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Overview of Mouth, Nose, and Throat Cancers

By Bradley A. Schiff, MD, Albert Einstein College of Medicine

Cancers of the mouth, nose, and throat develop in almost 60,000 people in the United States each year. These cancers are more common among men, but the number of affected women is rising because smoking has increased among women. Most affected people are between the ages of 50 and 70. However, these cancers are occurring more often in younger people.

Often, cancers of the mouth, nose, and throat are considered together by doctors because of certain similarities. Among the similarities are the type of cancer and the causes. More than 90% of cancers of the mouth, nose, and throat are squamous cell carcinomas, which means the cancer develops in the squamous cells that line the inside of the mouth, nose, or throat. Most people who have mouth, nose, or throat cancers use tobacco, drink alcohol, or both. Another cause of some types of these cancers is viral infection. The human papillomavirus (HPV)can cause mouth and throat cancer, and the Epstein-Barr virus can cause nasopharyngeal cancer.

The most common sites of mouth, nose, and throat cancers are

For cancers that affect the bones, including the jawbone (osteosarcomas, malignant giant cell tumors, multiple myeloma, and metastatic tumors), see primary cancerous bone tumors.

Less common sites for these cancers are

Also see Thyroid Cancer and Skin Cancer for information regarding tumors of the thyroid gland and skin.

Symptoms

Symptoms vary depending on the location of the cancer. Common symptoms of mouth, nose, and throat cancers include

  • Hoarseness

  • A lump in the neck

  • A painful open sore or a growth in the mouth

  • Difficulty swallowing and resulting weight loss

Sometimes red or white patches (erythroplakia or leukoplakia) in the mouth may be early symptoms.

Diagnosis

  • Examination by a doctor or dentist

  • Endoscopy

  • Biopsy

  • Imaging tests to determine the extent (called staging)

Some cancers inside the mouth do not cause symptoms at first but can be seen or felt by a doctor or dentist during a routine mouth examination. If a person has symptoms, the doctor can use a flexible viewing tube, called an endoscope, to examine the deeper regions in the mouth, nose, and throat. The diagnosis is made by examining a sample of tissue, called a biopsy, from the suspected cancer. Doctors insert a needle into the growth to get a small amount of tissue or cut out a small piece using a scalpel.

Staging tests

Before the best form of treatment can be selected, doctors do tests to see whether and how far the cancer has spread ( staging). Staging is a way for doctors to describe how advanced the cancer has become, taking into account both the size and spread (metastasis) of the cancer. Oral cancer is staged according to the size and location of the original tumor, the number and size of metastases to the lymph nodes in the neck, and evidence of metastases to distant parts of the body. Stage I cancer is the least advanced, and stage IV is the most advanced.

Staging tests for cancers of the mouth, nose, and throat usually include imaging tests, typically computed tomography (CT) and/or magnetic resonance imaging (MRI) scans and sometimes a positron emission tomography (PET) scan.

Prognosis

The outcome of mouth, nose, and throat cancers varies greatly depending on the type, location, cause, and stage of the cancer. In general, outcomes are better when the cancer is diagnosed and treated before it has spread. People with mouth and throat cancers caused by HPV have a better prognosis than a person whose tumors were caused by tobacco or alcohol.

Prevention

It is important for people to eliminate risk factors, so everyone should stop using tobacco (smoking and chewing tobacco) and limit how much alcohol they drink. Removing risk factors also helps prevent disease from coming back in people who have been treated for cancer.

Current vaccines against HPV target some of the HPV strains that cause mouth and throat cancers, so childhood vaccination may prevent some of these cancers from developing.

Treatment

  • Surgery and/or radiation therapy

  • Sometimes chemotherapy

  • Palliative treatment

Treatment of mouth, nose, and throat cancers usually involves surgery and/or radiation therapy. Chemotherapy is usually not the primary form of treatment, although it is sometimes added to other treatments. Because so many factors are involved in choosing the right treatment, teams of specialists work together to plan a person's care.

Unless a cancer is easily treated, measures to manage a person's pain and quality of life (called palliative treatment) is essential. Pain and palliative care specialists develop plans to manage a person's pain, difficulty eating, choking on secretions, and other troublesome symptoms. Treatment may include surgery, radiation, or chemotherapy. For example, if a tumor is causing pain but cannot be removed surgically, radiation to the tumor may shrink it, temporarily reducing the person's pain.

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* This is the Consumer Version. *