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Head and neck cancer

Information about head and neck cancer, as well as guidance about what support is available from Changing Faces and other organisations.

What is head and neck cancer?

The term “head and neck cancer” refers to a number of forms of cancer which may affect the:

  • Mouth / lips
  • Voice box (larynx)
  • Throat (pharynx)
  • Salivary glands
  • Nose and sinuses
  • Back of the nose and throat (nasopharynx)

Head and neck cancers are relatively rare, with around 12,000 new cases diagnosed each year in the UK.

Sometimes, the surgery or radiotherapy used to treat certain head and neck cancers can lead to changes in your appearance. This may affect your confidence and self-esteem. On this page, we look at the impacts of head and neck cancer, how it can affect your appearance, and what we can do to support you with this.

The effects of the operation [to remove the cancer] have been both practical and emotional. My limited eyesight has stopped me from riding my motorbike and playing golf which were both important pastimes. It has also affected my self-confidence and, subsequently, my social life.

Mark, who has a visible difference following surgery to treat head and neck cancer

Types of head and neck cancer

Cancer Research UK lists nine forms of head and neck cancer. You can find out more about each of these on their website and also the NHS site.

  • Laryngeal cancer: Affects the voice box (“larynx”).
  • Mouth and oropharyngeal cancer: Mouth cancer affects the lips, gums or soft insides of the mouth, while oropharyngeal cancer the area just behind it. Tongue cancer is also a type of mouth cancer.
  • Nasopharyngeal cancer: Affects the area behind the nose where it meets the throat.
  • Nasal and paranasal sinus cancer: Nasal cancer affects the gap behind the nose, paranasal cancer the air-filled spaces inside the bones near the nasal cavity.
  • Oesophageal cancer: Affects the food pipe.
  • Salivary gland cancer: Affects the glands which produce spit.
  • Tonsil cancer: Affects the tonsils.
  • Throat cancer: Affects the throat.

Signs and symptoms

The signs and symptoms are different for each of these cancers. Check the NHS, Cancer Research UK and Macmillan Cancer Support websites for details of the symptoms to look out for.

What causes head and neck cancer? Is it genetic?

Each of our bodily characteristics, such as our hair, skin or eye colour, is encoded in something called a “gene”. A gene is a section of DNA, a molecule which carries bits of genetic code. Sometimes DNA changes (“mutates”) and this can cause cancer. This makes cancer a genetic disease.

However, there are certain things which may make these mutations more likely to occur and lead to head and neck cancer:

  • Smoking increases the risk of laryngeal, pharyngeal, nasopharyngeal and mouth cancer.
  • High alcohol consumption increases the risk of pharyngeal, mouth and laryngeal cancer.
  • Infection by human papilloma virus (HPV) causes 70% of pharyngeal cancer cases and 1% of mouth cancer cases.
  • Infection by Epstein-Barr virus (EBV) causes 80% of cases of nasopharyngeal cancer.

Real stories about head and neck cancer

Treatments for head and neck cancer

There are typically three ways of treating head and neck cancer, and other forms of cancer:

  • Surgery: To remove the cancer from the affected area.
  • Radiotherapy: Destroys the cancer using targeted high-energy rays.
  • Chemotherapy: Cytotoxic (anti-cancer) drugs destroy cancer cells.

Radiotherapy and chemotherapy used in combination is known as chemoradiation.

Targeted therapy is sometimes used to destroy things in and around the cancer which are helping it to persist and grow.

Immunotherapy is another approach. This encourages the immune system to seek and destroy cancer cells.

You can read more about the treatment available for the different types of head and neck cancer on the NHS, Cancer Research UK or Macmillan Cancer Support websites.

How can head and neck cancer affect my appearance?

Treatment for neck and head cancer may have various long-term effects and other effects which emerge later on (“late effects”). This may include changes to your appearance.

Surgery for head and neck cancer may involve removal of the eye, part of the jaw, nose, ear or skin. Reconstructive surgery may be carried out to reduce the visible impacts of this.

