I have a lump in my neck. It has been there for a month. Should I be worried about head and neck cancer?
Although a lump in the neck does not necessarily mean you have head and neck cancer, the lump does need to be examined by your otolaryngologist. Signs and symptoms of head and neck cancer are a lump in the neck, voice changes, a growth in the mouth, bringing up blood, swallowing problems, skin changes or persistent earaches. These symptoms can occur by themselves or in combination with one another.
Let’s look at each symptom in more detail. A lump in the neck can be one of the first symptoms of head and neck cancer you notice. Cancers occurring in the head and neck often spread to the lymph nodes of the neck. Therefore, an examination of your mouth, nose, throat, thyroid and neck is indicated.
Larynx cancer cause voice changes such as hoarseness. Although changes in voice can be attributed to other medical conditions, an examination of the larynx will give information regarding how the larynx is functioning and if there are any growths in or around the vocal cords.
A growth in the mouth may indicate head and neck cancer. Swelling, lumps, ulcers, sore or painful tongue, gums or throat can be symptoms of head and neck cancer. Bleeding of a lump or ulcer in the mouth often occurs late in the disease process. These lumps or ulcers need to be biopsied to determine if the lump/ulcer is benign or malignant.
Tumors in the mouth, nose, or throat often cause bleeding. Bleeding of these sites or blood tinged phlegm or saliva persisting for more than a few days can indicate head and neck cancer. Again, this is an indication to see a otolaryngologist.
Another symptom of larynx cancer is difficulty swallowing. Difficulty swallowing liquids or soft foods, or foods sticking in certain areas of the throat are often patient complaints. Sometimes patients complain of reflux, or food coming back up after being swallowed. If swallowing difficulties become worse and are always present, an examination by a physician is recommended. After an otolaryngologist examines your throat and swallowing tube, and to obtain more information on the mechanics of swallowing, a barium swallow (an x-ray taken while swallowing) may be ordered.
Changes in skin, such as a small pale or reddened area on the skin surface, persistent ulcer, persistent changed skin lesion, or a sore throat which does not heal may also indicate skin cancer. Basal cell cancers are commonly seen cancers which are easily treated. Basal cell cancer occurs due to sun exposure and are prevalent on the face or forehead. A sore on the lip, face, forehead or ear that does not heal needs medical attention. A black or blue-black spot or a mole that undergoes color changes, bleeding, or change in size needs to be immediately examined by a physician for basal cell cancer. Malignant melanoma can present with the above symptoms and can be a serious problem.
Lastly, a constant earache or ear pain when you swallow can indicate infection or a throat tumor. Examination by an otolaryngologist is recommended.
In summary, any of the aforementioned symptoms, a lump in the neck, changes in your voice, a growth in the mouth, blood tinged secretions, problems with swallowing, changes in skin, or persistent earache may be symptoms of head and neck cancer, larynx cancer or malignant melanoma. Any of these symptoms that persist over two weeks are worrisome for cancer, and an appointment to see an otolaryngologist is highly recommended. However, if the symptoms lead to the diagnosis of head and neck cancer, there is hope that if caught early, this disease is very treatable and potentially curable.
With the exception of skin cancer, the people at greatest risk for head and neck cancer are those with a history of years of using various forms of tobacco (i.e. cigarettes, cigars, snuff, chewing tobacco) and consumption of alcoholic beverages. These chronic irritants are responsible for mouth, throat, voice box and larynx cancer. Cancer of the sinuses occur because of long term exposure to carcinogens such as inhaled wood, dust, nickel, and various forms of carcinogenic chemicals. Skin cancers generally occur in people who have had prolonged sun exposure.
The physician will question you regarding your past and present medical history, surgeries, present medications, and allergies. Questions regarding your current symptoms, how long have you had these symptoms, and what you have done to treat or tolerate these symptoms will be reviewed. After this history taking, an examination of your ears, nose and throat will be performed. Oftentimes a telescope (laryngoscope) will be used to better visualize your nose and throat. Based on the information obtained from this examination, a biopsy, x-rays,