Head and neck cancers symptoms and risk factors

What are the symptoms?

In the early stages, head and neck cancers may have no symptoms. Many of the symptoms of head and neck cancers are common for other illnesses, so they don’t necessarily mean you have cancer – only tests can confirm the diagnosis. 

If you are concerned about any of these symptoms, see your general practitioner (GP) without delay. For oral cancers, your dentist may also be able to give you advice and refer you to a specialist.

Mouth (oral) cancers

• mouth pain
• pain when swallowing
• a persistent sore or swelling in the mouth, or the area not healing after having a tooth extracted
• a sore throat that doesn’t get better
• unusual bleeding or numbness in the mouth
• red or white patches on the gums, tongue or mouth
• bad breath
• changes in speech or trouble pronouncing words
• difficulty chewing or swallowing food or moving the tongue
• weight loss
• loose teeth, or dentures that no longer fit
• earache
• lump in the neck.

Throat (pharyngeal) cancers

• a lump in the neck
• a persistent sore throat or cough
• difficulty swallowing or opening the mouth wide
• pain when swallowing
• coughing up bloody mucus
• bad breath
• weight loss
• voice changes or hoarseness
• dull pain around the neck
• earache
• feeling that your air supply is blocked
• numb face
• a blocked nose
• hearing loss
• headache.

Voice box (laryngeal) cancers

• a persistent change in the sound of your voice, including hoarseness
• a sore throat that doesn’t get better
• difficulty swallowing or pain when swallowing
• coughing all the time
• difficulty breathing
• weight loss
• pain in the ear
• a lump in the neck.

Nose (nasal cavity or sinus) cancers

• reduced sense of smell
• a persistent blocked nose or ear
• frequent nosebleeds
• lots of mucus in the throat or the back of the nos
• frequent headaches or sinus pressure
• difficulty swallowing
• loose or painful upper teeth
• a lump on the face or in the nose or mouth
• numb face, upper lip or inside mouth
• pressure or pain in ears
• a bulging or watery eye
• double vision or complete or partial loss of eyesight
• a lump in the neck.

Salivary gland cancers

• swelling or a lump near the ear, jaw or lip, or inside the mouth
• left and right sides of the face or neck looking different
• drooping, numbness or muscle weakness on one side of the face (palsy).

What are the risk factors?

The main factors that increase the risk of developing the most common head and neck cancers are:

• smoking tobacco (including cigarettes, cigars and pipes)
• drinking alcohol
• having had human papillomavirus (HPV).

If you drink and smoke your risk is higher than just drinking or smoking. Aboriginal and Torres Strait Islander peoples are at higher risk. Research suggests that vaping and e-cigarettes may potentially also increase oral cancer risk, due to carcinogenic substances, increased inflammation risk and possible damage to oral tissue.

Other risk factors account for a smaller proportion of head and neck cancers. These risk factors include:

• having persistent sores or red or white patches in the mouth
• chewing tobacco, snuff, betel nut, areca nut, paan or gutka
• breathing in asbestos fibres, wood dust or certain chemicals
• poor dental health
• having a weakened immune system
• having had radiation therapy to the head or neck area in the past
• having too much sun exposure (for lip cancer and skin cancer)
• having a parent, child or sibling with head and neck cancer (possibly because you have similar lifestyle factors)
• inheriting a condition linked to head and neck cancer (e.g. Fanconi anaemia, Li-Fraumeni syndrome)
• having had Epstein-Barr Virus (also called glandular fever).

Talk to your doctor if you are worried about any risk factors.

Human papillomavirus (HPV) and cancer risk

Human papillomavirus (HPV) is a group of viruses that affect the surface or lining of parts of the body, including the throat, cervix and skin. It is the most common sexually transmitted infection, and may also be transferred in other ways. About 4 out of 5 people are exposed to HPV in their lifetime and most won’t show symptoms or know they’ve had it.

There are many types of HPV, but only some subtypes are linked to oropharyngeal cancer, which starts in the tonsils and tongue base. This HPV may be spread through oral sex and kissing.

Most HPV infections are cleared by our immune system. In some people, the virus can lie dormant for years and then cause cancer. We still do not understand why this happens. HPV vaccination can protect you against HPV infection. Talk to your doctor about vaccination or if you are worried about HPV.