Head & Neck Cancer

Head and neck cancers encompass a range of malignancies that affect the oral cavity, oropharynx, skin, and lymph nodes. These cancers can significantly impact speech, swallowing, and appearance, making early diagnosis and specialised treatment essential.

Below is an overview of common head and neck cancers, their causes, symptoms, risk factors, and treatment options.

Overview

Oral cavity cancer affects structures such as the tongue, floor of the mouth, and buccal mucosa (inner cheek). It is one of the most common head and neck cancers in Australia, with squamous cell carcinoma (SCC) being the predominant type.

Causes

  • Chronic tobacco and alcohol use
  • Human papillomavirus (HPV) infection (less common than in oropharyngeal cancer)
  • Poor oral hygiene and chronic irritation (e.g., ill-fitting dentures, sharp teeth)
  • Prolonged sun exposure (for lip cancer)

Symptoms

  • Non-healing mouth ulcers
  • Persistent pain or discomfort
  • White or red patches inside the mouth (leukoplakia or erythroplakia)
  • Difficulty chewing, swallowing, or speaking
  • Lump or swelling in the mouth

Risk Factors

  • Smoking and excessive alcohol consumption (synergistic effect)
  • HPV infection (particularly for tongue cancer)
  • Poor dental hygiene and chronic irritation
  • Previous history of head and neck cancer

Treatment Options

  • Surgery – Primary treatment for localised oral cancers, including tumour resection and reconstruction for restoration of function
  • Radiotherapy – Used for advanced cases or in combination with surgery
  • Chemotherapy – Typically used in conjunction with radiotherapy for advanced disease
  • Targeted Therapy & Immunotherapy – Emerging treatment options for specific cases

Overview

Oropharyngeal cancer affects the tonsils, base of the tongue, and soft palate. It has been increasingly linked to Human papillomavirus (HPV) infection, which differs from traditional tobacco and alcohol-related cases.

Causes

  • Human papillomavirus (HPV), particularly HPV-16
  • Smoking and excessive alcohol use
  • Chronic inflammation and irritation

Symptoms

  • Persistent sore throat or difficulty swallowing
  • Lump in the neck (due to lymph node involvement)
  • Hoarseness or voice changes
  • Ear pain on one side (referred pain from tumour involvement)
  • Unexplained weight loss

Risk Factors

  • HPV infection (higher risk in younger, non-smoking individuals)
  • Smoking and heavy alcohol use
  • Male gender (higher incidence than in females)
  • Weakened immune system

Treatment Options

  • Surgery – May involve transoral robotic surgery (TORS) for HPV-related cancers
  • Radiotherapy – Often used as a primary treatment or post-surgery
  • Chemotherapy – Used in combination with radiotherapy for advanced cases
  • Immunotherapy – An option for recurrent or metastatic disease

Overview

Skin cancers, including melanoma, squamous cell carcinoma (SCC), and basal cell carcinoma (BCC), are among the most common malignancies in Australia due to high UV exposure.

Types

  • Melanoma – The most aggressive form of skin cancer, prone to spreading.
  • Squamous Cell Carcinoma (SCC) – Can invade deeper tissues and spread to lymph nodes.
  • Basal Cell Carcinoma (BCC) – The most common but least aggressive skin cancer.

Causes

  • Prolonged UV radiation exposure
  • Genetic predisposition
  • Immunosuppression (e.g., post-transplant patients)

Symptoms

  • New or changing mole (melanoma)
  • Non-healing ulcer or scaly lesion (SCC, BCC)
  • Raised, pearly, or translucent growth (BCC)
  • Bleeding or crusting skin lesion
  • Enlarged lymph nodes (suggestive of metastasis)

Risk Factors

  • Fair skin and excessive sun exposure
  • History of sunburns or tanning bed use
  • Family history of melanoma
  • Weakened immune system

Treatment Options

  • Surgical Excision – Primary treatment for most skin cancers
  • Mohs Surgery – Used for facial and high-risk BCC/SCC
  • Radiotherapy – For advanced or recurrent cases
  • Immunotherapy and Targeted Therapy – Used for metastatic melanoma

Overview

Lymph node metastases occur when cancer spreads to the lymph nodes in the neck from a primary site elsewhere. Sometimes, the primary tumour remains unidentified, known as “unknown primary” cancer.

Causes

  • Secondary spread from head and neck cancers (oral cavity, oropharyngeal, thyroid, skin)
  • Unknown primary cancer (likely originating in the head and neck region but undetectable)

Symptoms

  • Persistent lump in the neck
  • No obvious primary tumour despite imaging
  • Swelling or discomfort in the affected area
  • Unexplained weight loss or fatigue

Risk Factors

  • History of smoking and alcohol use
  • HPV infection (related to unknown primary oropharyngeal cancers)
  • Previous history of cancer

Treatment Options

  • Surgical Removal (Neck Dissection) – To remove affected lymph nodes
  • Radiotherapy – Often used post-surgery
  • Chemotherapy or Targeted Therapy – For advanced or systemic disease
  • Investigative Procedures – Including PET-CT and panendoscopy to locate the primary tumour

Conclusion

Dr Laura Wang specialises in the diagnosis and treatment of head and neck cancers, providing expert surgical and multidisciplinary care. Early detection and comprehensive treatment planning are crucial for optimal outcomes. If you have concerns about symptoms or require specialised evaluation, book a consultation today for personalised care.

Dr Laura Wang is a highly-experienced, fellowship-trained Endocrine and Head & Neck surgeon consulting and operating across Sydney.

Dr Wang holds both a Master of Surgery (MS) Degree and a Doctorate of Philosophy (PhD) in thyroid cancer surgery and performs a high-volume of thyroid and parathyroid surgeries. She was the first surgeon to be dual-trained in both head and neck cancer surgery (for benign and cancerous conditions), as well as microvascular reconstructive surgery at Memorial Sloan Kettering Cancer Centre in New York, which is the oldest cancer hospital in the world (founded in 1884).

Get in touch to book an appointment. Urgent appointments available for cancer patients.

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Endocrine and Head & Neck Surgeon
& Reconstructive Microvascular Surgeon
Phone

(02) 8076 4961

Fax

(02) 8080 8146

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