Head and Neck Cancer FAQs

Head and neck cancer is the term used for a handful of cancers found in or around the throat, larynx, nose, sinuses, mouth, and other areas of the face and neck. 

There are several risk factors of head and neck cancer, including, but not limited to:

• Tobacco use, including both smoking and chewing/ smokeless tobacco
• Frequent and heavy alcohol use
• Excessive sun exposure
• History of prior radiation to the head and neck
• Human Papilloma Virus (HPV)

Head and neck cancer may begin in the throat or on the voice box. The paranasal sinuses, the air-filled spaces behind the nose responsible for heating inhaled air and increasing speech resonance, are also a region susceptible for developing cancer. Head and neck cancer can also affect the tongue or gums in addition to the salivary glands which make saliva and help soft mass of chewed food go down the esophagus easily. Another site which is prone to cancer is the lymphatic system, the part of the circulatory system which transports white blood cells throughout the body to fight infection.

Common head and neck cancer symptoms include:

• White or a red area on the gums, tongue, or lining of the mouth.
• Swollen jaw with mouth pain/bleeding which makes it difficult to swallow and speak.
• Numbness or paralysis of the face along with persistent face, chin, and neck pain.
• Clogged sinuses and/or chronic sinus infections that don't respond to antibiotics.
• Breathing issues.
• Reoccurring headaches.
• Pain or ringing in the ears which lead to hearing impairment.

Tobacco products such as: snuff, chewing tobacco, cigarettes, cigars, and pipes are main contributors to individuals getting head and neck cancer. High amounts of nicotine damage the cheek's inner lining allowing for the toxic chemicals to enter the bloodstream and then circulate to other regions of the body. Also, heavy alcohol consumption use raises the risk of developing head and neck cancer. Seventy-five percent of all cancerous mouth and throat tumors are associated with tobacco and alcohol use.

Penn treats more head and neck cancer patients than any other hospital in the region. Our center performs twice as many head and neck cancer procedures as any other Greater Philadelphia hospital. By putting this experience to work, we offer our patients the best possible treatment outcomes.

TransOral Robotic Surgery, or TORS was pioneered and developed by Dr. Weinstein and Dr. O'Malley in the Department of Otorhinolaryngology – Head and Neck Surgery at Penn Medicine. TORS is a minimally-invasive, robotically-assisted surgical approach to removing tumors of the mouth, throat and voice box. It dramatically improves the treatment of head and neck cancers. Using this approach, tumors can be completely removed while preserving speech, swallowing, and other key functions, thus maintaining quality of life.

Patients who are interested in TransOral robotic surgery (TORS) should schedule an evaluation by a TORS physician. They will review the patient's records, meet with them to assess their needs, and advise of all treatment options available as well as the risks and benefits of each approach.

The rationale for adding radiation or chemoradiation after TORS is almost always based on presence or absence of cancer in the lymph nodes. Almost half the patients who undergo TORS do not have the need for chemotherapy as a postoperative treatment. After a patient undergoes the TORS procedure, the Penn Medicine team is able to decrease the intensity of the radiation or chemoradiation, so patients receive less of a dose than they would have if they did not have TORS. Long-term swallowing function has been shown to be far better with TORS when compared to patients treated with full intensity chemoradiation as reported in the medical literature for patients with oropharyngeal cancer (tonsil and tongue base cancer).

Individuals who come to the Penn Center for Head and Cancer benefit from MyChart by myPennMedicine, the region's only patient-accessible Electronic Medical Record. MyChart by myPennMedicine allows for patients to request prescription renewals and review their health history online.

At Penn, patients can have their tumor type screened for free by the Center for Personalized Diagnostics which pinpoint the gene mutation responsible and the treatment best suited for the cancer.

Penn has a number of survivorship services in place to help patients following treatment. The Abramson Cancer Center Survivorship Center of Excellence works to help patients with the needs of long term cancer survivorship and the CARE Clinic addresses the more specific concerns of head and neck cancer survivors.

Many head and neck cancers are known as squamous cell carcinomas. Squamous cells make up the moist surfaces inside the mouth, head, and neck. Squamous cell cancer of the head and neck is common, with tens of thousands of cases being diagnosed in the United States annually.

The different types of head and neck cancers, some of which are squamous cell carcinomas, are named based on where they begin:

• Larynx
• Oral Cavity
• Pharynx
• Salivary Glands
• Skin