Overview of Mouth, Nose, and Throat Cancers
Cancers of the mouth, nose, and throat develop in almost 65,000 people in the United States each year. These cancers are more common among men because male smokers continue to outnumber female smokers and because oral human papillomavirus (HPV) infection is more frequent in males. Most affected people are between the ages of 50 and 70. However, the cancers caused by HPV, which are primarily oropharyngeal cancers, occur 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. 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
Less common sites for these cancers are
The hollow spaces located in the bones around the nose (paranasal sinuses)
The nasal cavity and nasal passages
The upper throat (nasopharynx)
The lower part of the throat (hypopharynx)
Also see Thyroid Cancer and Skin Cancer for information regarding tumors of the thyroid gland and skin. For cancers that affect the bones, including the jawbone (osteosarcomas, malignant giant cell tumors, multiple myeloma, and metastatic tumors), see Primary Cancerous Bone Tumors.
Symptoms vary depending on the location of the cancer. Common symptoms of mouth, nose, and throat cancers include
Sometimes red or white patches (erythroplakia or leukoplakia) in the mouth may be early symptoms.
Examination by a doctor or dentist
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.
Before they can select the best form of treatment for a person's mouth, nose, or throat cancer, doctors do staging tests to determine how advanced the cancer has become, taking into account the cancer's size, invasion into nearby tissues, and distant spread (metastasis). Cancers of the mouth, nose, and throat are staged according to the size, location, and invasiveness 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. For oropharyngeal cancer, the person's HPV status also is taken into consideration.
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.
It is important for people to eliminate risk factors of mouth, nose, and throat cancers, 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 vaccination may prevent some of these cancers from developing.
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.