Symptoms of head and neck cancer

The most common symptoms of a cancer of the head and neck include:

• an ulcer in the mouth that doesn’t heal within a few weeks
• difficulty in swallowing, or pain when chewing or swallowing
• trouble with speaking or breathing, such as a hoarse voice or persistent noisy breathing
• a constant sore throat and earache affecting one side
• a swelling or lump in the mouth or neck.

Less common symptoms include:

• a numb feeling in the mouth or on the lips
• an unexplained loose tooth
• a persistent blocked nose or nosebleeds
• ringing in the ear or difficulty hearing
• pain in the face or upper jaw
• pre-cancerous changes in the lining of the mouth or on the tongue, which can appear as persistent white patches (leukoplakia) or red patches (erythroplakia) – they are usually painless but can sometimes be sore and may bleed.

Although these symptoms can be caused by conditions other than cancer, it’s important that they are always checked out by your doctor or dentist, particularly if they persist.

Lymph nodes

An important common symptom of head and neck cancer is swelling of one or more of the lymph nodes in the neck.

The lymph nodes (also known as lymph glands) form part of the lymphatic system, which is the body’s natural defence against infection. They contain white blood cells that help to fight infection and disease. Lymph nodes occur throughout the body but can sometimes be felt as tiny pea-sized lumps in the neck, under the armpits and in the groin.

Diagram of the lymphatic system in the upper body

Cancers in any part of the body can spread into nearby lymph nodes. This is particularly common with head and neck cancers, where the lymph nodes in the neck can become enlarged. Sometimes the first symptom of a head and neck cancer will be a painless enlargement of one of these lymph nodes.

Enlarged lymph nodes are much more likely to be due to a harmless infection than to cancer. However, if a lump stays for more than 3–4 weeks, despite a course of antibiotics, it should be examined by a specialist.