Are you at risk of head and neck cancer?

Michael Douglas, well-known cancer victim of HPV infection.
Michael Douglas, well-known cancer victim of HPV infection.

Skin cancers, cancers of the lips, mouth, throat (pharynx) and voice box (larynx), cancers of the salivary glands and less commonly of the nose and sinuses are a leading cause of death and disability in many parts of the world.

This cancer burden is putting a strain on national health care systems and impoverishes individuals, families and society. Fortunately, the vast majority of these cancers can be prevented or can be cured if detected early. Yet every week patients are seen at our cancer clinics with delayed diagnoses that with cancers that are too advanced to offer curative treatment.

What causes head and neck cancers?

Cancers of the mouth, throat and voice box are caused by smoking and alcohol. People who smoke and drink are at even higher risk of developing cancer. Skin cancers are caused by excessive sun exposure. Another common cause of cancer of the mouth is chewing betel quid, which is a common practice in India and surrounding countries.

Read: Are you at risk of skin cancer?

However of particular concern in recent years is the association between oral sex and cancers of the throat. Oral sex causes transmission of the human papilloma virus (HPV) between sexual partners. This has been associated with a dramatic increase in cancers of the tonsils and back of the tongue, especially in younger people, all over the world, possibly due to a change in sexual practices.

A well-known cancer victim of HPV infection is the film star Michael Douglas.

When should you suspect you may have head and neck cancer?

Any skin ulcer or a sore on the lips, mouth, tongue or throat that does not heal within a few weeks should be checked out by your doctor.

Read: Leg/skin ulcers

Other reasons to consult your doctor include a sore throat, voice change or swallowing difficulty that does not get better within a few weeks. Lumps in the neck or of the salivary glands also need to be assessed.

Who do I consult if I am concerned about cancer in the head and neck?

The first step is to make a diagnosis of cancer. This can be done by your doctor or dentist. He/she will then refer you to an ear, nose and throat specialist, general surgeon or maxillofacial surgeon who would then take a biopsy or sample of the suspicious area, usually under local anaesthesia.

How is head and neck cancer treated?

These cancers are treated by a multidisciplinary team, comprising of surgeons, oncologists, nurses, speech therapists, dieticians and social workers. Surgery, radiation, chemotherapy or combinations of these three modalities are used. The choice of treatment depends on where the cancer is located, the type of cancer cells, how advanced the cancer is, and the patient’s age and general fitness.

It is also critical for cancer patients to stop smoking and drinking to reduce the chance of getting more cancers, as well as allowing the treatment to work well. Patients are then followed up very closely for many years to detect recurrences early, and to detect new cancers related to smoking, alcohol and HPV infection at an early stage before the patient is even aware of it.

Is head and neck cancer curable?

Yes, if caught early, most head and neck cancers are curable.  Therefore like most cancers, it is vital that cancer be diagnosed at an early stage before it has spread to other parts of the body.

How can one avoid developing cancer of the head and neck?

Virtually all patients with cancers of the mouth, throat and voice box are smokers and drink alcohol. Stopping smoking and drinking alcohol reduces the chance of developing cancer. Reduce your risk of developing skin cancer by staying out of the sun or covering up and wearing a hat and applying a high-factor sunblock.

Read: Remember the sunblock

Educate your children about the risks associated with oral sex, and have your daughters and sons vaccinated against HPV infection. This is now available at government clinics. It can also be bought at pharmacies and can be administered by your family doctor.

A typical cancer of the tongue

A voice box that has be removed for cancer of the vocal cords

Cancer of the lower gums

Radiotherapy machine used to treat cancer

Read more:

Oral sex not safe sex

Cell phones up mouth cancer risk

Gum disease may cause cancer


Prof Johan Fagan, Dr Sameera Dalvie, Dr Julie Wetter

Members of the Head & Neck Cancer Unit, Groote Schuur Hospital

Image above: Michael Douglas, Shutterstock, all other images supplied.

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