Understanding Head and Neck Cancer: A Guide for Newly Diagnosed Patients

A diagnosis of head and neck cancer can bring up many questions and concerns. Understanding the basics of your condition is the first step in your cancer journey. This guide is designed to provide you with key information about head and neck cancer, from diagnosis to treatment, to help you have an informed conversation with your medical team.

Head and neck cancers are a group of cancers that start in the cells of the mouth, throat, voice box, sinuses or salivary glands. The most common type is squamous cell carcinoma, which begins in the thin, flat cells that line these areas.

Risk factors for these cancers often include tobacco and heavy alcohol use. Another significant risk factor is the human papillomavirus (HPV), especially for cancers of the tonsils and the base of the tongue.

Diagnosis: Understanding Head and Neck Cancer

Your oncologist will use several methods to confirm a diagnosis and determine the extent of the cancer. This process, known as staging, helps your medical team create the most effective treatment plan.

• Physical exam and biopsy: A doctor will examine the head and neck area for any abnormalities. A biopsy, which involves taking a small tissue sample, is the only way to definitively diagnose cancer.
• Imaging scans: These tests provide detailed pictures of the inside of your body. Common scans include computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET) scans. They help determine the tumor's size, location and whether it has spread to other parts of the body.
• Endoscopy: In some cases, a thin, flexible tube with a camera may be used to look inside the throat or voice box to get a closer look at the tumor and surrounding tissue.

Head and Neck Cancer Treatment Options: A Tailored Approach

Treatment for patients with head and neck cancer is highly personalized and depends on several factors, including the cancer's type, location and stage, as well a patient’s overall health. Your medical team may use one or a combination of the following therapies.

• Surgery: The goal of surgery is to remove the tumor and some surrounding healthy tissue. For small tumors, this may be a straightforward procedure. For larger or more advanced cancers, surgery can be more complex and may require reconstructive procedures.

Dr. Zafar Sayed, an assistant professor of surgery (otolaryngology) and a part of the Head and Neck Cancers Program at the Yale School of Medicine, located in New Haven, Connecticut, shared in an interview with CURE how surgical treatment has evolved for patients with this disease.

“The evolution in treatment, at least on the surgical side, has been to try to make things a little less invasive,” Sayed said. “Many of the surgeries we used to do decades ago, even before I was a physician, would involve placing tracheostomy tubes (breathing tubes in the neck) and feeding tubes (something called a G-tube, a gastrostomy tube, was very common). What we're doing with newer techniques is trying to limit the number of patients who need those measures long term. With some of the newer surgeries, you may need a tracheostomy or a feeding tube, but usually, that will be temporary, and by the time you go home, a lot of that has been removed so you can resume function.”

• Radiation therapy: This treatment uses high-energy x-rays or particles to kill cancer cells. It can be used alone for some early-stage cancers or in combination with other treatments. Radiation may also be given after surgery to eliminate any remaining cancer cells.
• Chemotherapy: Chemotherapy uses drugs to kill cancer cells. It's often used in combination with radiation therapy to make the cancer cells more sensitive to the effects of radiation.
• Targeted therapy and immunotherapy: These are newer treatments that can be highly effective. Targeted therapies focus on specific genes or proteins that help cancer cells grow. Immunotherapy helps your body's own immune system find and destroy cancer cells.
• Targeted therapy: This treatment is a form of precision medicine that works by targeting specific molecules or pathways that cancer cells need to grow, divide and spread. Think of it like a smart bomb that seeks out a specific weak point in the enemy's fortress, rather than a carpet bomb that hits everything in its path.

For head and neck cancer, one common target is EGFR, a protein on the surface of some cancer cells that helps them grow. Drugs like Erbitux (cetuximab) are monoclonal antibodies that attach to EGFR, blocking its signals and preventing the cancer cell from multiplying. By zeroing in on these unique characteristics, targeted therapy can be very effective with potentially fewer side effects on healthy cells compared with traditional chemotherapy.

