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Head and Neck Cancer

Head and neck tumors, also known as cervicofacial cancers, include neoplasms that develop in the upper aero-digestive tract: mouth, tongue, gums, pharynx, larynx, nose, paranasal sinuses, and salivary glands.

According to the report "Cancer Numbers in Italy 2024" (AIOM-AIRTUM), an estimated 5,977 new diagnoses of these conditions were recorded in Italy. In 85% of cases, the main risk factor is cigarette smoking, followed by excessive alcohol consumption.

Thanks to advances in early diagnosis and oncological treatments, survival rates are improving, although they vary depending on the stage of the disease. When lymph nodes are not involved, the 5-year survival rate exceeds 80%. If lymph node involvement is present, this drops to around 50%.

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What Is Head and Neck Cancer?

Head and neck tumors comprise a group of neoplasms that develop in anatomical areas such as the mouth, larynx, pharynx, nose, and salivary glands. The majority of these tumors originate in the larynx, followed by the oral cavity and pharynx.

The most common type is squamous cell carcinoma, which accounts for around 90% of cases. This tumor forms in the squamous cells that line the internal surfaces of the mucosa. Other forms—such as tumors of the salivary glands, paranasal sinuses, or those arising from muscles, nerves, and other soft tissues—are more rare but clinically significant.

Types of Head and Neck Tumors

Below are some of the most common benign and malignant tumors in the head and neck region:

  • Squamous cell carcinoma (most frequently found in the larynx and tongue).
  • Skin tumors of the face and neck
  • Thyroid tumors (among the most common in this anatomical region).
  • Tumors of the parotid and submandibular glands.
  • Tumors of the minor salivary glands (found in the oral cavity and palate).
  • Parathyroid tumors.
  • Salivary gland tumors of various types (benign or malignant).

What are the risk factors for head and neck cancers?

The main risk factor for the development of head and neck cancers is cigarette smoking, followed by alcohol abuse. The combination of these two factors significantly multiplies the risk.

Other known risk factors include:

  • A diet low in vitamins A and B, which are essential for tissue health.
  • Exposure to radiation during childhood, for example, for therapeutic treatments.
  • Advanced age: most diagnoses occur after the age of 50.
  • Infection with human papillomavirus (HPV), particularly high-risk strains.
  • Poor oral hygiene and lack of regular dental check-ups.
  • Male sex: head and neck cancers are more common in men.

How to Prevent Head and Neck Cancers

There is no guaranteed way to completely prevent head and neck cancers, but you can significantly reduce the risk by adopting healthy lifestyle habits and protective behaviors. Here are some effective prevention measures:

  • Take care of dental prosthetics and have them checked periodically.
  • Get regular dental check-ups and maintain good oral hygiene.
  • Avoid using chewing tobacco.
  • Limit the number of sexual partners to reduce the risk of HPV infection.
  • Reduce or eliminate alcohol consumption.
  • Quit smoking, even after many years of the habit.
  • Use proper sun protection, especially on the face and lips.
  • Get vaccinated against human papillomavirus (HPV) between the ages of 9 and 45.

Currently, there are no structured screening programs for these types of cancer, but early diagnosis remains a key tool for improving treatment outcomes and chances of recovery.

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What Are the Symptoms of Head and Neck Cancer?

Head and neck cancers can develop without obvious symptoms in the early stages. That’s why it’s important to pay attention to any persistent or unusual signs. As the disease progresses, symptoms may vary depending on the affected area.

Here are the main symptoms not to overlook:

  • Hoarseness or persistent changes in voice.
  • Difficulty swallowing, breathing, or speaking.
  • Pain in the upper teeth or trouble using dental prosthetics.
  • Ear pain or tinnitus (ringing/buzzing in the ears).
  • Persistent pain in the face, chin, or neck.
  • Swelling in the jaw or under the chin.
  • Swelling or visual disturbances related to the eyes.
  • Chronic sinus infections that are resistant to antibiotic therapy.
  • Numbness or partial facial paralysis.
  • Chronic sore throat or one that doesn’t improve.
  • Recurring headaches.
  • Lump, ulcer, or sore in the mouth or throat that doesn’t heal.
  • Unusual bleeding from the mouth or nose.
  • Chronic or recurrent sinusitis.

Many of these symptoms may also be linked to non-cancerous conditions. However, if one or more of these signs persist for over two weeks, it’s important to consult your physician or a specialist for a thorough evaluation.

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How Do You Diagnose Head and Neck Cancer?

Diagnosing head and neck tumors can be complex, as initial symptoms often resemble those of benign and common conditions. To formulate an accurate diagnosis, specialists rely on an integrated approach using various tools and technologies.

Depending on symptoms, age, medical history, and the suspected tumor location, the doctor may request:

  • Thorough medical history and lifestyle assessment: includes a clinical interview, measurement of weight and height, analysis of tobacco and alcohol use, and sometimes blood tests.
  • Biopsy: removal of a small sample of suspicious tissue for microscopic histological analysis, used to confirm the presence and type of tumor.
  • Diagnostic imaging tests: including CT scans, PET-CT, MRI, and ultrasound — essential for locating the lesion, assessing its extent, and checking for lymph node or tissue involvement.
  • Speech and swallowing tests: often used to evaluate the function of sensitive structures before and after treatment.

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How Do You Treat Head and Neck Cancer?

The treatment of head and neck tumors varies depending on several factors, including:

  • Therapeutic goals shared with the patient.
  • Stage and aggressiveness of the tumor.
  • Type and location of the neoplasm.

Based on these evaluations, the multidisciplinary team may propose one or more therapeutic approaches:

  • Surgery – This is often the first treatment option. The surgical procedure may be more or less extensive depending on the site and stage of the tumor.
  • Radiotherapy – Uses high-energy radiation to destroy cancer cells, often combined with other treatments.
  • Drug therapy – Includes chemotherapy and, in selected cases, the use of monoclonal antibodies or other targeted medications.

In some cases, a combined therapy is recommended to enhance treatment effectiveness and improve prognosis. A personalized and integrated approach is essential to achieve the best possible outcomes.

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Reviewed June 2025.