Head and Neck Cancer

Squamous cells are the cells that line the skin, mouth, throat and larynx (voice box). Squamous cell carcinoma (SCC) is a cancer arising from these cells. Head and Neck SCC is cancer of the mouth, throat and larynx.

Cancers are curable if they are picked up and treated as early as possible. Don’t ignore your symptoms. Stopping smoking, drinking less alcohol and eating well will help you get the best outcome from your treatment.

You are welcome to bring a friend or relative to your appointments, to provide support, ask questions and help you remember information. Ask for written information if this helps you remember. Ask to see a social worker if you need help with applying for income support or accommodation during your treatment. You can also have counselling and psychological support when needed.

Symptoms can include:

• A red or white patch in the mouth;
• An ulcer that doesn’t heal within 4 weeks;
• A lump in the mouth or neck;
• Change in voice;
• Trouble swallowing;
• Pain in the throat or ear lasting more than 2 weeks and not relieved by antibiotic;
• Coughing blood.

Head and Neck SCC can be caused by:

• Smoking;
• Alcohol;
• HPV infection.

SCC is diagnosed by:

• Examination of the nose, mouth, throat and neck including nasal endoscopy;
• Biopsy or FNA. For mouth cancers this can be done in the office. Neck lumps have FNA under ultrasound guidance in the x-ray (medical imaging) department. Throat and larynx cancers are harder to biopsy while you are awake; you may need a microlaryngoscopy with general anaesthetic for the biopsy;
• CT scan of the head, neck and chest;
• MRI and PET scan.

Staging SCC

SCC starts in the lining of the mouth, throat or voice box. As it grows, it can spread to other structures next to the cancer, and to the lymph nodes in the neck or to other organs like the lungs. The examination and CT scan helps to stage the cancer. This means finding out how big it is and how far it has spread. There are 4 stages of cancer:

• Stage 1 and 2 are small cancers that haven’t spread far;
• Stage 3 and 4 are bigger cancers that have spread to the lymph nodes or other organs. Spreading to the lymph nodes or other organs is called metastasis.

Staging helps your treating team decide what treatments you need and what will work best for you.

Treating SCC

SCC can be treated with surgery and radiotherapy. Sometimes chemotherapy is combined with radiotherapy. A team of carers is involved in your treatment. The team is called a Multidisciplinary team. Your team will discuss you and your cancer and make a recommendation for the best treatment for you. The team includes:

• Surgeons
• Radiation oncologist (radiotherapy)
• Oncologist (chemotherapy)
• Head and Neck Cancer Nurse coordinator
• Radiologist
• Pathologist
• Speech therapist
• Dietitian
• Social worker
• Dentist

More information:

Head and Neck Cancer Australia website, and YouTube video for people with a new diagnosis of cancer and lots of other videos about treatment and recovery

Cancer Council Understanding Head and Neck Cancers
You can pick up a booklet from my rooms or read it online or download a PDF

Oral Cancer Foundation HPV fact sheet

Quitting smoking and quit.org.au