowing therapy early, before radiation therapy begins to help prevent long-term problems with speaking or eating.

Radiation therapy to the head and neck area may also damage the salivary glands, causing dry mouth, also called xerostomia. ASCO recommends using IMRT or other radiation therapy methods that reduce the amount of radiation directed at the salivary glands to reduce the risk of this side effect.

In addition, radiation therapy to the head and neck may cause redness or skin irritation in the treated area, swelling, bone pain, nausea, fatigue, mouth sores, and sore throat. Many of these side effects go away soon after treatment has finished. Other side effects may include hearing loss due to a buildup of fluid in the middle ear, a buildup of earwax that dries out because of the radiation therapy’s effect on the ear canal, and scarring (fibrosis). If the treatment damaged the lymph nodes, there may be a risk for lymphedema.

Depending on where the radiation therapy is administered, treatment also may cause a condition called hypothyroidism in which the thyroid gland (located in the neck) slows down and causes the patient to feel tired and sluggish. This may be treated with thyroid hormone replacement medication. Every patient who receives radiation therapy to the neck area should have their thyroid function checked regularly. Patients are encouraged to talk with their health care team about what side effects of radiation therapy to expect before treatment begins, including how these side effects can be prevented or managed.

Learn more about the basics of radiation therapy.

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Therapies using medication

The treatment plan may include medication to destroy cancer cells. Medication may be given through the bloodstream to reach cancer cells throughout the body. When a drug is given this way, it is called systemic therapy. Medication may also be given locally, which is when the medication is applied directly to the cancer or kept in a single part of the body.

This treatment is generally prescribed by a medical oncologist, a doctor who specializes in treating cancer with medication. Medications are often given through an intravenous (IV) tube placed into a vein using a needle or as a pill or capsule that is swallowed (orally). If you are given oral medications, be sure to ask your health care team about how to safely store and handle them.

The types of medications used for head and neck cancer include:

  • Chemotherapy

  • Targeted therapy

  • Immunotherapy

Each of these types of therapies is discussed below in more detail. A person may receive 1 type of medication at a time or a combination of medications given at the same time. They can also be given as part of a treatment plan that includes surgery and/or radiation therapy.

The medications used to treat cancer are continually being evaluated. Talking with your doctor is often the best way to learn about the medications prescribed for you, their purpose, and their potential side effects or interactions with other medications. It is also important to let your doctor know if you are taking any other prescription or over-the-counter medications or supplements. Herbs, supplements, and other drugs can interact with cancer medications, causing unwanted side effects or reduced effectiveness. Learn more about your prescriptions by using searchable drug databases.

Chemotherapy

Chemotherapy is the use of drugs to destroy cancer cells, usually by keeping the cancer cells from growing, dividing, and making more cells.

A chemotherapy regimen, or schedule, usually consists of a specific number of cycles given over a set period of time. A patient may receive 1 drug at a time or a combination of different drugs given at the same time.

The side effects of chemotherapy depend on the individual and the dose used, but they can include fatigue, risk of infection, nausea and vomiting, hair loss, loss of appetite, and diarrhea. These side effects usually go away after treatment is finished.

Learn more about the basics of chemotherapy.

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Targeted therapy

Targeted therapy is a treatment that targets the cancer’s specific genes, proteins, or the tissue environment that contributes to cancer growth and survival. This type of treatment blocks the growth and spread of cancer cells and limits damage to healthy cells.

Not all tumors have the same targets. To find the most effective treatment, your doctor may run tests to identify the genes, proteins, and other factors in your tumor. This helps doctors better match each patient with the most effective treatment whenever possible. In addition, research studies continue to find out more about specific molecular targets and new treatments directed at them.

  • EGFR inhibitors. For head and neck cancers, treatments that target a tumor protein called epidermal growth factor receptor (EGFR) may be recommended. Researchers have found that drugs that block EGFR help stop or slow the growth of certain types of head and neck cancer.

  • Tumor-agnostic therapy. Larotrectinib and entrectinib are oral medications, both are targeted therapies that are not specific to a certain type of cancer but focuses on a specific genetic change in NTRK genes. This type of genetic change is uncommon but does occur in a range of cancers, including a subset of salivary gland cancers called secretory carcinomas. Larotrectinib and entrectinib are approved as a treatment for tumors that are metastatic or cannot be removed with surgery and has worsened with other treatments that carry a genetic abnormality in NTRK.

