Head and neck cancers may make up a small percentage of all cancer diagnoses in the U.S., but when they do occur, they can be complex, aggressive and life-altering.
On a recent episode of Medical Monday with Brian Haldane, Rula Mualla, MD, a head and neck surgical oncologist with Our Lady of the Lake Cancer Institute, joined the conversation to shed light on these often-overlooked diseases.
“I like to describe what I do as looking at things above the clavicle,” Dr. Mualla says. “That includes cancers of the mouth, throat, larynx, nose, sinuses, salivary glands, and thyroid—and I also treat skin cancers of the head and neck.”
While head and neck cancers account for only about four percent of all cancers in the U.S., their seriousness depends on the location and the specific type. “Some tumors are less aggressive,” Dr. Mualla explains. “But others can have a five-year survival rate as low as 50 percent or less.”
Risk Factors Are Evolving
“Tobacco and alcohol are the most common risk factors for head and neck cancer,” Dr. Mualla says. However, she also emphasized the rising number of cases linked to the human papillomavirus (HPV), particularly in the throat and tonsil regions.
Other risk factors include poor oral hygiene, radiation exposure and sun exposure — especially for skin cancers in the head and neck region.
Subtle Symptoms Deserve Attention
One of the most concerning challenges with head and neck cancer is how quietly it can progress.
“A lot of patients present with just a neck mass that doesn’t go away,” Dr. Mualla says. “That alone is a reason to get checked out.”
Other symptoms may include:
- Persistent mouth or throat pain
- Difficulty swallowing
- Changes in the voice
- Ear pain
- Unexplained weight loss
Dr. Mualla notes that these symptoms are often brushed off, but early evaluation can make a significant difference.
Routine Checkups Matter
Because of the anatomy involved, these cancers can be difficult to detect without a trained eye.
“Routine checkups with your primary care physician or dentist are really the best way to identify these things early,” Dr. Mualla says. If there’s a concern, patients are often referred to an ear, nose and throat (ENT) specialist for a more detailed examination.
This may include a procedure called a laryngoscopy, a small camera passed through the nose to examine hard-to-see areas like the back of the throat, larynx, and sinuses. “
It’s a critical tool that helps us look beyond what we can see just by looking in the mouth,” she explains.
Treatment Depends on Type and Stage
Treatment plans vary depending on the cancer’s location and how advanced it is. “We may start with surgery to remove the tumor and nearby lymph nodes,” Dr. Mualla says. “In other cases, like for some early-stage laryngeal cancers, we may treat with radiation first.”
Some tumors, such as those in the back of the throat, are often treated with a combination of chemotherapy and radiation before considering surgery. Every plan is individualized to the patient’s needs, the specific diagnosis and the goal of preserving as much function as possible while eliminating the cancer.
Head and Neck Cancer: The Bottom Line
If something feels off, whether it’s a lump that won’t go away or pain that lingers, don’t ignore it. Routine care and timely referrals can lead to earlier diagnoses, more treatment options and better outcomes.
