Neck masses are often a result of infection or trauma. If these masses do not reduce in size or disappear after two weeks, consultation with a physician is advised. Head and neck cancer may present in the neck initially but rarely is the primary tumor site. Often a primary tumor site is located deep in the head and neck and must be located. Common primary sites include the nasopharynx, tonsils, base of the tongue, the larynx, and the pyriform sinuses. These areas must be evaluated thoroughly.

Thyroid cancer can also present as a lump or swelling in the neck. Often a large thyroid growth can lead to swallowing problems and narrowing of the airway. There are approximately 16,000 new thyroid cancer cases a year.

Hoarseness can result from an upper respiratory infection, allergy, a virus, and voice abuse (yelling at a baseball game). If the voice does not return to normal after two weeks, consultation with a physician is recommended. Nearly all cancers of the larynx (voice box) cause hoarseness. A persistent change in your voice should alert you to a potential problem in your hypopharynx, base of tongue, in addition to your larynx.

Throat and esophageal cancers can cause problems with swallowing. If you notice you have difficulty swallowing solid food, consultation with a physician is encouraged. Cancers can make swallowing liquids also difficult and sometimes cancers can cause food to get "stuck" in areas of the throat. Direct evaluation (endoscopy) of the esophagus and throat along with radiologic testing are necessary for a complete evaluation to diagnose a cancer in this area.

Relative Risk of Acquiring Head and Neck Cancer

Relative Risk = 1 is normal baseline

1. No, not necessarily. A physician who feels very comfortable with the management of a thyroid nodule should follow you. While the majority of thyroid nodules are benign, 5 - 10% can be cancer. Specific tests can aid a physician in determining if a thyroid nodule is benign or cancerous. These tests can include thyroid function tests, ultrasound of the thyroid, and a fine needle biopsy.

1. Rarely. The majority of tumors, if discovered early enough, can be either treated by radiation or limited surgery. Even large tumors of the voice box (Larynx) can now be treated in an organ preserving protocol. Removal of the voice box (laryngectomy) is a last resort.

1. No, today the majority of head and neck surgeons perform what is called a modified radical neck dissection, depending on the specifics of a particular case. All the critical structures are left untouched and only the lymph nodes are removed. Most patients are able to return home after two to three days of hospitalization, have very little pain, and have no obvious disfigurement.