Talk with your doctor about possible side effects for a specific medication and how they can be prevented or managed. Learn more about the basics of targeted treatments.

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Immunotherapy (updated 12/2022)

Immunotherapy uses the body's natural defenses to fight cancer by improving your immune system's ability to attack cancer cells.

Currently, there are 2 immunotherapy drugs approved by the U.S. Food and Drug Administration (FDA) to treat recurrent or metastatic head and neck squamous cell carcinoma:

  • Pembrolizumab (Keytruda). Pembrolizumab can be used by itself if the tumor expresses a certain amount of the PD-L1 protein or if the cancer continues to grow or spread during treatment with platinum-based chemotherapy. It can also be used in combination with chemotherapy regardless of the level of PD-L1 expressed by the tumor.

  • Nivolumab (Opdivo). Nivolumab can be used if the cancer continues to grow or spread during treatment with platinum-based chemotherapy.

This information is based in part on the ASCO guideline, “Immunotherapy and Biomarker Testing in Recurrent and Metastatic Head and Neck Cancers.” Please note that this link takes you to a different ASCO website.

Different types of immunotherapy can cause different side effects. Common side effects include skin reactions, flu-like symptoms, diarrhea, and weight changes. Talk with your doctor about possible side effects for the immunotherapy recommended for you. Learn more about the basics of immunotherapy.

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Physical, emotional, and social effects of cancer

Cancer and its treatment cause physical symptoms and side effects, as well as emotional, social, and financial effects. Managing all of these effects is called palliative care or supportive care. It is an important part of your care that is included along with treatments intended to slow, stop, or eliminate the cancer.

Palliative care focuses on improving how you feel during treatment by managing symptoms and supporting patients and their families with other, non-medical needs. Any person, regardless of age or type and stage of cancer, may receive this type of care. And it often works best when it is started right after a cancer diagnosis. People who receive palliative care along with treatment for the cancer often have less severe symptoms, better quality of life, and report that they are more satisfied with treatment.

Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional and spiritual support, and other therapies. You may also receive palliative treatments similar to those meant to get rid of the cancer, such as chemotherapy, surgery, or radiation therapy.

Before treatment begins, talk with your doctor about the goals of each treatment in the recommended treatment plan. You should also talk about the possible side effects of the specific treatment plan and palliative care options. Many patients also benefit from talking with a social worker and participating in support groups. Ask your doctor about these resources, too.

During treatment, your health care team may ask you to answer questions about your symptoms and side effects and to describe each problem. Be sure to tell the health care team if you are experiencing a problem. This helps the health care team treat any symptoms and side effects as quickly as possible. It can also help prevent more serious problems in the future.

Learn more about the importance of tracking side effects in another part of this guide. Learn more about palliative care in a separate section of this website.

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Metastatic head and neck cancer

If cancer spreads to another part in the body from where it started, doctors call it metastatic cancer. If this happens, it is a good idea to talk with doctors who have experience in treating it. Doctors can have different opinions about the best standard treatment plan. Clinical trials might also be an option. Learn more about getting a second opinion before starting treatment, so you are comfortable with your chosen treatment plan.

Your treatment plan may include a combination of surgery, radiation therapy, chemotherapy, targeted therapy, or immunotherapy. Palliative care will also be important to help relieve symptoms and side effects.

For most people, a diagnosis of metastatic cancer is very stressful and difficult. You and your family are encouraged to talk about how you feel with doctors, nurses, social workers, or other members of your health care team. It may also be helpful to talk with other patients, such as through a support group or other peer support program.

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Remission and the chance of recurrence

A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called having “no evidence of disease” or NED.

A remission may be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. While many remissions are permanent, it is important to talk with your doctor about the possibility of the cancer returning. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. Learn more about coping with the fear of recurrence.

If the cancer returns after the original treatment, it is called recurrent cancer. It may come back in the same place (called a local recurrence), nearby (regional recurrence), or in another place (distant recurrence).

If a recurrence happens, a new cycle of testing will begin again to learn as much as possible about it. After this testing is done, you and your doctor will talk about the treatment options. Often the treatment plan will include the treatments described above, such as surgery, chemotherapy, targeted therapy, radiation therapy, or immunotherapy, but they may be used in a different combination or given at a different pace. Your doctor may suggest clinical trials that are studying new ways to treat recurrent head and neck cancer. Whichever treatment plan you choose, palliative care will be important for relieving symptoms and side effects.

