Ear Cancer: Symptoms and Causes of Cancerous Inner and Outer Ear Growths

Types of cancer that affect the ears

Ear cancer is a rare type of cancer. Most of these cancers begin on the skin of the outer ear. About 5 to 10 percent of skin cancers occur on the ear. Ear cancer can affect both the external and internal parts of your ear.

The ear has three parts: the inner, middle, and outer ear.

The outer ear is further divided into three parts:

• The pinna (the visible, outer auricle of the ear)
• The meatus (ear canal)
• The tympanic membrane (eardrum)

The middle ear contains three small bones that pass sound vibrations from your eardrum to your inner ear.

The temporal bone surrounds your ear and is part of your skull.

The most common kind of ear cancer affecting the inner and outer ear is squamous cell carcinoma. Other cancers that affect the ear include are:

• Melanoma
• Basal cell carcinoma 

Other cancers that affect the inner ear, middle ear, and ear canal include:

• Melanoma
• Basal cell carcinoma 
• Adenocarcinoma
• Adenoid cystic carcinoma

Basal cell carcinoma of the ears

Basal cell carcinoma is a kind of skin cancer that starts in the basal skin cells. It often looks like a transparent bump on the skin, though it may appear in other forms. Most basal cell carcinomas happen because of excessive exposure to the harmful ultraviolet (UV) rays of the sun.

Squamous cell carcinoma

Squamous cell carcinoma develops in the squamous cells of your skin. If squamous cell carcinoma is left untreated, it can grow bigger or spread to other areas of the body, causing serious complications. Most squamous cell carcinomas of the skin happen because of excessive exposure to harmful UV rays, either from tanning beds or natural sunlight.

Melanoma on the ears

Melanoma is a type of skin cancer that affects the melanocytes (cells that give your skin their color when exposed to the sun). Melanoma is less common than squamous or basal cell carcinoma, and it is more aggressive.

Adenoid cystic carcinoma

This is a rare type of cancer that arises in the secretory glands (commonly in the minor and major salivary glands). Other places where this cancer can originate include the lacrimal gland, trachea, vulva, breast, and skin.

Parotid tumors

The parotid glands are located in front of your ears on both sides of the face. They are the largest of the three main sets of salivary glands. Many kinds of benign or cancerous tumors can develop in the salivary glands inside or near the mouth.

Salivary glands contain many different types of cells, and tumors can grow in any of them. Cancers of the salivary gland include:

• Adenoid cystic carcinoma
• Mucoepidermoid carcinoma
• Malignant mixed tumors (may include metastasizing mixed tumors, carcinosarcoma, and carcinoma ex pleomorphic adenoma)
• Adenocarcinoma

Parotid gland cancers can spread to your ear canal.

Ear cancer symptoms

Symptoms of ear cancer depend on where the tumor is within your ear.

Outer ear and earlobe cancer

Basal cell carcinoma may look like:

• A firm, flat, yellow, or pale area resembling a scar
• Small, red or pink, shiny, translucent, pearly bumps that may have black, brown, or blue areas
• Raised red-colored patches that may itch
• Pink growths that have raised borders and a sunken central area, potentially from abnormal blood capillaries spreading out
• Open sores (possibly with crusted or oozing areas) that don’t heal or recur after healing
• Basal cell carcinoma lesions are usually fragile and can bleed even from a minor injury.

Squamous cell carcinoma may look like:

• Scaly or rough red patches that may bleed or crust
• Raised lumps or growths with a sunken central area in some cases
• Open sores (possibly with crusted or oozing areas) that don’t heal or recur after healing
• Growths similar to warts

The ABCDE mnemonic may help you spot a melanoma on the ear. While checking your ear for moles, look for the following abnormal signs:

• Asymmetry — The mole is asymmetrical, with two halves that are different from each other.
• Border — The mole has jagged or blurry edges.
• Color — The mole changes color. It may be darkening, spreading color, have multiple colors, or lose color.
• Diameter — The diameter of the mole is larger than one-fourth of an inch.
• Evolving — The mole is changing its size, color, or shape.

