• lip and oral cavity
• paranasal sinuses: hollow space behind lowest part of forehead, nose, cheeks, and eyes
• nasal cavity
• salivary glands: gland in the mouth that makes saliva
• oropharynx: part of the throat at back of the mouth, including the soft palate, base of tongue, and tonsils
• nasopharynx: upper part of the throat behind the nose
• hypopharynx: lower part of the throat, and
• larynx: voice box

Some risk factors can be changed and others can not. Some risk factors for head and neck cancer are from the environment and others come from lifestyle choices, such as tobacco and alcohol.

The two most common causes of head and neck cancer are tobacco use and alcohol intake. Fortunately, both of these causes can be avoided. When used together, the risk of cancer of the head and neck increases the risk much more. Smoking and drinking heavily do their damage by first causing changes in cells that form the outer layer in the organs of the head and neck. These cells may become pre-cancerous, which in turn can become full blown cancer.

Head and neck cancer can be caused by the use of any tobacco products, not just smoking cigarettes. Tobacco in the form of cigars, pipes, chewing tobacco and snuff can contribute to the development of head and neck cancers.

Poor nutrition often happens with alcohol abuse and may be responsible for users of alcohol's increased risk. It is felt not eating enough foods with vitamins A and B may play a role. Recent research suggests that people who have used marijuana may be at higher than average risk for head and neck cancer.

Human papilloma viruses are a group of over 100 similar viruses. Most of these viruses cause warts on the hands and feet, which are annoying but not necessarily dangerous. Many cancers of the female cervix are caused by one of two human papilloma viruses known to cause cervical cancer. They may also be a factor in some cases of voice box cancer. Another virus, Epstein-Barr, has been associated with nasopharynx cancer.

Poor oral hygiene is thought to contribute to head and neck cancer. Ill fitting dentures or broken teeth that cause chronic irritation in the mouth/gums can also contribute to oral cancers.

Wood dust inhalation by furniture making workers may be related to cancers of the nasal cavity. Another occupational exposure which may contribute to paranasal sinus cancer is exposure to metal nickel.

Early detection of head and neck cancers is very important. Symptoms to see a health care professional about are:

• Mouth and oral cavity: Swelling or sore in the mouth that doesn't heal.
• Nose, sinuses, nasopharynx: Pain, swelling, bloody nasal discharge, double vision or chronic sinus trouble that does not respond to antibiotics.
• Salivary glands: Painless swelling and later paralysis of one side of the face.
• Oropharynx and hypopharynx: Difficulty or pain on swallowing and/or ear pain.
• Voice Box: Persistent hoarseness, difficulty breathing or swallowing.

For more information about any cancer concern, contact:

Cancer Information Service
Holden Comprehensive Cancer Center
UI Hospitals and Clinics
200 Hawkins Drive, 4802 JPP
Iowa City, Iowa 52242
Toll-free: 1-800-237-1225
cancer-information@uiowa.edu