People with recurrent cancer sometimes experience emotions such as disbelief or fear. You are encouraged to talk with your health care team about these feelings and ask about support services to help you cope. Learn more about dealing with cancer recurrence.

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If treatment does not work

Recovery from head and neck cancer is not always possible. If the cancer cannot be cured or controlled, the disease may be called advanced or terminal.

This diagnosis is stressful, and for some people, advanced cancer is difficult to discuss. However, it is important to have open and honest conversations with your health care team to express your feelings, preferences, and concerns. The health care team has special skills, experience, and knowledge to support patients and their families and is there to help. Making sure a person is physically comfortable, free from pain, and emotionally supported is extremely important.

People who have advanced cancer and who are expected to live less than 6 months may want to consider hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to talk with the health care team about hospice care options, which include hospice care at home, a special hospice center, or other health care locations. Nursing care and special equipment can make staying at home a workable option for many families. Learn more about advanced cancer care planning and what caregivers should know about end of life care for people with advanced head and neck cancer.

After the death of a loved one, many people need support to help them cope with the loss. Learn more about grief and loss.

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The next section in this guide is About Clinical Trials. It offers more information about research studies that are focused on finding better ways to care for people with cancer. Use the menu to choose a different section to read in this guide.

Head and Neck Cancer - About Clinical Trials

Approved by the Cancer.Net Editorial Board, 09/2022

ON THIS PAGE: You will learn more about clinical trials, which are the main way that new medical approaches are studied to see how well they work. Use the menu to see other pages.

What are clinical trials?

Doctors and scientists are always looking for better ways to care for people with head and neck cancer. To make scientific advances, doctors create research studies involving volunteers, called clinical trials. Every drug that is now approved by the FDA was tested in clinical trials.

Clinical trials are used for all types and stages of head and neck cancer. Many focus on new treatments to learn if a new treatment is safe, effective, and possibly better than the existing treatments. These types of studies evaluate new drugs, different combinations of treatments, new approaches to radiation therapy or surgery, and new methods of treatment.

People who participate in clinical trials can be some of the first to get a treatment before it is available to the public. However, there are some risks with a clinical trial, including possible side effects and the chance that the new treatment may not work. People are encouraged to talk with their health care team about the pros and cons of joining a specific study.

Some clinical trials study new ways to relieve symptoms and side effects during treatment. Others study ways to manage the late effects that may happen a long time after treatment. Talk with your doctor about clinical trials for symptoms and side effects.

Deciding to join a clinical trial

People decide to participate in clinical trials for many reasons. For some, a clinical trial is the best treatment option available. Because standard treatments are not perfect, patients are often willing to face the added uncertainty of a clinical trial in the hope of a better result. Others volunteer for clinical trials because they know that these studies are a way to contribute to the progress in treating head and neck cancer. Even if they do not benefit directly from the clinical trial, their participation may benefit future people with head and neck cancer.

Insurance coverage and the costs of clinical trials differ by location and by study. In some programs, some of the expenses from participating in the clinical trial are reimbursed. In others, they are not. It is important to talk with the research team and your insurance company first to learn if and how your treatment in a clinical trial will be covered. Learn more about health insurance coverage of clinical trials.

Sometimes people have concerns that, in a clinical trial, they may receive no treatment by being given a placebo or a “sugar pill.” When used, placebos are usually combined with standard treatment in most cancer clinical trials. Study participants will always be told when a placebo is used in a study. Find out more about placebos in cancer clinical trials

Patient safety and informed consent

To join a clinical trial, people must participate in a process known as informed consent. During informed consent, the doctor should:

  • Describe all of the treatment options so that the person understands how the new treatment differs from the standard treatment.

  • List all of the risks of the new treatment, which may or may not be different than the risks of standard treatment.

  • Explain what will be required of each person in order to participate in the clinical trial, including the number of doctor visits, tests, and the schedule of treatment.

  • Describe the purposes of the clinical trial and what researchers are trying to learn.

Clinical trials also have certain rules called “eligibility criteria” that help structure the research and keep patients safe. You and the research team will carefully review these criteria together. You will need to meet all of the eligibility criteria in order to participate in a clinical trial. Learn more about eligibility criteria in clinical trials.

People who participate in a clinical trial may stop participating at any time for personal or medical reasons. This may include that the new treatment is not working or there are serious side effects. Clinical trials are also closely monitored by experts who watch for any problems with each study. It is important that people participating in a clinical trial talk with their doctor and researchers about who will be providing their treatment and care during the clinical trial, after the clinical trial ends, and/or if they choose to leave the clinical trial before it ends.

