About Head & Neck Cancer

The head and neck cancer category also includes cancers of the buccal cavity (mouth), larynx, pharynx, thyroid, salivary glands and nose/nasal passages. African Americans men and women have the highest risk of developing head and neck cancer. Thyroid cancer is almost three times higher in females than in males.

Signs and Symptoms of Head and Neck Cancer

Many of the symptoms of head and neck cancer mimic other common problems such as tonsillitis, ear infections and strep throat. If the following symptoms are persistent, schedule an evaluation with the Head and Neck Cancer care team at Virginia Mason Hospital & Seattle Medical Center.

  • Hoarseness that lasts more than two — three weeks
  • Difficulty breathing
  • Chronic cough
  • Persistent sore throat
  • Difficulty swallowing or pain with swallowing
  • Persistent ear pain
  • Unexpected weight loss
  • A lump or mass in the neck
  • Mass or ulcer in the mouth
  • Facial numbness or pain or weakness of facial movement
  • Dentures which no longer fit the architecture of jaw
  • Coughing or spitting up blood
  • Loosening teeth

Diagnosing Head and Neck Cancer

Over the past several years, diagnosing head and neck cancer has occurred at earlier stages thanks to greater public awareness of the disease and improved technology. An earlier diagnosis is important because early-stage tumors are less likely to have spread beyond the primary site.

In addition to a complete physical exam, different imaging techniques are used for diagnosing head and neck cancers:

Computed Tomography (CT or CAT) Scan

CT scans are a special form of x-ray that allows pictures of the body to be taken in cross section, greatly enhancing physician’s ability to visualize tumors of the head and neck region. CT scans have been an important asset in determining extent of disease and determining whether tumors in these regions are able to be surgically removed.

Magnetic Resonance Imaging (MRI)

An MRI combines a magnetic field and radio waves to create an image of the body’s internal organs.


Positron Emission Tomography (PET) can be used in the treatment of certain cancers for staging a malignancy, detecting recurrence of disease and monitoring response to therapy.

Barium Swallow

Occasionally in the evaluation of swallowing problems, which may lead to the diagnosis of a hypopharyngeal tumor, a barium swallow may be performed. This is a series of x-rays performed while the patient swallows a liquid which can be seen on the x-rays.

Chest X-ray

Because lung cancer and emphysema are caused by many of the same risk factors as head and neck cancer, a routine chest x-ray is performed. Any suspicious lesions on the chest x-ray may require a CT scan of the chest for further evaluation.

CT Pulmogram

The CT pulmogram can show small tumors not seen on standard chest X-ray images. The CT pulmogram is faster and uses less radiation than a standard CT. This procedure is used to improve the early diagnosis and treatment of lung cancers.

Biopsy and Panendoscopy

A biopsy is the removal of tissue for inspection under the microscope. A biopsy is the only way to confirm the diagnosis of cancer. Because many areas of the throat may not be accessible for easy and safe biopsing in the office, biopsies of these areas may be performed in the operating room. Special scopes used to perform this exam called laryngoscopes, esophagoscopes and bronchoscopes.

Fine Needle Aspiration (FNA)

If a patient has a neck mass that can be felt, a needle may be placed into the mass and cells can be withdrawn for inspection under the microscope. However, cancerous neck masses often are the result of spread of cancer from another area and further examination in the operating room is oftern still called for.

Panendoscopy (including laryngoscopy, esophagoscopy and possible bronchoscopy)

A thorough exam of the larynx, hypopharynx and esophagus, called a panendoscopy, uses scopes that allow the doctor to see and biopsy tissue. At this time the size of the tumor and the extent of spread to surrounding areas may be determined and a biopsy is performed.

Risk Factors for Head and Neck Cancer

A risk factor is anything that increases a person's chance of getting a disease such as cancer. Risk factors for head and neck cancer include:


Tobacco use is the largest risk factor for developing cancers in the head and neck, especially the larynx and hypopharynx. The more one smokes, the greater the risk. The risk of developing cancer in this area is five to 35 times more likely in smokers than those who do not smoke.

Alcohol Consumption

Alcohol consumption, particularly in combination with tobacco use, increases one's chance for laryngeal cancer approximately two to five times that of non-drinkers.

Nutritional Deficiencies and Immune Suppression

Nutritional deficiencies often go hand-in-hand with alcohol use and may be equally responsible for alcohol's increased risk. Malnutrition, as well as dietary deficiencies in some vitamins such as riboflavin, vitamin B derivatives, vitamin A, and retinoids may also play a role.

Gastroesophageal Reflux

Gastroesophageal reflux is produced when acid in the stomach goes back up the food pipe (or esophagus). People often call it "heartburn". This acid reflux can irritate the lining of the esophagus and has been associated with cancer of the esophagus.


Some viruses like the human papilloma virus (HPV), which commonly causes routine warts of the skin, may infect the larynx. Laryngeal papillomas are extremely rare, but may increase the risk of developing laryngeal cancer in the long run.

Other risk factors include exposure to things such as wood dust, paint fumes, metal fragments, radiation, gasoline, plastics and textile by-products.

For more information about head and neck cancer, contact us at (206) 341-0675.