It can be overwhelming after being told that you have or may have head and neck cancer. A lot can happen quickly, and you might have lots of questions, like 'What happens next after a diagnosis?'
This support resource can help to guide you, your family, and your friends through this experience.
Information and support
If you need additional information or would like support, you can visit the head and neck cancer page or call Cancer Council on 13 11 20 to talk to an experienced healthcare professional.
If you need a translator, call TIS on 13 14 50 or visit the TIS National website.
1. Initial investigation and referral
Symptoms
Your general practitioner (GP) or dentist should do a checkup to see if they can find what is causing your symptoms. They will ask you about any problems or issues you might be having – for example, a mouth ulcer that hasn’t healed, a lump in your neck or finding it hard to swallow, or changes to your voice.
Initial tests you may have
Blood test
A sample of your blood is collected to see if your body is working well.
Ultrasound
Soundwaves are used to create a picture of the head and neck.
Computed tomography (CT) scan
Computers and x-rays are used to create a detailed picture of the head and neck.
Magnetic resonance imaging (MRI) scan
A scan where a powerful magnet and radio waves are used to create a detailed picture of the body.
Ultrasound-guided fine-needle aspiration
Soundwaves are used to create a picture of the lump. Using this picture as a guide the doctor inserts needles into the lump to collect samples. The samples are checked under a microscope. This is done with a local anaesthetic so you don’t feel pain
Referrals
If your GP or dentist has concerns, you will be referred to a specialist at a public hospital or in private practice for more tests. Specialists are doctors who are highly trained in a particular area of health care.
Specialists may include a head and neck surgeon or a maxillofacial surgeon (a surgeon who treats the head, neck, mouth, jaw and face).
You can bring a family member or friend with you to your appointments.
Timeframes
Your specialist appointment should happen within two weeks of referral. If you can’t get an appointment within this time, follow up with your GP or dentist.
Questions you might want to ask
- Can I choose whether I go to a public hospital or private practice?
- Can I choose the specialist I see?
- How much will appointments cost me?
2. Diagnosis and staging
The specialist will do more tests to see if you have head and neck cancer. This process of working out if you have a medical problem is called making a diagnosis. You might have one test or a mix of tests:
Nasoendoscopy
A tube is inserted into the nose and passed into your throat to make a careful inspection of these areas
Positron emission tomography (PET) scan
A small amount of radioactive material is injected and your whole body is scanned to show where the cancer is.
Biopsy
A sample of the abnormal area may be taken. This sample is sent to a laboratory so they can see if it is head and neck cancer or not. This may be done by a specialist or with a fine needle in radiology. You will have a local anaesthetic or a general anaesthetic (you will be put to sleep) so you cannot feel it.
An ultrasound, CT scan and MRI scan will be done if you haven’t already had one.
These tests will give the specialist more information about the cancer, such as where exactly it is in your body, if the cancer is growing or has spread, and what stage it is at. This is called staging, which helps to work out the best treatment for you.
Timeframes
Results should be available within two weeks from when you have the tests.
Questions you might want to ask
- What is head and neck cancer?
- What tests will I have?
- How much will tests/appointments cost?
- Where should I be treated, and do I have a choice?
- What stage is my cancer?
- What support services are available to me?
3. Treatment
There are several ways to treat head and neck cancer. Your specialist will talk to you about your treatment options.
You will be treated by a team of experts, and you may need more than one treatment type to get the best results. The team will work with you and your family or carer to plan your treatment.
You might have one treatment or a mix of treatments:
Surgery is where the cancer is cut out. It is the most common treatment for people with head and neck cancer.
Radiation therapy uses x-rays to kill cancer cells and stop the cancer growing. Radiation therapy might be used alone, or with chemotherapy.
Chemotherapy uses drugs to kill cancer cells and stop the cancer growing. It may be used with radiation therapy to increase how well the treatment works, or alone to slow the cancer growing and reduce symptoms.
For more information, visit Cancer Treatment. Supportive care (treatment or services that support you through a cancer experience) are also available.
Timeframes
After agreeing to your treatment plan, treatment should start within four weeks if trying to cure the cancer or within two weeks if a cure is unlikely.
You can ask your GP for a referral to another specialist for a second opinion.
Clinical trials
You may be offered to take part in a clinical trial. Clinical trials are used to test whether new treatments are safe and work better than current treatments. Many people with cancer are now living longer, with a better quality of life, because of clinical trials. For more information, visit www.australiancancertrials.gov.au
Complementary therapies
Speak to your healthcare team about any complementary therapies (including dietary supplements like vitamins) you use or would like to use. Something as common as vitamins might not work well with your treatment.
Questions you might want to ask
- What treatment do you recommend?
- Where will I have to go to have treatment?
- What will treatment cost and how much of the cost will I have to pay myself?
- What activities/exercise will help me during and after treatment?
- Can I still work?
- How will the treatment affect my day-to-day life?
- Who are the people in my team and who is my main contact person?
- What side effects could I have from treatment?
- Who do I contact if I am feeling unwell or have any questions?
- Will treatment affect my ability to have a child?