Finding a clinical trial

Research through clinical trials is ongoing for all types of cancer. For specific topics being studied for head and neck cancer, learn more in the Latest Research section.

Cancer.Net offers more information about cancer clinical trials in other areas of the website, including a complete section on clinical trials and places to search for clinical trials for a specific type of cancer.

PRE-ACT, Preparatory Education About Clinical Trials

In addition, you can find a free video-based educational program about cancer clinical trials in another section of this website.

The next section in this guide is Latest Research. It explains areas of scientific research for head and neck cancer. Use the menu to choose a different section to read in this guide.

Head and Neck Cancer - Latest Research

Approved by the Cancer.Net Editorial Board, 09/2022

ON THIS PAGE: You will read about the scientific research being done to learn more about head and neck cancer and how to treat it. Use the menu to see other pages.

Doctors are working to learn more about head and neck cancer, ways to prevent it, how to best treat it, and how to provide the best care to people diagnosed with this disease. The following areas of research may include new options for patients through clinical trials. Always talk with your doctor about the best diagnostic and treatment options for you.

  • New medications. Many studies are underway to learn more about new types of drugs that may help treat head and neck cancer.

  • Immunotherapy. An active area of immunotherapy research is focused on drugs that block a protein called PD-1. PD-1 is found on the surface of T cells, which are a type of white blood cell that helps the body’s immune system fight disease. Because PD-1 keeps the immune system from destroying cancer cells, stopping PD-1 from working allows the immune system to better eliminate the disease. There are 2 immunotherapy drugs approved for the treatment of metastatic or recurrent head and neck cancers (see Types of Treatment). Researchers are studying PD-1 immunotherapy for people with recurrent and metastatic head and neck cancer in clinical trials.

  • Combined therapies. Most research for head and neck cancer focuses on combining different types of treatments to improve treatment effectiveness and the patient’s quality of life.

  • Radiofrequency thermal ablation (RFA). RFA is a minimally invasive treatment option that applies heat to the tumor to destroy cancer cells. It is usually used to treat a localized tumor that cannot be removed by surgery.

  • Gene therapy. Gene therapy is a targeted form of treatment that uses biologic gene manipulation to change bits of genetic code in a person’s cells. Although gene therapy is relatively new, it appears to show promise in treating head and neck cancer.

  • Photodynamic therapy. In photodynamic therapy, a light-sensitive substance is injected into the tumor that stays longer in cancer cells than in healthy cells. A laser is then directed at the tumor to destroy the cancer cells. The long-term effects of photodynamic therapy are still being studied.

  • Proton therapy. Proton therapy can be added to a treatment plan to reduce the damage done to healthy tissue. This radiation therapy technique may help protect important structures in the head, such as the brain stem and the optic nerves that run to the eyes, when used to treat nasopharyngeal cancer, chordoma, or chondrosarcoma. A chordoma is a rare tumor that usually occurs in the spine or the base of the skull. Chondrosarcoma is a tumor that develops in cartilage. They are both types of bone cancer.

  • HPV. Researchers continue to investigate the link between HPV and head and neck cancers. These studies are evaluating why HPV raises the risk of the disease and how the virus may affect the outcome of some treatments. Studies are also looking at whether the HPV vaccine that is currently used to prevent cervical, vaginal, vulvar, and anal cancer is effective at preventing some head and neck cancers as well.

  • Palliative care/supportive care. Clinical trials are underway to find better ways of reducing symptoms and side effects of current head and neck cancer treatments to improve comfort and quality of life for patients.

Looking for More About the Latest Research?

If you would like more information about the latest areas of research in head and neck cancer, explore these related items that take you outside of this guide:

The next section in this guide is Coping with Treatment. It offers some guidance in how to cope with the physical, emotional, social, and financial changes that cancer and its treatment can bring. Use the menu to choose a different section to read in this guide.

Head and Neck Cancer - Coping with Treatment

Approved by the Cancer.Net Editorial Board, 09/2022

ON THIS PAGE: You will learn more about coping with the physical, emotional, social, and financial effects of cancer and its treatment. Use the menu to see other pages.

Every cancer treatment can cause side effects or changes to your body and how you feel. For many reasons, people do not experience the same side effects even when they are given the same treatment for the same type of cancer. This can make it hard to predict how you will feel during treatment. People who are being treated for head and neck cancer may find it helpful to reach out to support groups that specialize in helping people being treated for this type of cancer. If you do not live near a support group or prefer receiving support in a different way, many patient advocacy groups offer one-on-one matching programs for patients as well as caregivers.

