Principles and management of head and neck cancer

Head and neck cancer is predominantly squamous cell carcinoma and affects the whole of the upper aerodigestive tract. It is traditionally associated with tobacco and alcohol use in older males. Cancer of the oropharynx has the most rapid increase in incidence at the present time due to human papillomavirus-related malignancy, with a younger age presentation in both sexes. This subtype has been termed ‘a viral epidemic of cancer’. This article outlines the relevant anatomy, aetiology, presentation, examination and investigatory pathway for this group of patients including relevant national guidelines. An overview of surgical and non-surgical managements available for early and late stage tumours is given. This is supported by information about the multidisciplinary approach to these cancers which is current best practice. Potential future developments in management are discussed.