4. After treatment
Recovery
Cancer treatment can cause a range of physical and emotional changes.
Follow-up care plan
Your healthcare team will work with you to make a plan for you and your GP. This plan will explain:
- who your main contact person is after treatment
- how often you should have check-ups and what tests this will include
- understanding and dealing with side effects of treatment
- how to get help quickly if you think the cancer has returned or is worse
Many people worry that the cancer will return. Your specialist and healthcare team will talk with you about your needs and can refer you to other healthcare professionals and community support services.
Other information you may get:
- signs and symptoms to look out for if the cancer returns
- late effects of treatment and the specialists you may need to see
- how to make healthy lifestyle choices to give you the best chance of recovery and staying well
For more information, visit After Cancer Treatment.
Questions you might want to ask
- Who should I contact if I am feeling unwell?
- What can I do to be as healthy as possible?
- Where can I get more help?
5. If cancer returns
Sometimes cancer can come back after treatment. It can come back in the same place or can appear somewhere different in your body.
If cancer returns, you may be referred to the specialist or the hospital where you were first treated, or to a different specialist.
Treatment will depend on how far the cancer has spread, how fast-growing it might be, and the symptoms you are experiencing.
Questions you might want to ask
- Where is the cancer and has it spread?
- What are my treatment options?
- What are the chances that the treatment will work this time?
- Is there a clinical trial available?
- Where else can I get support?
Advance care planning
Your GP or healthcare team may talk with you, your family, and carer about your future treatment and medical needs.
Advance care directive
Sometimes known as a living will, an advance care directive is a legally binding document that you prepare to let your family and healthcare team know about the treatment and care you might want or not want in case you become too unwell to make those decisions yourself.
For more information, visit Advance Care Planning Australia.
Palliative care
Your specialist may refer you to palliative care services, but this doesn’t always mean end-of-life care. Today, people can be referred to these services much earlier if they’re living with cancer or if their cancer returns. Palliative care can help you to live as well as you can, including managing pain and symptoms. This care may be at home, in a hospital or at another location you choose.
Speak to your GP or specialist or visit Palliative Care Australia.
Making treatment decisions
You may decide not to have treatment at all, or to only have some treatment to reduce pain and discomfort. You may want to discuss your decision with your healthcare team, GP, family and carer.
For more information, visit Advanced Cancer Treatment.
Questions you might want to ask
- What can you do to reduce my symptoms?
- What extra support can I get if my family and friends care for me at home?
- Can you help me to talk to my family about what is happening?
- What support is available for my family or carer?
- Can I be referred to a community support service?
6. Questions of cost
Decisions about cost
You may have to pay for some appointments, tests, medications, accommodation, travel or parking. Speak with your GP, specialist or private health insurer (if you have one) to understand what is covered and what your out-of-pocket costs may be.
If you have concerns about costs, talk to your healthcare team or a social worker about:
- being bulk-billed or being treated in the public system
- help with accommodation during treatment
- the possible financial impact of your treatment
You can call Cancer Council on 13 11 20 to speak to a healthcare professional about financial support. For more information about costs, visit Practical and financial assistance and What will I have to pay for treatment.
7. Further support
Listen to audio in your language
Head and neck cancer support
You can speak to specially trained staff at Cancer Council on 13 11 20. They can answer your questions about the effects of cancer, explain what will happen during treatment and link you to support groups and other community resources.
If you need an interpreter, call TIS (the Translating and Interpreting Service) on 13 14 50.
For support and advice for carers, call the Carers Association on 1800 242 636.
More support options
Head and Neck Cancer Australia (formerly Beyond Five)
Head and Neck Cancer Australia is dedicated to providing education and support to people living with head and neck cancer. We provide comprehensive and easy to understand information from diagnosis, treatment to life after cancer helping people to navigate their cancer journey and have the best quality of life possible. We also lead the national effort to raise awareness of head and neck cancer among all Australians and healthcare professionals to increase early diagnosis and encourage prevention.
• Telephone: 1300 424 848
• Email: contact@headandneckcancer.org.au
• Website: www.headandneckcancer.org.au
beyondblue: The national depression initiative
Information on depression, anxiety and related disorders, available treatment and support services
• Telephone: 1300 22 4636
• Website: www.beyondblue.org.au
National Health Services Directory
A directory providing information on local hospital and community services
• Website: www.nhsd.com.au
Cancer Australia
Information on cancer prevention, screening, diagnosis, treatment and supportive care for Australians affected by cancer, and their families and carers
• Telephone: 1800 624 973
• Website: www.canceraustralia.gov.au
Care Search: Palliative Care Knowledge network
Information for patients and carers on living with illness, practical advice on how to care, and finding services
• Telephone: (08) 7221 8233
• Website: www.caresearch.com.au
NEMICS A common path: Head and neck cancer
Videos offering support and advice from people who have been through cancer.
• Visit: www.youtube.com/c/ACommonPathCancersupportandadvice
Optimal care pathways have been developed for health professionals and health services. However, patients and carers may find useful information in this version to help understand the processes their treating health professionals are following.