As you prepare to start cancer treatment, it is normal to fear treatment-related side effects. It may help to know that your health care team will work to prevent and relieve side effects. This part of cancer treatment is called palliative care or supportive care. It is an important part of your treatment plan, regardless of your age or the stage of disease.

Coping with physical side effects (updated 09/2022)

Common physical side effects from each treatment option for head and neck cancer are described in the Types of Treatment section. Learn more about side effects of cancer and its treatment, along with ways to prevent or control them. Changes to your physical health depend on several factors, including the cancer’s stage, the length and dose of treatment, and your general health.

Many people who have been treated for head and neck cancer have difficulty eating. Working with a speech-language pathologist and a registered dietitian can help. Listen to a podcast about managing eating challenges after treatment.

Side effects can also include problems with your sex life. Read an article on how people with head and neck cancer can cope with changes to sexual health.

In general, talk with your health care team regularly about how you are feeling and side effects you are experiencing. It is important to let them know about any new side effects or changes in existing side effects. If they know how you are feeling, they can find ways to relieve or manage your side effects to help you feel more comfortable and potentially keep any side effects from worsening. The American Society of Clinical Oncology (ASCO) recommends that massage, acupuncture, acupressure/reflexology, guided imagery with progressive muscle relaxation, or hatha yoga, which is a slower-paced form of yoga that focuses on the breath, may be offered to anyone experiencing pain after treatment for head and neck cancer.

You may find it helpful to keep track of your side effects so it is easier to talk about any changes with your health care team. Learn more about why tracking side effects is helpful.

Sometimes, side effects can last after treatment ends. Doctors call these long-term side effects. Side effects that occur months or years after treatment are called late effects. Treating long-term side effects and late effects is an important part of survivorship care. Learn more by reading the Follow-up Care section of this guide or talking with your doctor.

Coping with emotional and social effects

You can have emotional and social effects as well after a cancer diagnosis. This may include dealing with a variety of emotions, such as sadness, anxiety, or anger, or managing your stress level. Sometimes, people find it difficult to express how they feel to their loved ones. Some have found that talking to an oncology social worker, counselor, or member of the clergy can help them develop more effective ways of coping and talking about cancer.

You can also find coping strategies for emotional and social effects in a separate section of this website. This section includes many resources for finding support and information to meet your needs.

Coping with the costs of cancer care

Cancer treatment can be expensive. It is may be a source of stress and anxiety for people with cancer and their families. In addition to treatment costs, many people find they have extra, unplanned expenses related to their care. For some people, the high cost of medical care stops them from following or completing their cancer treatment plan. This can put their health at risk and may lead to higher costs in the future. Patients and their families are encouraged to talk about financial concerns with a member of their health care team. Learn more about managing financial considerations in a separate part of this website.

Coping with barriers to care

Some groups of people experience different rates of new cancer cases and experience different outcomes from their cancer diagnosis. These differences are called "cancer disparities." Disparities are caused in part by real-world barriers to quality medical care and social determinants of health, such as where a person lives and whether they have access to food and health care. Cancer disparities more often negatively affect racial and ethnic minorities, people with fewer financial resources, sexual and gender minorities (LGBTQ+), adolescent and young adult populations, older adults, and people who live in rural areas or other underserved communities.

If you are having difficulty getting the care you need, talk with a member of your health care team or explore other resources that help support medically underserved people.

Talking with your health care team about side effects

Before starting treatment, talk with your doctor about possible side effects. Ask:

  • Which side effects are most likely?

  • When are they likely to happen?

  • What can we do to prevent or relieve them?

  • When and who should we call about side effects?

Be sure to tell your health care team about any side effects that happen during treatment and afterward, too. Tell them even if you do not think the side effects are serious. This discussion should include physical, emotional, social, and financial effects of cancer.

Caring for a loved one with cancer

Family members and friends often play an important role in taking care of a person with head or neck cancer. This is called being a caregiver. Caregivers can provide physical, practical, and emotional support to the patient, even if they live far away. Being a caregiver can also be stressful and emotionally challenging. One of the most important tasks for caregivers is caring for themselves.

