Everything to Know About Ear Cancer

Medically Reviewed By Teresa Hagan Thomas PHD, BA, RN
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Ear cancer can affect the outer ear, middle ear, or inner ear. Ear cancer usually starts as skin cancer in the ear canal or on the skin of the outer ear. About 6–10% of skin cancers develop on the outer ear. It is rare to have cancer that develops inside the ear.

Cancer of the ear may affect only the ear canal, or it may also involve the temporal bone.

Read on to find out more about ear cancer. This guide describes the types and causes of ear cancer, as well as symptoms, treatments, and more.

What are the types of ear cancer?

A person is having an ear checkup.
Vladimir Vladimirov/Getty Images

Types of cancer that can affect the ear include:

  • squamous cell carcinoma
  • basal cell carcinoma
  • adenocarcinoma
  • adenoid cystic carcinoma
  • melanoma

Squamous cell carcinoma is the most common type of ear cancer. It is the second most common type of skin cancer after basal cell carcinoma.

Learn about squamous cell carcinoma.

What does skin cancer on the ear look like?

View the slideshow below for pictures of skin cancer on the ear.

hg-hand-showing-ear-cancer.jpg

This shows basal cell carcinoma on the ear.

Kelly Nelson (Photographer), Public domain, via Wikimedia Commons

hg-infiltrating-spinocellular-carcinoma.jpg

This shows squamous cell carcinoma on the ear.

Photo By BSIP/UIG Via Getty Images

hg-retro-auricular-basal-cell-carcinoma.jpg

This shows basal cell carcinoma on the ear.

Photo By BSIP/UIG Via Getty Images

hg-squamous-cell-carcinoma.jpg

This shows squamous cell carcinoma on the ear.

Photo By BSIP/UIG Via Getty Images

What are the symptoms of ear cancer?

Symptoms depend on the location of the tumor. Symptoms can affect the ear flap, ear canal, middle ear, or inner ear.

Ear flap

Symptoms of ear cancer on the ear flap include:

  • a spot or sore that does not heal within 4 weeks
  • pink lumps with a hard, scaly surface
  • lumps that become open sores and bleed easily

Ear canal

Symptoms of cancer affecting the ear canal include:

Middle ear

Discharge from the ear is the most common symptom of cancer affecting the middle ear. The discharge may be stained with blood.

Other symptoms can include:

  • earache
  • loss of hearing
  • inability to move the side of the face with the affected ear

Learn more about causes of bleeding from the ear.

Inner ear

Symptoms of cancer of the inner ear include:

Ear cancer may also cause the lymph nodes in your neck to swell.

Contact your doctor as soon as you experience symptoms of ear cancer. While some symptoms can occur with other conditions, you should receive a diagnosis and begin treatment as soon as possible.

Learn more about conditions that can affect the ear.

What causes ear cancer?

Medical professionals do not always know the cause of ear cancer.

Possible risk factors for cancer of the ear include:

  • having fair skin
  • exposure to the sun’s ultraviolet rays
  • repeated ear infections
  • radiotherapy of the head and neck
  • HPV
    • There is mixed evidence regarding the role of HPV in getting ear cancer and how HPV impacts people with ear cancer. Research is ongoing to better understand this relationship.

More research is needed into the causes of ear cancer.

How is ear cancer diagnosed?

Your doctor will take a full medical history and carry out a physical examination. They may refer you to an ear, nose, and throat (ENT) specialist to assist with diagnosis.

Tests that can help diagnose ear cancer include:

  • a hearing test
  • biopsy
  • MRI
  • CT or PET-CT scan

Hearing test

Your doctor may first recommend that you have a hearing test. This will determine how well you can hear in the unaffected ear, as treatment for the affected ear may result in hearing loss.

Find out more about how doctors diagnose hearing loss.

Biopsy

A biopsy is necessary for confirming an ear cancer diagnosis. A biopsy involves removing a small amount of affected tissue and analyzing it under a microscope. You will usually receive a local anesthetic for a biopsy of the outer ear. However, you may require a general anesthetic for a middle ear biopsy.

If biopsy is difficult, or if the cancer affects your inner ear, your doctor may arrange for a scan instead.

Learn more about biopsies.

Scans

An MRI or CT scan can show where the cancer has grown. Scans can also show how big the tumor is, and if it has spread.

How is ear cancer treated?

Treatments for ear cancer depend on the size and location of the cancer, and whether it has spread. Typically, surgical removal is necessary. Your doctor may also recommend radiotherapy or chemotherapy.

Surgery for outer ear cancer

Treatments for cancer of the outer ear include:

  • excision biopsy
  • Mohs micrographic surgery
  • wide local excision
  • lymph node dissection
  • removal and reconstruction of the ear

Excision biopsy

Excision biopsy is the most common type of treatment for outer ear cancer. Your surgeon will remove all of the tumor as well as some of the healthy tissue around it. This reduces the risk of the cancer returning.