Some other signs of skin cancer are:

• A mole that bleeds or itches
• A mole that is growing quickly
• A crusted or scaly growth
• A sore that isn’t healing
• A skin patch that is changing color

Ear canal

Symptoms of cancer of the ear canal may include:

• Pain
• Hearing loss
• Discharge from your ear
• Weakness in the face
• A lump inside your ear canal

Middle ear

One of the most common symptoms of ear cancer in the middle ear is discharge that may be stained with blood. Other middle ear cancer symptoms may include:

• Earache
• Hearing loss
• Inability to move the face on the affected side

Inner ear

Symptoms of inner ear cancer may include:

• Headache
• Pain in the ear
• Hearing loss
• Dizziness
• Tinnitus (ringing in your ear)

Causes of ear cancer

Lack of skin protection

Most cases of ear cancer on the skin happen because of excessive exposure to UV rays, either from tanning beds or natural sunlight. UVA and UVB rays can both cause skin cancer on the ear and other areas of the body.

Some factors that can make you more prone to developing skin cancer are:

• Having a fair complexion, red or blonde hair, and light-colored eyes
• Excessive exposure to the sun (e.g., working outside in the sun)
• Having a personal history of severe sunburns, particularly during childhood or teenage years
• Using tanning booths/beds
• Having a weak immune system (e.g., having an organ transplant or HIV/AIDS)

Frequent infections

Having frequent and chronic (for 10 years or more) infections in the ear may make you more prone to developing middle ear cancer.

Age

Certain kinds of cancer of the ear occur more commonly in older people. Research suggests that squamous cell carcinoma affecting the temporal bone is most common in people who are in their 70s.

Ear cancer diagnosis

Your health care provider will examine you and conduct blood tests to determine your overall health. They may do a skin biopsy where they take a tiny tissue sample of the abnormal area and send it to a lab for examination. The pathologist examines the sample with a microscope to make a diagnosis. You may need local anesthesia for a skin biopsy on the external ear. You may need general anesthesia for a biopsy of a middle ear lesion.

The health care provider may order a CT or MRI scan if the biopsy results are positive for cancer. This will help them determine the best treatment options for your ear cancer.

Health care providers don’t perform biopsies on the inner ear because it is too difficult to reach without causing damage to the nearby structures. They usually diagnose inner ear cancer by using CT and MRI scans.

Ear cancer treatment options

You may have radiation therapy, surgery, or both to treat carcinoma affecting the outer ear. The type of treatment depends on:

• Your overall health
• The location of the ear cancer
• The type of ear cancer
• The size of the cancer
• The stage of the cancer

Surgical options for treating ear cancer include:

• Excisional biopsy
• Mohs surgery
• Lymph node surgery
• Wide local excision
• Whole ear removal with reconstruction

Your health care provider may suggest radiation therapy if the surgeon can’t remove a healthy tissue border from the skin cancer on your ear or if the cancer is small and on the pinna.

Treatment for cancer of the middle ear, inner ear, and ear canal

The primary treatments for cancer starting in the inner and middle ear and the ear canal are radiation therapy and surgery. You may also receive chemotherapy depending upon your cancer stage.

The amount and type of surgery that you will receive depends on the location of the cancer and whether it has spread into nearby tissues. The surgeon may remove the following structures as well:

• The ear canal
• The middle ear
• The temporal bone (either partially or completely)
• The inner ear

In rare cases, the surgeon may remove your facial nerve. They may also remove the salivary glands and/or neck lymph nodes on the affected side.

Balance and hearing

You may not be able to hear on the affected side if the surgeon removes the inner and middle ear. You may feel dizzy, and the surgery may affect your balance.

Chemotherapy uses cytotoxic (anti-cancer) drugs to kill cancer cells. It can’t cure ear cancer by itself, but health care providers may use it to ease symptoms or if you can’t receive other treatments.

Can you die from ear cancer?

Skin cancer on your ear is treatable, especially if you’re diagnosed in the initial stages. If it’s not caught early, melanoma on the ear can be dangerous because it has a greater tendency to spread to other areas of your body. In some people, a melanoma on the ear may never be completely cured. They may have to get regular treatments to manage it. It can be very stressful to live with cancer that recurs. Talk with your health care provider about developing a plan for caring for yourself and preventing any symptoms.

Takeaway

Ear cancer is a very rare type of cancer. The survival rates depend on the stage and location of cancer. A health care provider should examine any abnormal growths on your ears. The same applies for any unexplained earache or ear drainage. If you have a recurring or long-term ear infection, particularly if it happens without any other congestions, it is recommended to visit an ear, nose, and throat specialist.