KEYTRUDA for head and neck cancer 

About head and neck cancer

If you have been diagnosed with head or neck cancer, or you know somebody who has, you’re probably looking for reliable information about the disease and its treatments. This section will help to answer many of your questions.

Types of head and neck cancer

How head and neck cancers are named depends on where the cancer first starts. Cancer can also start in the brain, eye, oesophagus, thyroid gland, skin, scalp or the bones or muscles of the head and neck, however these cancers are not known as head and neck cancers. The following are types of head and neck cancers.

  • Oral cancer describes cancer that affects your lips, gums, cheek lining, floor of your mouth, roof of the mouth (hard palate), your tongue or the muscles on the base of your tongue that extend down into your throat.
  • Nasopharyngeal cancer refers to cancer in the upper region of the throat behind the nose, but before your mouth joins the throat.
  • Oropharyngeal cancer is cancer that begins in the middle region of the throat, roughly behind your mouth.
  • Hypopharyngeal cancer describes cancer in the lower region of your throat, behind your voice box (larynx).
  • Laryngeal cancer means cancer that affects your voice box (larynx).
  • Salivary gland cancer affects any or all of your salivary glands – there are three large salivary glands and hundreds of smaller ones.
  • Nasal cancer begins in any of the cells lining the large, hollow space (nasal cavity) inside the nose that warms, moistens and filters the air you breathe.
  • Paranasal sinus cancer affects any or all of the small, air-filled spaces (paranasal sinuses) that surround the nasal cavity.
  • Metastatic head and neck cancer refers to cancer that has spread from where it started to another part of your body.
  • Recurrent head and neck cancer means cancer that has come back after previous treatment.

Incidence of head and neck cancer

Head and neck cancer represents the sixth leading cancer by incidence worldwide. Nearly all the cases of head and neck malignancies (95%) are represented by squamous cell carcinoma arising in the oral cavity and pharynx.

What are the symptoms?

  • Pain in the area
  • Swelling in the area
  • A hoarse voice
  • Difficulty swallowing
  • Bad breath

How is it diagnosed?

If your doctor suspects head or neck cancer, these tests may be required:

  • Physical examination
    Diagnosis usually begins with an examination of your mouth, throat, nose, neck, ears and eyes.
  • Nasendoscopy
    A nasendoscope is an examination device that allows closer inspection of the nose and throat area. It involves a thin flexible tube with a light and camera on the end that is passed through your nostril.
  • Biopsy
    The nasendoscope can be used to take a tissue sample (biopsy) of unusual looking areas.
  • Laryngoscopy
    A laryngoscope is a device that allows your doctor to look at your larynx and pharynx, then take a biopsy if necessary. In this procedure, a tube with a light and camera on it is inserted into your mouth and throat.
  • Imaging tests
    An X-ray scan, CT scan, MRI scan, PET scan or ultrasound may be required as part of the diagnostic process.

Treatment for head and neck cancer

  • Tumour surgery
    Surgery aims to remove cancerous tissue in a way that preserves the functions of your head and neck, such as breathing, swallowing and talking. Surgical procedures and recovery times will differ depending on the location and extent of your cancer.
  • Lymph node removal
    Depending on the extent of your cancer, your surgeon may remove some lymph nodes. This operation is called a lymphadenectomy. There is a possibility it will affect the movement and appearance of your neck or shoulder.
  • Radiotherapy
    Also known as radiation therapy, radiotherapy is used to kill or harm cancer cells. It is carefully targeted to do as little harm as possible to healthy tissue.
  • Chemotherapy
    Chemotherapy involves the use of drugs to kill or slow the growth of cancer cells in the body. It is usually given by injection into a vein (intravenously) at treatment sessions over several weeks. Chemotherapy affects all rapidly dividing cells, so there can be uncomfortable side effects.
  • Targeted therapies
    Targeted therapies are newer treatments that attack specific molecules within cells to help prevent cell growth. Compared to chemotherapy, they have fewer side effects.
  • Immuno-oncology treatment
    KEYTRUDA is an immuno-oncology treatment for advanced and reoccurring head and neck cancer. It may be used when platinum and cetuximab-based* therapies didn’t work, or are no longer working.

*Cetuximab is not funded in New Zealand

Questions to ask your doctor about head and neck cancer


How to access KEYTRUDA


KEYTRUDA (pembrolizumab) 50mg powder for infusion
KEYTRUDA is a Prescription Only Medicine Use: KEYTRUDA is used:
  • in the treatment of melanoma which cannot be removed by surgery alone or when it has spread to multiple sites in the body.
  • in the treatment of a kind of lung cancer called non-small cell lung cancer (NSCLC).
  • in the treatment of classical Hodgkin Lymphoma (cHL)
  • in the treatment of urothelial carcinoma, including bladder cancer
  • in the treatment of a kind of head and neck cancer called head and neck squamous cell carcinoma (HNSCC)

Side effects: Immune-mediated side effects including inflammation of the lungs, colon, liver, kidneys, pituitary gland, brain, eye, muscles, nervous system, pancreas, and heart, thyroid disorders, type 1 diabetes mellitus. Severe skin reactions including Steven-Johnson syndrome and toxic epidermal necrolysis. Severe infusion reactions including hypersensitivity and anaphylaxis. Transplant recipients: rejection of a transplanted organ, graft-versus-host-disease (in people with a bone marrow transplant using donor cells). Very common side effects include diarrhea, nausea, itching, rash, joint pain, back pain, feeling tired, cough, patches of discoloured skin, stomach pain, decreased levels of sodium in blood. Tiredness, nausea, vomiting, diarrhea, constipation, shortness of breath, rash, itching, headache, hair loss, and, infections of the upper respiratory tract were reported when given in combination with chemotherapy. You may experience more than one side effect at the same time.

All medicines have risks and benefits. Talk to your doctor to see if KEYTRUDA is right for you. KEYTRUDA is a funded medicine for melanoma patients– restrictions apply. KEYTRUDA is an unfunded medicine for NSCLC, HNSCC, cHL and urothelial carcinoma patients. Ask your health professional the cost of the medicine and any other medical fees that may apply. Use only as directed and if symptoms continue or you have side effects, see your doctor, pharmacist, or health professional.

Based on data sheet prepared 17 July 2018. Marketed by: Merck Sharp & Dohme (New Zealand) Limited, Newmarket, Auckland. . For additional product information, consult the Consumer Medicine Information (CMI), available on request, phone 0800 500 673 or refer to the Medsafe website

This site is intended for New Zealand residents.

References to support this are available on request.

MSD recommends people always seek the medical advice of their healthcare professional.

Copyright © 2018 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, New Jersey, USA. All rights reserved.

Copyright © 2018 Merck Sharp & Dohme (New Zealand) Limited. Level 3, 123 Carlton Gore Road, Newmarket, Auckland. All rights reserved.

ONCO-1273154-0000 First Issued November 2017 TAPS NA10076 essence MSD8360

Updated: October 2018