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Head and Neck Cancer

The scope of this page is limited to malignant tumors in adults, located in and/or around the nose, paranasal sinuses, oral cavity, pharynx, larynx, and salivary glands. This resource does not discuss benign tumors of the head and neck region, tumors of the thyroid, skin cancers involving the head and neck, auditory nerve lesions, and brain tumors.

See the Head and Neck Cancers Evidence Map for summaries of available research on this topic.

Head and neck cancer (HNC) includes malignant tumors that most commonly arise from the moist squamous cell mucosa or lining of the head and neck regions. They are characterized according to their primary site of origin as malignancies of the

  • nasal cavity and paranasal sinuses;
  • oral cavity (lip, anterior two-thirds of the tongue, gums, oral mucosa, floor of mouth, hard palate, maxilla, and mandible);
  • pharynx, including the nasopharynx, oropharynx (soft palate, tongue base, tonsils, and adenoids), and hypopharynx;
  • larynx (supraglottic, glottic, and subglottic regions); and
  • salivary glands.

HNC usually originates within one of these primary sites. Occasionally, it is secondary in nature, with the primary site elsewhere in the body.

The most commonly used model for classifying HNC is the TNM staging model—used to define severity of the malignancy (Amin et al., 2017; Greene & Sobin, 2009). The TNM model assigns a numerical status (Stage 0, x, I, II, III, or IV) based on

  • tumor size and/or location (T);
  • degree of lymph node involvement (N); and
  • presence or absence of distant metastasis (M).

With the exception of tumors related to human papillomavirus (HPV), lymph node involvement is typically defined as a late-stage (III or IV) malignancy, regardless of the size or location of the primary tumor (Amin et al., 2017; Lydiatt et al., 2017).

The following factors help determine overall prognosis:

  • Natural history of the specific tumor based on staging, histology, and other comorbidities
  • Ability to achieve disease control through treatment (surgery, radiation therapy, chemotherapy—alone or in combination)
  • Etiology—for example, HPV-associated oropharyngeal cancers have a better prognosis than HPV-negative oropharyngeal cancers (National Cancer Institute, 2015)
  • Complexity of treatment—for example, in advanced HNC, multimodal treatment (e.g., surgery, radiation therapy, and chemotherapy) is more likely to result in short- and long-term side effects and may result in greater communication, swallowing, and hearing needs (Perkins, Hancock, & Ward, 2014).

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