Lucan · Conditions

Head and neck cancer

Australian guidance: eviQ head and neck cancer protocols; Cancer Council Australia; RACGP red flags for suspected malignancy

1. Overview

Most head and neck cancers are squamous cell carcinomas arising from the mucosa of the oral cavity, oropharynx, larynx, hypopharynx, and nasopharynx. The two dominant risk profiles are tobacco plus alcohol (synergistic, classically older smokers and drinkers, HPV negative) and human papillomavirus type 16, which drives oropharyngeal (tonsil and tongue base) cancer in a younger group and carries a markedly better prognosis. The high-yield primary-care skill is recognising the red-flag presentations that warrant urgent ENT referral before a curable cancer is missed: a neck lump, hoarseness, a non-healing oral ulcer, or referred otalgia with a normal ear, each persisting beyond three weeks. A metastatic cervical node should have fine-needle aspiration, never an excisional biopsy that seeds the neck. A new unilateral middle ear effusion in an adult is nasopharyngeal carcinoma until proven otherwise.

Written for Australian practice and grounded in the guidance named above. Study material only — not medical advice. Always check against current guidelines.