If a surgeon needs to cut through your jaw (known as a mandibulotomy) they will reconstruct it with a plate, which can leave a scar.

Surgery to remove lymph nodes may also lead to scarring. As the wound heals, you may notice tightening and thickening of the skin.

Removal of the lymph nodes can also lead to recurring episodes of lymphoedema. Lymphoedema is the improper draining of the lymph glands. It may cause swelling, redness and skin warmth. If it occurs, you should contact your GP.

Changes to your appearance can be distressing and affect your confidence and self-esteem. You may become more aware of others looking at you, and it can be particularly distressing if people make comments or ask questions.

As a child, I learned that you shouldn’t judge people for what their face looks like, but I knew that a lot of people do. A lot of people stared at me and asked questions because of my visible difference. I quickly learned to ignore them but that didn’t mean I was fine about it.

Abigail, who has a visible difference following surgery to treat head and neck cancer

What head and neck cancer support can we offer?

If you are struggling with the impacts of head and neck cancer on your appearance, there are a number of services available which can help.

Here at Changing Faces, our trained wellbeing practitioners may be able to provide confidential one-to-one social, emotional and psychological support through counselling and wellbeing support.

We also have lots of self-help guides to help you manage these feelings and the way you respond to challenging experiences – browse the whole set here.

I feel my involvement [in Peer Group Chat] has put my situation into perspective. I have learned the importance of self-confidence and that building that is a priority. I also realised that life has changed for me. I should not be looking back at what I used to be able to do but looking forward and finding out what I can achieve and enjoy now.

Mark, who has a visible difference following surgery to treat head and neck cancer

You don’t need to change your appearance to meet other people’s expectations. However, if you decide this is the best option for you, skin camouflage can in some cases reduce the appearance of scarring from surgery by matching the affected skin colour with the area around it. Skin camouflage does not change the texture of the skin, or alter raised or indented skin. We cannot apply skin camouflage to skin that is infected, inflamed, or broken. Find out more about our Skin Camouflage Service on our dedicated page.

There are a number of other ways we can support people living with the effects of head and neck cancer here at Changing Faces:

  • Online Community: An online moderated forum managed by Changing Faces staff, where you can talk to others living with the effects of head and neck cancer as well as those with other visible differences.
  • Peer Group Chat Service: An online support group of up to eight participants, taking place on Zoom or via a chatroom and facilitated by Changing Faces staff.
  • Workshops for children and young people and their parents: An opportunity to meet others and learn tools, tips and techniques for managing challenges caused by your visible difference.
  • Real stories: Read stories by other people living with changes to their appearance caused by head and neck cancer.

Please contact our Support and Information Line and if you are interested in accessing our services. Our friendly team also offer support calls for you to talk about the impact of head and neck cancer on your life.

Other organisations

Guidance, support and advice is also available from other organisations. Please follow the links to their websites to learn more.

Cancer Research UK logo

Cancer Research UK

Cancer Research UK funds cancer research and treatment, and raises money and awareness about cancer. They offer specialist resources covering the symptoms, treatments and outlook for different forms of cancer, as well as opportunities to get involved with research into cancer.

Macmillan logo

Macmillan Cancer Support

Macmillan Cancer Support provides information, advice and guidance about different types of cancer, physical, emotional, financial and other practical support for people with cancer, an online community for people affected by cancer, and Macmillan nurses who can help you understand your diagnosis.

Outlook logo

Outlook

A national, highly specialist psychological service based at North Bristol NHS Trust, supporting adults (16+) with appearance-related distress. They can provide face-to-face and remote support via NHS Attend AnyWhere. Please speak to your GP or healthcare professional to discuss a referral.

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NHS

Please have a look at the NHS conditions page for official guidance on the different types of head and neck cancer, and links to more information about treatments available on the NHS. You will also find information about the current impact of coronavirus (COVID-19) on NHS services.