Caregivers may have a range of responsibilities on a daily or as-needed basis, including:

  • Providing support and encouragement

  • Talking with the health care team

  • Giving medications

  • Helping manage symptoms and side effects

  • Coordinating medical appointments

  • Providing a ride to and from appointments

  • Assisting with meals

  • Helping with household chores

  • Handling insurance and billing issues

A caregiving plan can help caregivers stay organized and help identify opportunities to delegate tasks to others. It may be helpful to ask the health care team how much care will be needed at home and with daily tasks during and after treatment. Use this 1-page fact sheet to help make a caregiving action plan. This free fact sheet is available as a PDF, so it is easy to print.

Learn more about caregiving or read the ASCO Answers Guide to Caring for a Loved One With Cancer in English or Spanish.

Looking for More on How to Track Side Effects?

Cancer.Net offers several resources to help you keep track of your symptoms and side effects. Please note that these links will take you to other sections of Cancer.Net:

The next section in this guide is Follow-up Care. It explains the importance of checkups after cancer treatment is finished. Use the menu to choose a different section to read in this guide.

Head and Neck Cancer - Follow-Up Care

Approved by the Cancer.Net Editorial Board, 09/2022

ON THIS PAGE: You will read about your medical care after cancer treatment is completed and why this follow-up care is important. Use the menu to see other pages.

Care for people diagnosed with cancer does not end when active treatment has finished. Your health care team will continue to check that the cancer has not come back, manage any side effects, and monitor your overall health. This is called follow-up care.

Your follow-up care may include regular physical examinations, medical tests, or both. Cancer rehabilitation is a major part of follow-up care after head and neck cancer treatment. The goal of rehabilitation is to help people regain control over many aspects of their lives and remain as independent as possible.

People may receive physical therapy to maintain movement and range of movement, as well as speech and swallowing therapy to regain skills like talking and eating. Proper evaluation and treatment may often prevent long-term speech and swallowing problems. Supportive care or palliative care to manage symptoms and maintain nutrition after treatment may be recommended. Some people may need to learn new ways to eat or prepare foods differently. Learn more about cancer rehabilitation.

After treatment for head and neck cancer, people may look different, feel tired, and be unable to talk or eat the way they used to. Many people experience depression. The health care team can help people adjust and connect them with support services. Support groups may help people cope with changes following treatment, as well as mentoring programs through patient advocacy groups.

Doctors want to keep track of your recovery in the months and years ahead. Learn more about the importance of follow-up care.

Watching for recurrence

One goal of follow-up care is to check for a recurrence, which means that the cancer has come back. Cancer recurs because small areas of cancer cells may remain undetected in the body. Over time, these cells may increase in number until they show up on test results or cause signs or symptoms. During follow-up care, a doctor familiar with your medical history can give you personalized information about your risk of recurrence. Your doctor will ask specific questions about your health. Some people may have blood tests or imaging tests done as part of regular follow-up care, but testing recommendations depend on several factors, including the type and stage of head and neck cancer first diagnosed and the types of treatment given. Your doctor will also teach you which signs and symptoms of recurrence to watch for.

The anticipation before having a follow-up test or waiting for test results may add stress to you or a family member. This is sometimes called “scanxiety.” Learn more about how to cope with this type of stress.

Managing long-term and late side effects

Most people expect to have side effects when receiving treatment. However, it is often surprising to survivors that some side effects may linger beyond the treatment period. These are called long-term side effects. Other side effects called late effects may develop months or even years after treatment has ended. Long-term and late effects can include both physical and emotional changes.

Talk with your doctor about your risk of developing such side effects based on your diagnosis, your individual treatment plan, and your overall health. If you had a treatment known to cause specific late effects, you may also have certain physical examinations, scans, or blood tests to help find and manage them. For example, if you received radiation therapy, your doctor may recommend regular blood tests to check the function of your thyroid gland. Your doctor may refer you to a specialist to treat some of the late effects associated with head and neck cancer.

Keeping personal health records

You and your doctor should work together to develop a personalized follow-up care plan. Be sure to discuss any concerns you have about your future physical or emotional health. ASCO offers forms to help keep track of the cancer treatment you received and develop a survivorship care plan when treatment is completed. Survivorship care guidelines created by the American Cancer Society (ACS) and endorsed by ASCO recommend that all survivors of head and neck cancer develop a survivorship care plan with their cancer care team.

This is also a good time to talk with your doctor and health care team about who will lead your follow-up care. Some survivors continue to see their oncologist, while others transition back to the care of their primary care doctor or another health care professional. This decision depends on several factors, including the type and stage of cancer, side effects, health insurance rules, and your personal preferences. ASCO emphasizes that survivors of head and neck cancer should receive follow-up care from a multidisciplinary team that includes primary care physicians, oncology specialists, otolaryngologists, dentists, and others.

