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Head & Neck Cancers: A How-to and Why You Should Do a Self-Exam Guide

Catching cancer early often starts at home. Here’s what may increase your risk for head or neck cancer and the early warning signs you can look for.

Self-exams are a simple, yet powerful way to help catch early warning signs of cancer. Anyone can benefit from these brief health “check-ins” between routine doctors’ visits; but for those at higher risk for cancer, they are highly recommended.

Head and neck self-exams are lesser known than your traditional skin or breast self-exam. However, with rates continuously increasing for the past two decades – accounting for more than 66,000 annual diagnoses in the U.S. – they are becoming more popular.

Cancers of the head and neck can occur in the voice box (larynx); mouth (oral cavity); lower throat (hypopharynx); middle throat (oropharynx); upper throat, behind the nose (nasopharynx); nasal cavity; sinuses; and salivary glands. Checking these areas can be a little tricky, but still possible, says otolaryngologist (ENT) Joseph M. Curry, MD.

When You Should Check

People over 40 years of age should consider head and neck self-exams about as often as they go to the dentist, or around every six months; although you can do them more frequently, notes Dr. Curry.

You might be at higher-than-average risk for head and neck cancer if you:

  • Have a history of smoking or tobacco use (or significant known secondhand smoke exposure)
  • Frequently or heavily consume alcohol
  • Have HPV (Human Papillomavirus) or have not been vaccinated to protect against HPV

[Editor’s Note: Experts recommend the HPV vaccine for males, as well as females. Read more about common misconceptions surrounding the vaccine.]

A Shift in the Impact of HPV

HPV is a lot more common than we once thought, says Dr. Curry. The HPV virus has many strains. Sometimes infection clears on its own; other times it causes common warts, sexually transmitted diseases or even certain cancers, such as cervical and oropharyngeal (throat) cancer. It’s estimated that most of the population will be exposed to some form of cancer-causing HPV in their lives.

For many years, most head and neck cancers were linked to heavy smoking and drinking, explains Dr. Curry. However, an emergence of data has shown a significant increase in HPV-related head and neck cancers.

Cervical cancer is still the most common HPV-related cancer among women; but now head and neck cancers are the most common HPV-related cancer overall in the U.S. and specifically among men, according to the Center for Disease Control and Prevention.

“HPV-related cancers result from persistent viral infection in the tonsils and base of the tongue – also known as oropharyngeal cancer,” adds Dr. Curry.

How to Perform a Self-Exam

First thing’s first: grab a flashlight and a mirror.

In your mouth (or oral cavity), focus on the lips, inside the cheeks, tongue, gums, and the floor of the mouth, suggests Dr. Curry. Suspicious presentations include a white or red patch, painful lump, or anything tender or firm to the touch that has persisted for more than two weeks.

While you may not be able to see much further back in the throat, you should be able to see the tonsils and a small portion of the base of the tongue, which are key parts of the oropharynx.

“We’re concerned with asymmetrical or uneven tonsils or a lump on the back of the tongue,” explains Dr. Curry. “A change in voice may also indicate something further back in the throat. Some people experience a ‘froggy’ sound or feel as if something is stuck in the back of the throat, which we call a ‘globus’ sensation.”

Next, you should feel your neck for any firm lumps that don’t match the other side. Many head and neck cancers, including those within the nasopharynx (upper part of the throat in the back of the nose), can cause such lumps, explains Dr. Curry. “Most patients with HPV present this way, even if their cancer started in the throat. Whether lumps are painful or pain-free, they’re worth getting evaluated. A lump doesn’t always mean cancer; it could be a benign (non-cancerous) cyst or an infection, which will still require treatment.”

Another common, yet unexpected, symptom of head and neck cancers is referred pain in the ear (when it’s not an ear-related issue). Any symptoms that have persisted for two weeks or more are concerning and should be brought to the attention of your primary care provider or ENT.

What You Can Do

An ENT or head and neck surgeon may order imaging and a biopsy to either rule out or diagnose cancer; results usually take around three to five days to come back.

Cancer treatment – surgery, radiation, chemotherapy or immunotherapy – depends on the stage, tumor size and location, and one’s general health standing, says Dr. Curry. Most HPV-related cancers are considered lower-stage compared to smoking-related cancers, because they are very responsive to treatment. Often early-stage throat cancers require only surgery or radiation, while more advanced cancers may require multiple treatment methods.

“Our primary goals are to first, cure the cancer, and second, preserve the function of the affected area,” explains Dr. Curry. “We want to preserve speech and swallowing as much as possible, so the treatment of choice (surgery or radiation) may differ based on the site.”

So, how can you reduce your risk? Many of the same tried-and-true ways you help prevent other cancers, answers Dr. Curry. “If you smoke, seek help to quit. It will decrease your cancer risk, help your body heal from the many damaging effects of smoking, as well as benefit you in other ways. Heavy drinking, or alcohol dependency, is also a significant risk factor. Professional help from a substance abuse treatment program may help mitigate this.”

Understanding what causes HPV-related oropharyngeal cancers is being actively researched, adds Dr. Curry, but we do know that the number of oral sex partners one has (specifically if greater than five partners) increases risk. Safe sex practices – including proper use of condoms and dental dams – can reduce your risk for cancer and STDs.

Leading a healthy lifestyle – with routine physical activity, a well-balanced diet, and up-to-date vaccinations and other preventive care – can also help avert cancer, reduce the risk for recurrence if you’ve already had cancer, and even improve cancer treatment outcomes.

Cancers of the head and neck may soon be a “household name,” as they are steadily increasing in incidence, says Dr. Curry. If you’re an adult over 40, know your risks, take a few minutes to check yourself and be sure to ask for help when you suspect something is wrong.

[Main photo credit:]

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From the Experts, Healthy You