Neck lumps and their link to head and neck cancer

Finding a lump in your neck can be concerning, and it’s natural to wonder what it might indicate. Neck lumps are common and often have benign (non-cancerous) causes, such as swollen lymph nodes due to infection. However, in some cases, a lump in the neck may be linked to more serious health issues, including head and neck cancer.

We speak to a leading ENT head and neck surgeon who helps guide you through what a neck lump might mean, what symptoms to look out for, and when to seek medical advice.

What are common causes of a neck lump?

Neck lumps may arise from a variety of conditions, many of which are not cancerous. One of the most common causes is lymphadenopathy, or swelling of the lymph nodes, which occurs when the body is fighting off infection. Swollen lymph nodes typically feel soft and are tender to the touch. They tend to resolve on their own as the infection clears.

Other causes include cysts, which are fluid-filled sacs often present from birth, and benign growths such as lipomas (soft, fatty lumps under the skin). Thyroid nodules can also appear as lumps in the neck and may need evaluation, especially if they grow or become painful.

On the more serious side, neck lumps can be linked to cancers of the head and neck. These include cancers in areas such as the mouth, throat, larynx (voice box), and even salivary glands.

When should I be concerned about a neck lump?

Most neck lumps are harmless and may go away within a week or two. However, certain characteristics may raise concern, particularly if they persist for longer periods, are hard or fixed in place, or continue to grow. Cancerous lumps are often painless, firm, and immovable, unlike swollen lymph nodes caused by infection, which are typically tender and mobile.

Head and neck cancer-related lumps may also be accompanied by other symptoms, such as:

• Persistent sore throat.
• Difficulty swallowing.
• Unexplained weight loss.
• Hoarseness or changes in the voice.
• Persistent ear pain (especially in one ear).

If you have a neck lump that lasts more than two weeks or is associated with any of the above symptoms, it’s essential to seek medical advice.

How are neck lumps related to head and neck cancer?

A neck lump can sometimes be the first sign of head and neck cancer. These cancers usually start in the mucosal surfaces of the head and neck, such as the mouth, throat, or nasal passages. Cancerous cells can then spread to nearby lymph nodes, leading to the formation of a lump in the neck.

Risk factors for head and neck cancers include tobacco use, heavy alcohol consumption, and infection with human papillomavirus (HPV). Those who have been exposed to these factors may have a higher risk of developing head and neck cancers, and thus should be particularly attentive to any unusual neck lumps.

What tests will I require if my neck lump Is concerning?

If your doctor suspects that a neck lump may be cancerous, they will likely recommend a thorough examination and diagnostic testing. This can include imaging studies such as an ultrasound, which uses sound waves to create images of the neck tissue, or a CT scan (a type of detailed X-ray) to better view any abnormal masses.

In many cases, a biopsy may be necessary. A biopsy involves removing a small piece of tissue from the lump, which is then examined under a microscope to check for cancer cells. There are various types of biopsies, including fine needle aspiration, where a thin needle is used to extract cells, and core needle biopsy, which removes a small cylinder of tissue. Your doctor will discuss which method is most appropriate based on your situation.

Can neck lumps be treated if cancer is diagnosed?

If a neck lump is found to be related to head and neck cancer, there are several treatment options available. Treatment often depends on the cancer’s type, location, and stage. The main treatment methods are surgery, radiation therapy, and chemotherapy. In some cases, immunotherapy (treatment that helps the body’s immune system fight cancer) or targeted therapy (drugs that target specific cancer cell mechanisms) may also be recommended.

A multidisciplinary approach—where a team of doctors specialising in surgery, oncology (the study and treatment of cancer), and radiation therapy works together—is often used to create a personalised treatment plan.

This guide is designed to help you understand some of the potential causes and implications of neck lumps, as well as the importance of timely diagnosis and treatment. Always consult a healthcare professional if you notice any persistent or unusual symptoms for proper evaluation and peace of mind.