In those with advanced disease, there may be unusual bleeding, facial pain, numbness or swelling, and visible lumps on the outside of the neck or oral cavity.

[5] Surgeries for oral cancers include:[citation needed] The defect is typically covered or improved by using another part of the body and/or skin grafts and/or wearing a prosthesis.

[17] Nasopharyngeal cancer arises in the nasopharynx, the region in which the nasal cavities and the Eustachian tubes connect with the upper part of the throat.

[21] Most tumors of the salivary glands differ from the common head and neck cancers in cause, histopathology, clinical presentation, and therapy.

Cigarette smokers have a lifetime increased risk for head and neck cancer that is 5 to 25 times higher than the general population.

[5][47][48] Smokeless tobacco is associated with a higher risk of developing head and neck cancer due to the presence of the tobacco-specific carcinogen N'-nitrosonornicotine.

[23] The use of electronic cigarettes may also lead to the development of head and neck cancers due to the substances like propylene glycol, glycerol, nitrosamines, and metals contained therein, which can cause damage to the airways.

[56][57] Overall, a poor nutritional intake (often associated with alcoholism) with subsequent vitamin deficiencies is a risk factor for head and neck cancer.

[56][22] In terms of nutritional supplements, antioxidants such as vitamin E and beta-carotene might reduce the toxic effect of radiotherapy in people with head and neck cancer but they can also increase recurrence rates, especially in smokers.

[62] Risk factors for HPV-positive oropharyngeal cancer include multiple sexual partners, anal and oral sex and a weak immune system.

[56] Approximately 15–25% of head and neck cancers contain genomic DNA from HPV,[66] and the association varies based on the site of the tumor.

[71] HPV can induce tumors by several mechanisms:[71][72] There are observed biological differences between HPV-positive and HPV-negative head and neck cancer, for example in terms of mutation patterns.

[citation needed] Neck masses typically undergo assessment with ultrasound and a fine-needle aspiration (FNA, a type of needle biopsy).

In such cases people will undergo additional testing to attempt to find the initial site of cancer, as this has significant implications for their treatment.

[citation needed] All squamous cell carcinomas arising from the oropharynx, and all neck node metastases of unknown primary should undergo testing for HPV status.

[citation needed] Surgical resection and radiation therapy are the mainstays of treatment for most head and neck cancers and remain the standard of care in most cases.

For small primary cancers without regional metastases (stage I or II), wide surgical excision alone or curative radiation therapy alone is used.

For more extensive primary tumors or those with regional metastases (stage III or IV), planned combinations of pre- or postoperative radiation and complete surgical excision are generally used.

During the surgery, the surgeon and pathologist work together to assess the adequacy of excision ("margin status"), minimizing the amount of normal tissue removed or damaged.

[100] Radiation therapy for head and neck cancers can also cause acute skin reactions of varying severity, which can be treated and managed with topically applied creams or specialist films.

[citation needed] Docetaxel-based chemotherapy has shown a very good response in locally advanced head and neck cancer.

[citation needed] In 2016, the FDA granted accelerated approval to pembrolizumab for the treatment of people with recurrent or metastatic head and neck cancer with disease progression on or after platinum-containing chemotherapy.

[110] Later that year, the FDA approved nivolumab for the treatment of recurrent or metastatic head and neck cancer with disease progression on or after platinum-based chemotherapy.

[113] There is no clear evidence on the effectiveness of these interventions or any particular type of psychosocial program or length of time that is most helpful for those with head and neck cancer.

[12] Consensus panels in America (AJCC) and Europe (UICC) have established staging systems for head and neck cancers.

These staging systems attempt to standardize clinical trial criteria for research studies and define prognostic categories of disease.

[115] Survival advantages provided by new treatment modalities have been undermined by the significant percentage of people cured of head and neck cancer who subsequently develop second primary tumors.

It is becoming increasingly apparent that caregivers (most often spouses, children, or close family members) might not be adequately informed about, prepared for, or trained for the tasks and roles they will encounter during the treatment and recovery phases of this unique patient population, which span both technical and emotional support.

[121] Of note, caregivers of patients who report lower quality of life demonstrate increased burden and fatigue that extend beyond the treatment phase.

[22] In North America and Europe, the tumors usually arise from the oral cavity, oropharynx, or larynx, whereas nasopharyngeal cancer is more common in the Mediterranean countries and in the Far East.