To see him now, you’d be hard pressed to imagine what Harvey Deaton has been through. He’s fit and healthy and enjoys spending his time between the UK and his holiday home in Spain.
He’s lucky to be doing any of this. For months Harvey was told that repeated bouts of pain in his left ear were due to an infection. In fact, it was a sign of advanced tongue cancer.
Harvey had been back and forth to his GP for help with the ear pain. But despite trying antibiotics and ear syringing, six months on he was still suffering.
It was during a routine dental appointment that his dentist noticed a ‘red patch’ in his mouth that wasn’t healing, he recalls.
The dentist advised Harvey to see a head and neck specialist. And within minutes they diagnosed the true cause of his earache and the sore in his mouth: cancer of the tongue, classified as a type of head and neck cancer.
Harvey, 59, a former BT manager who lives in Kippax, Leeds, says: ‘They told me ear pain was a classic sign of head and neck cancer – but I had no idea it could be.
‘It was caught in the nick of time – I’m lucky to be here.’
By the time he was diagnosed, Harvey, who is married to Helena, 56, had stage 4 cancer which had spread under his tongue to one of his lymph nodes.
Harvey Deaton, 59, is lucky to be alive after discovery of his tongue cancer
Around 12,800 people in the UK are diagnosed with head and neck cancer each year, according to Cancer Research UK.
But cases have been rising – one report said by as much as 47 per cent each year – and the ‘huge surge’ is expected to continue, says Dr Oladejo Olaleye, a consultant ear, nose and throat surgeon at the Leicester Cancer Research Centre and ambassador for the charity Oracle Head and Neck Cancer UK.
Head and neck cancers are those affecting the throat, voice box, nose, sinuses, tongue, tonsils, gums, lips, jaw bone, cheek bone, cheek, neck lumps, salivary glands, and the thyroid area.
Although most cases occur among those in their mid to late 60s, the numbers are rising ‘alarmingly’ in younger men and women too, says Dr Olaleye.
The recent surge in head and neck cancers has been attributed to infection with high-risk strains of the human papillomavirus (HPV), a common virus previously linked to cancers in the tonsils and base of the tongue. (Other strains of HPV have also been linked with cervical cancer.)
These cases are now more prevalent in younger men, who may present with only a lump in their neck or a persistent sore throat.
However, whilst some strains of HPV are sexually transmitted, those that are linked with head and neck cancer do not require sexual activity – they can spread through skin-to-skin contact, meaning anyone can be at risk, explains Dr Olaleye.
‘Although HPV vaccination was introduced [for teenage girls in 2008, but also for boys in 2019] and is expected to reduce cases of head and neck cancer, the full impact won’t be seen for several decades as these cancers typically develop later in life,’ he adds.
There are however other risk factors for head and neck cancers, including smoking and excessive alcohol consumption.
Symptoms of head and neck cancers can include a persistent sore throat (or other type of pain in throat or mouth area), a neck lump or swelling, lump or ulcer on the lip or in the mouth that does not heal, changes in voice or hoarseness, painful swallowing or difficulty swallowing and earache or ear pain.
‘Ear pain can be a sign of certain head and neck cancers, particularly those affecting the throat or base of the tongue, due to shared nerve pathways,’ says Dr Olaleye.
‘Most of the time ear pain is caused by other conditions such as infections or jaw joint disorders but if there is unexplained ear pain for three weeks or more, it should be investigated thoroughly.’
He stresses that it’s also vital for anyone who has symptoms including unusual lumps on the tongue; whiteish or red patches on the tongue/cheek; non-healing ulcers; and sore throats that last more than three weeks, to see their GP or dentist.
Survival rates for head and neck cancers are generally lower than for some other cancers, such as breast cancer, says Dr Olaleye, partly because the anatomy of the head can make surgically removing such cancers challenging.
Hence while around 70-90 per cent of patients with lip cancers, which are easily visible and accessible, will live five years or more, only 40 per cent of patients with more inaccessible cancers – which develop in the lower throat behind the voice box, for instance – live five years or more. In comparison, the overall survival rate for breast cancer is around 90 per cent.
Harvey’s earache began in August 2022 and when his pain failed to improve despite painkillers, antibiotics and ear syringing by October, he returned to his GP.
This time he was given a nasal balloon device to try – the idea being that breathing out through your nose to fill the balloon with air helps to equalise pressure in the ears. This too did not work.
In November 2022, Harvey burnt his mouth with hot soup – but the wound wouldn’t heal.
By now he was seriously alarmed. In January 2023 he insisted that his GP refer him to an ear, nose and throat specialist.
He underwent tests on his hearing, as well as investigations where a camera on the end of a long, thin tube was inserted to check for abnormalities in his throat and the eustachian tubes (connecting his middle ears and the back of his throat). But these all came back clear.
In April, he had happened to have a dental check-up while in Spain, and mentioned the burn in his mouth that hadn’t healed.
The Spanish dentist examined it carefully, appeared concerned and said there was an infection at the base of his tongue. She asked Harvey to come back and see her three weeks later so she could examine the red patch again – and this time found it was more inflamed.
Harvey mentioned his ear pain too, and the dentist advised him to quickly book an appointment with a private maxillofacial consultant – whom he saw on his return to the UK.
After examining Harvey’s tongue and listening to his symptoms, the consultant simply said: ‘I know what this is. It’s cancer. I’ll put you back into the NHS as this is going to be expensive to cure,’ Harvey recalls.
He was ‘stunned’ that his symptoms could be diagnosed by an expert ‘in seconds’, after being ‘fobbed off for months’.
Symptoms of head and neck cancers can include a persistent sore throat, a neck lump or swelling, and a lump or ulcer on the lip or in the mouth that does not heal
The cancer was situated under his tongue. However a phenomenon known as ‘referred pain’ meant that the pain could also be felt in his ear. That’s thought to be because the mouth and ear share common nerve pathways, so pain signals from one area can be felt in another.
The diagnosis was confirmed by a scan and a biopsy. This also revealed that his cancer was caused by a strain of HPV.
Harvey underwent 35 sessions of radiation on his head and neck and three doses of chemotherapy, over a gruelling seven weeks.
He had to have five teeth taken out to reduce the risk of dental complications in later life, and had a tube fitted into his stomach for feeding.
‘I couldn’t have surgery because the tumour was 4cm wide and in a difficult place to operate under the base of my tongue,’ says Harvey.
‘The treatment I had was brutal as its effect is cumulative, and the pain in my mouth and throat was so intense. I was given liquid morphine which caused constipation and was tube-fed throughout treatment and for four weeks afterwards.
‘It was very hard for me and for Helena watching me go through it.’
Harvey went from 13st 6lb to 12st (he is 5ft 10in) during the three months of treatment.
Dr Olaleye says that while improved diagnosis rates are urgently needed, ‘it’s not only about survival’.
‘It’s also about quality of life – a lot of patients who survive head and neck cancer go on to have very challenging lives post-treatment if they are diagnosed late and their cancer has spread due to breathing problems and often complex reconstruction.’
For some, extensive surgery can involve removing their tongue and/or voice box, he says.
A year after his treatment ended, Harvey is cancer-free but still being monitored by his consultant. He volunteers for the charity Oracle Head & Neck Cancer UK, as he wants to ‘give something back’.
He is telling his story to raise awareness among others of the signs to watch out for.
‘I now know that ear pain is a classic sign of head and neck cancer. Yet my GP and ENT specialist I saw never mentioned this. That meant my cancer could grow to stage 4,’ Harvey says.
He remains grateful, however, that his cancer was caught.
‘I am so lucky to be here. I am sharing my story so that other people know the signs to look out for.’