If a doctor who was not directly involved in your cancer care will lead your follow-up care, be sure to share your cancer treatment summary and survivorship care plan forms with them and with all future health care providers. Details about your cancer treatment are very valuable to the health care professionals who will care for you throughout your lifetime.

The next section in this guide is Survivorship. It describes how to cope with challenges in everyday life after a cancer diagnosis. Use the menu to choose a different section to read in this guide.

Head and Neck Cancer - Survivorship

Approved by the Cancer.Net Editorial Board, 09/2022

ON THIS PAGE: You will read about how to cope with challenges in everyday life after a cancer diagnosis. Use the menu to see other pages.

What is survivorship?

The word “survivorship” is complicated because it means different things to different people. Common definitions include:

  • Having no signs of cancer after finishing treatment.

  • Living with, through, and beyond cancer. According to this definition, cancer survivorship begins at diagnosis and continues during treatment and through the rest of a person's life.

For some, even the term "survivorship" does not feel right, and they prefer to use different language to describe and define their experience. Sometimes extended treatment will be used for months or years to manage or control cancer. Living with cancer indefinitely is not easy, and the health care team can help you manage the challenges that come with it. Everyone has to find their own path to name and navigate the changes and challenges that are the results of their cancer diagnosis and treatment.

Survivors may experience a mixture of strong feelings, including joy, concern, relief, guilt, and fear. Some people say they appreciate life more after a cancer diagnosis and have gained a greater acceptance of themselves. Others become very anxious about their health and uncertain about coping with everyday life. Feelings of fear and anxiety may still occur as time passes, but these emotions should not be a constant part of your daily life. If they persist, be sure to talk with a member of your health care team.

Survivors may feel some stress when their frequent visits to the health care team end after completing treatment. Often, relationships built with the cancer care team provide a sense of security during treatment, and people miss this source of support. This may be especially true when new worries and challenges surface over time, such as any late effects of treatment, emotional challenges including fear of recurrence, sexual health and fertility concerns, and financial and workplace issues.

Every survivor has individual concerns and challenges. With any challenge, a good first step is being able to recognize your fears and talk about them. Effective coping requires:

  • Understanding the challenge you are facing

  • Thinking through solutions

  • Asking for and allowing the support of others

  • Feeling comfortable with the course of action you choose

Many survivors find it helpful to join an in-person support group or an online community of survivors. This allows you to talk with people who have had similar first-hand experiences. Other options for finding support include talking with a friend or member of your health care team, individual counseling, or asking for assistance at the learning resource center of the place where you received treatment.

A new perspective on your health

For many people, survivorship serves as a strong motivator to make lifestyle changes.

People recovering from head and neck cancer are encouraged to follow established guidelines for good health, such as not smoking, limiting alcohol, eating well, exercising regularly, and managing stress. Regular physical activity can help rebuild your strength and energy level. Your health care team can help you create an appropriate exercise plan based on your needs, physical abilities, and fitness level. Learn more about making healthy lifestyle choices.

It is important to have recommended medical checkups and tests (see Follow-up Care) to take care of your health.

Talk with your doctor to develop a survivorship care plan that is best for your needs.

Changing role of caregivers

Family members and friends may also go through periods of transition. A caregiver plays a very important role in supporting a person diagnosed with cancer, providing physical, emotional, and practical care on a daily or as-needed basis. Many caregivers become focused on providing this support, especially if the treatment period lasts for many months or longer.

However, as treatment is completed, the caregiver's role often changes. Eventually, the need for caregiving related to the cancer diagnosis will become much less or come to an end. Caregivers can learn more about adjusting to life after caregiving.

Looking for More Survivorship Resources?

For more information about cancer survivorship, explore these related items. Please note that these links will take you to other sections of Cancer.Net:

  • ASCO Answers Guide to Cancer Survivorship: Get this 48-page booklet that helps people transition into life after treatment. It includes blank treatment summary and survivorship care plan forms. The free booklet is available as a PDF, so it is easy to print.

  • Survivorship Resources: Cancer.Net offers information and resources to help survivors cope, including specific sections for children, teens and young adults, and people over age 65. There is also a main section on survivorship for people of all ages.

The next section offers Questions to Ask the Health Care Team to help start conversations with your cancer care team. Use the menu to choose a different section to read in this guide.

