Head and neck cancer
Red flags for mouth, pharyngeal and laryngeal cancer, HPV-positive oropharyngeal cancer and why it behaves differently, FNA rather than open biopsy of a neck lump, cisplatin chemoradiation, the 2025 perioperative immunotherapy trials, and the late effects physicians manage.
Tier 2Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Over 90% are squamous cell carcinomas of the oral cavity, oropharynx, larynx or hypopharynx. Nasopharyngeal, salivary and sinonasal cancers behave differently.
- Two diseases: tobacco and alcohol related (synergistic risk), and HPV-related oropharyngeal cancer, now the most common head and neck cancer in many high-income countries.
- A neck lump in an adult over 3 weeks is cancer until proven otherwise. FNA, never open biopsy first.
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Sources
- Optimal care pathway for people with head and neck cancers (2nd edition)AU/NZCancer Council Australia and Cancer Australia, 2021 (current edition, checked November 2026)
- eviQ Cancer Treatments Online (head and neck protocols)AU/NZCancer Institute NSW
- Australian Immunisation Handbook (human papillomavirus)AU/NZAustralian Government Department of Health, Disability and Ageing
- Machiels JP et al. Squamous cell carcinoma of the oral cavity, larynx, oropharynx and hypopharynx: EHNS-ESMO-ESTRO Clinical Practice Guidelines. Ann Oncol 2020;31:1462-75European Society for Medical Oncology, 2020 (latest ESMO version found, November 2026)
- NCCN Guidelines Insights: Head and Neck Cancers, Version 2.2025. J Natl Compr Canc Netw 2025National Comprehensive Cancer Network, 2025
- Lewis JS et al. Human papillomavirus testing in head and neck carcinomas: guideline update. Arch Pathol Lab Med 2025;149(6):e115-e150College of American Pathologists, 2025
- Uppaluri R et al. Neoadjuvant and adjuvant pembrolizumab in locally advanced head and neck cancer (KEYNOTE-689). N Engl J Med 2025;393:37-50New England Journal of Medicine, 2025
- Imamura Y et al. Comparative review of KEYNOTE-689 and NIVOPOSTOP trials. Cancer Treat Rev 2025;140:103018Cancer Treatment Reviews, 2025
- Gillison ML et al. Radiotherapy plus cetuximab or cisplatin in HPV-positive oropharyngeal cancer (NRG Oncology RTOG 1016). Lancet 2019;393:40-50The Lancet, 2019
- Burtness B et al. Pembrolizumab alone or with chemotherapy versus cetuximab with chemotherapy for recurrent or metastatic HNSCC (KEYNOTE-048). Lancet 2019;394:1915-28The Lancet, 2019
- Patil VM et al. Docetaxel as a radiosensitizer in head and neck cancer unsuitable for cisplatin-based chemoradiation: phase III randomized trial. J Clin Oncol 2023;41:2350-61Journal of Clinical Oncology, 2023
- Mehanna H et al. PET-CT surveillance versus neck dissection in advanced head and neck cancer (PET-NECK). N Engl J Med 2016;374:1444-54New England Journal of Medicine, 2016
- Peterson DE et al. Prevention and management of osteoradionecrosis in patients with head and neck cancer treated with radiation therapy: ISOO-MASCC-ASCO guideline. J Clin Oncol 2024ISOO, MASCC and ASCO, 2024
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Turnstile bot check on sign-in and signed-out feedback