Mohs surgery

Mohs surgery involves removing a thin layer of the affected tissue and immediately examining it under a microscope. Your surgeon will continue to remove layers until no more cancer cells are visible.

This technique helps to ensure that as little tissue is removed as possible.

Learn more about what to expect with Mohs surgery.

Wide local excision

You may require wide local excision following a biopsy if some of the cancer remains. Your surgeon will remove a larger area of tissue and skin to remove the remaining cancer cells.

If your surgeon needs to remove a large area of skin, you may require a skin graft or flap.

Other treatments

In some cases, if the lymph nodes are swollen, your surgeon may need to perform lymph node dissection.

In very rare cases, if the cancer affects most of your outer ear, your surgeon may need to remove the whole ear. Your surgeon will then rebuild your ear with either living tissue or a prosthetic ear.

Surgery for middle and inner ear cancer

For cancer of the middle or inner ear, your surgeon will remove the cancer as well as the surrounding healthy tissue. This reduces the risk of the cancer returning.

Depending on the location of the cancer, your surgeon may remove part or all of the:

  • ear canal
  • middle ear
  • inner ear
  • lymph nodes around the ear
  • temporal bone
  • facial nerve

Radiotherapy

Radiotherapy uses high energy waves to treat cancer. Specifically, intensity modulated radiotherapy (IMRT) is useful for treating middle or inner ear cancer. IMRT shapes the radiation beams to fit the shape of the cancer.

You may have radiotherapy on its own or alongside chemotherapy treatment. Your surgeon may also recommend radiotherapy if they cannot fully remove all of the cancer cells during surgery.

Learn more about radiotherapy.

Chemotherapy

If you have chemotherapy, you will take cytotoxic drugs such as fluorouracil or cisplatin. These help to destroy the cancer cells.

Your doctor may recommend chemotherapy alongside other treatments or to relieve symptoms.

Find out what to expect with chemotherapy.

What stage is my ear cancer?

The stage of a cancer refers to how big the cancer is and if it has spread.

When discussing ear cancer, your doctor may talk about tumor, node, metastasis (TNM) staging. TNM staging focuses on:

  • the size of the tumor
  • whether it affects the lymph nodes
  • whether it has metastasized, spread to other areas of the body

There are three “T” stages with TNM staging:

  • T1: The tumor affects the middle ear only, and the tumor does not cause facial numbness.
  • T2: The tumor causes numbness or affects the nearby bone as a result of growing outside of the original area.
  • T3: The tumor has grown into a nearby salivary gland, joint of the jaw, or base of the skull.

Your doctor will answer any questions you have about the stages of ear cancer.

Learn more about carcinoma staging.

When should I contact a doctor?

You should contact your doctor as soon as you experience symptoms of ear cancer. Your doctor may refer you to an ENT clinic or other specialist.

You should also contact your doctor if you have a mole on the ear flap that:

  • causes pain
  • grows
  • itches
  • bleeds

What are the complications of ear cancer?

Complications of ear cancer can include:

  • pain
  • loss of hearing
  • metastasis, spread of the cancer

Without successful treatment, ear cancer can be fatal.

Complications of surgery

It is important to be aware of complications or changes to your hearing that can occur following surgery. Your doctor or surgeon will discuss these with you before your procedure.

Possible complications of ear cancer surgery include:

  • wound infection
  • scarring
  • inability to hear from the affected ear
  • changes to balance
  • nerve damage

Complications of surgery are often temporary. In rare cases, they can be permanent.

Contact your doctor as soon as you experience symptoms of ear cancer. It is important to begin treatment as soon as possible.

Can I prevent ear cancer?

It may be possible to reduce the risk of developing ear cancer by:

  • avoiding spending time outdoors, particularly between 10 a.m. to 4 p.m. when the sun’s UV radiation is strongest
  • wearing sunscreen with an SPF of 30 or higher
  • staying in shaded areas
  • wearing protective clothing such as sun hats with wide brims
  • avoiding tanning beds and sun lamps, which contain UV rays
  • avoiding harmful chemicals such as arsenic, which is present in some herbicides, pesticides, and well water
  • quitting smoking if you currently smoke

Regularly check your skin and seek medical advice if you notice any changes in the appearance of your skin.

Find out more about protecting your skin from the sun.

Learn more

Summary

Ear cancer typically affects the outer ear, although it can also affect the middle or inner ear. Squamous cell carcinoma is the most common type of cancer affecting the ear.

Medical professionals do not always know the cause of ear cancer. Risk factors for developing ear cancer may include having fair skin, exposure to UV radiation, and repeated ear infections. Certain infections and radiotherapy on the head and neck may also increase your risk of ear cancer.

It is important to regularly check your skin for any changes. You should contact your doctor if you notice any irregularities or growths. Also seek medical advice if you experience any ear discharge or changes in your hearing.

Treatment for ear cancer may include radiotherapy, chemotherapy, and surgery.

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Medical Reviewer: Teresa Hagan Thomas PHD, BA, RN
Last Review Date: 2022 Sep 7
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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