- A sore throat that does not go away
- A change or hoarseness in the voice
- A lump or a sore that does not heal
- Difficulty swallowing
- Unintentional weight loss
- Pain when swallowing or ear pain
- A white or red patch on the gums, tongue, or lining of the mouth
- A swelling of the jaw that causes dentures to fit poorly or become uncomfortable
- Abnormal bleeding or pain in the mouth
- Sinuses that are blocked and do not clear
- Chronic sinus infections that do not respond to treatment with antibiotics
- Blockage in one nostril
- Pus or discharge from the nose
- Mucus draining from the back of the nose into the throat
- Sinus pain
- Nose bleeds
- Frequent headaches
- swelling or other trouble with the eyes
- Pain in the upper teeth
- Loose upper teeth or changes in how dentures fit
- Swelling under the chin or around the jawbone
- Painless lump(s) in the area of the ear, cheek, jaw, lips, or mouth
- Numbness or weakness of the muscles in the face
- Pain in the face, the chin, or the neck that does not go away
- Fluid draining from the ear
- Trouble swallowing
- Difficulty opening the mouth widely
- Sore in the mouth or on the lip that does not heal
- Red or white patch on the gums, tongue, tonsil, or lining of the mouth
- Lump on the lip, mouth, neck, or throat or a feeling of thickening in the cheek
- Persistent sore throat or feeling that something is caught in the throat
- Trouble breathing
- Hoarseness or change in voice
- Numbness of the mouth or tongue
- Difficulty in hearing
- Pain or bleeding in the mouth
- Pain in the neck or the throat that does not go away
- Difficulty chewing, swallowing, or moving the jaws or tongue
- Pain when swallowing
- Frequent headaches, pain, or ringing in the ears
- Ear and/or jaw pain
- Chronic bad breath
- Changes in speech
- Loosening of teeth or toothache
- Dentures that no longer fit
- Unexplained weight loss
- Loss of appetite
Symptoms and signs of laryngeal cancer include:
- Abnormal (high-pitched) breathing sounds
- Chronic cough (with and without blood)
- Difficulty swallowing
- A sensation of a lump in the throat
- Hoarseness that does not get better in 1 - 2 weeks
- Neck and ear pain
- Sore throat that does not get better in 1 - 2 weeks, even with antibiotics
- Swelling or lumps in the neck that does not heal
- Unintentional weight loss
There is no single test that can accurately diagnose cancer. The complete evaluation of a patient generally requires a thorough history and physical examination along with diagnostic testing. Many tests are required to determine if a person has cancer or if another condition (such as an infection) may be mimicking the symptoms of cancer.
Physical examination of the throat and neck: This enables the doctor to feel for swollen lymph nodes in the neck and to view the throat by using a small, long-handled mirror to check for abnormalities.
Endoscopy: A procedure by which an endoscope (a flexible lighted tube) is inserted through the nose or mouth into the upper airway to the larynx, enabling the examiner to directly view these structures.
Laryngoscopy: A procedure to examine the larynx with a mirror or a laryngoscope (a rigid lighted tube).
CT scan (computed tomography): A procedure that generates a series of detailed radiographs of body sites, taken from different directions. A contrast material such as an injected or swollen dye enables better visualization of the organs or tissues.
MRI (magnetic resonance imaging): A procedure that uses a magnet and radio waves to generate a series of detailed pictures of areas inside the body.
Barium swallow: A procedure to examine the esophagus and stomach in which the patient drinks a barium solution that coats the esophagus and stomach, and x-rays are obtained.
Biopsy: A procedure where tissues are obtained so that they can be viewed under a microscope to check for cancer.
- The extent the cancer has spread (the "stage")
- The appearance of the cancer cells (the "grade")
- The location(s) and size of the tumor
- The patient's age, gender, and general health
Individuals with early or small throat or laryngeal cancer may be treated with surgery or radiation therapy. Those with advanced or recurrent cancer may require a combination of treatments. This may include surgery as well as a combination of radiation therapy and chemotherapy generally given at the same time.
- Ear, nose, and throat doctors (otolaryngologists)
- General head and neck surgeons
- Medical oncologists
- Radiation oncologists
- The extent to which the cancer has spread (the stage)
- The location and size of the tumor
- Whether the cancer has return
- Maintaining the patient's ability to talk, eat, and breathe as normally as possible
- The patient’s general health
- Potential of side effects and toxicity
The medical team describes the available treatment choices to the patient and the expected results, as well as the possible side effects. Patients should carefully consider available options and understand how these treatments may affect their ability to eat, swallow, and talk, and whether the treatments will alter their appearance during and after treatment. The patient and his/her health care team can work together to develop a treatment plan that fits the patient's needs and expectations.
- What is the size, location, spread, and stage of the tumor?
- What is the HPV status of the cancer?
- What are the treatment options? Would they include surgery, radiation therapy, chemotherapy or a combination of these? Is laryngectomy the only viable option?
- What are the expected side effects, risks and benefits of each kind of treatment?
- How can side effects be managed?
- What is the risk of recurring cancer?
- What will be the sound of the voice with each of the above treatments?
- What are the chances of being able to eat normally?
- How will the breathing be affected?
- How to prepare for treatment?
- Will the treatment require hospitalization and if so for how long?
- What is the estimated cost of the treatment and will insurance cover it?
- How will the treatment affect one’s life, work and normal activities?
- Is a research study (clinical trial) a good option?
- Can the physician recommend an expert for a second opinion regarding the treatment options?
- How often and for how long will there be a need for follow ups?
- Is there a support group in the area that can assist after surgery?
- Detailed past medical, dental, social and psychological history
- Detailed description about your symptoms
- Any handicap you have
- Past surgeries
- Past vaccinations
- Medications you take
- Your diet
- Illnesses in your family
- Your work, and travel history (not only recent)
- Exposure to irritants, toxins etc.
- Allergies to food and medications
- Your life style, daily activities, and long term plans
- List of all the physicians and medical care providers
- Your preferred treatment (after hearing the options)
- Your preference knowing details on your condition, treatment and prognosis
- Your preferences about life support
- Your medical insurance coverage
Local, regional or metastatic recurrent head and neck cancer is more challenging and difficult than the initial cancer. Treatment options, curse and goals depend on whether the recurrence is local, regional or metastatic.