Head and Neck Cancer - Questions to Ask the Health Care Team

Approved by the Cancer.Net Editorial Board, 09/2022

ON THIS PAGE: You will find some questions to ask your doctor or other members of the health care team, to help you better understand your diagnosis, treatment plan, and overall care. Use the menu to see other pages.

Talking often with the health care team is important to make informed decisions about your health care. These suggested questions are a starting point to help you learn more about your cancer care and treatment. You are also encouraged to ask additional questions that are important to you. You may want to print this list and bring it to your next appointment. It may also be helpful to ask a family member or friend to come with you to appointments to help take notes.

Questions to ask after getting a diagnosis

  • What type of head and neck cancer do I have?

  • Where is the tumor located?

  • What stage is the cancer? What does this mean?

  • Can you explain my pathology report (laboratory test results) to me?

  • Is it important to find out whether the tumor was caused by HPV? Why or why not?

  • Should I get an additional consultation or second opinion?

Questions to ask about choosing a treatment and managing side effects

  • What are my treatment options?

  • What clinical trials are available for me? Where are they located, and how do I find out more about them?

  • What treatment plan do you recommend? Why?

  • What is the goal of each treatment? Is it to eliminate the cancer, help me feel better, or both?

  • What are the possible side effects of this treatment, both in the short term and the long term?

  • Who will be part of my health care team, and what does each member do?

  • Who will be leading my overall treatment?

  • Can you recommend an oncologic dentist?

  • Should I see a speech-language pathologist before starting treatment?

  • How will this treatment affect my daily life? Will I be able to work, exercise, and perform my usual activities?

  • Could this treatment affect my sex life? If so, how and for how long?

  • Could this treatment affect my ability to become pregnant or have children? If so, should I talk with a fertility specialist before cancer treatment begins?

  • If I’m worried about managing the costs of cancer care, who can help me?

  • What support services are available to me? To my family?

  • If I have questions or problems, who should I call?

Questions to ask about having surgery

  • Is surgery necessary, or is chemotherapy and radiation therapy an option to eliminate the cancer?

  • What type of surgery do you recommend?

  • Will any lymph nodes need to be removed? If so, what type of neck dissection will be done? What does this mean?

  • How long will the operation take?

  • How long will I be in the hospital?

  • Can you describe what my recovery from surgery will be like?

  • Who should I contact about any side effects I experience? And how soon?

  • What are the possible long-term effects of having this surgery?

  • Will this surgery affect my speech or ability to chew and swallow?

  • How will this surgery affect my appearance?

  • Will I need to have reconstructive surgery to replace lost tissue?

Questions to ask about having radiation therapy or systemic therapy using medication

  • What type of treatment is recommended?

  • What is the goal of this treatment?

  • How will this treatment be given?

  • Will this treatment be given at a hospital, a clinic, or in my home?

  • How long will I need to continue this treatment?

  • What side effects can I expect during treatment?

  • Who should I contact about any side effects I experience? And how soon?

  • What are the possible long-term and late effects of having this treatment?

  • What can be done to prevent or manage these side effects?

Questions to ask about planning follow-up care

  • Will I need physical therapy, speech therapy, dietitian, or another type of rehabilitation during or after finishing treatment?

  • What is the chance that the cancer will come back? Should I watch for specific signs or symptoms?

  • What long-term side effects or late effects are possible based on the cancer treatment I received?

  • What follow-up tests will I need, and how often will those tests be needed?

  • How do I get a treatment summary and survivorship care plan to keep in my personal records?

  • Who will be leading my follow-up care?

  • What survivorship support services are available to me? To my family?

The next section in this guide is Additional Resources. It offers more resources on this website that may be helpful to you. Use the menu to choose a different section to read in this guide.

Head and Neck Cancer - Additional Resources

Approved by the Cancer.Net Editorial Board, 09/2022

ON THIS PAGE: You will find some helpful links to other areas of Cancer.Net that provide information about cancer care and treatment. This is the final page of Cancer.Net’s Guide to Head and Neck Cancer. Use the menu to go back and see other pages.

Cancer.Net includes many other sections about the medical and emotional aspects of cancer for the person diagnosed and their family members and friends. This website is meant to be a resource for you and your loved ones from the time of diagnosis, through treatment, and beyond.

Here are a few links to help you explore other parts of Cancer.Net:

This is the end of Cancer.Net’s Guide to Head and Neck Cancer. Use the menu to choose a different section to read in this guide.