• Immunotherapy: Immunotherapy, on the other hand, doesn't directly attack the cancer cells. Instead, it unleashes and boosts your body's own immune system to find and destroy cancer cells. Normally, the immune system is very good at identifying and eliminating foreign invaders like bacteria or viruses. However, cancer cells can be tricky; they can use "checkpoints" to hide from the immune system and avoid being attacked.

The most common form of immunotherapy for head and neck cancer is called an immune checkpoint inhibitor. These drugs, such as Keytruda (pembrolizumab) and Opdivo (nivolumab), work by blocking the proteins that act as these "brakes" on your immune cells. By releasing the brakes, the immune system's T-cells are activated and can now recognize the cancer as a threat and mount a powerful attack. Immunotherapy can be used alone or in combination with other treatments and has shown promising results in treating advanced or recurrent head and neck cancers.

Adverse Effects: Managing Your Side Effects From Head and Neck Cancer Treatment

Cancer treatments can affect healthy cells, leading to side effects. Managing these side effects is a crucial part of your treatment plan. Your doctor or a specialized support team can provide strategies and medications to help.

• During and after treatment: Common side effects of radiation therapy include a sore throat, changes in taste, dry mouth and skin irritation. Chemotherapy can cause nausea, fatigue and a higher risk of infection.
• Long-term effects: Some side effects, like changes in speech, swallowing or dental issues, may persist after treatment ends. Your care team can connect you with specialists, such as a speech therapist or a dentist, to help manage these issues.

Living With Head and Neck Cancer

Beyond medical treatments, managing your daily life is an important part of your head and neck cancer journey. This includes focusing on your physical and emotional well-being.

• Nutrition: Treatment can make eating difficult. A registered dietitian can help you find food and liquid options that are easy to swallow and provide the nutrients you need.

In an interview with CURE, Kanisha Parikh, a dietitian at John Theurer Cancer Center in Hackensack, New Jersey shares tips for helping patients with cancer, including those with head and neck cancer, maintain nutrition when eating becomes difficult. Examples include Greek yogurt, mashed avocado and macaroni and cheese; she even walked through a recipe for creamy lentil soup.

• Emotional support: A cancer diagnosis can be emotionally challenging. Talking to a therapist, joining a support group or connecting with other survivors can provide a sense of community and help you cope with the emotional toll.
• Physical rehabilitation: A physical or occupational therapist can help you regain strength and function after surgery or other treatments. A speech-language pathologist is often a vital part of the team, helping with issues related to swallowing and speaking.

Beyond Diagnosis: Your Voice is Key to Effective Head and Neck Cancer Care

Your medical team is your partner in this journey. Asking questions and voicing your concerns are essential for making informed decisions about your care. Consider discussing the following with your oncologist:

• What is the specific type and stage of my cancer?
• What treatment plan do you recommend and why?
• What are the potential side effects of this treatment, both short- and long-term?
• What support services are available to me, such as nutrition counseling or a patient support group?

Remember, a head and neck cancer diagnosis is a significant life event. By understanding your condition and actively participating in your care, you can navigate your treatment with confidence.

Editor’s Note: This guide is designed to be a starting point. Your personal experience will be unique. By using this information as a foundation for your discussions, you can partner with your oncologist to make the best decisions for your health.

References

1. CURE. Eating Tips for When Cancer Treatment Makes Meals Challenging. Published June 26, 2025. https://www.curetoday.com/view/eating-tips-for-when-cancer-treatment-makes-meals-challenging
2. CURE. Comforting Lentil Soup Recipe to Ease Side Effects During Cancer Care. Published June 25, 2025. https://www.curetoday.com/view/comforting-lentil-soup-recipe-to-ease-side-effects-during-cancer-care
3. CURE. Recognizing Symptoms During Head and Neck Cancer Awareness Month. Published April 18, 2025. https://www.curetoday.com/view/recognizing-symptoms-during-head-and-neck-cancer-awareness-month

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