Ear cancer can affect both the inner and external parts of the ear. It often starts as a skin cancer on the outer ear that then spreads throughout the various ear structures, including the ear canal and the eardrum.

Ear cancer may also start from within the ear. It can affect the bone inside the ear, called the temporal bone. The temporal bone also includes the mastoid bone. This is the bony lump you feel behind your ear.

Ear cancer is very rare. Only about 300 people in the United States are diagnosed with it each year. In contrast, more than 250,000 new cases of breast cancer are expected to be diagnosed in 2018, according to the National Cancer Institute.

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The most common type of ear cancer is squamous cell carcinoma. Photo source: DermNet New Zealand.

Several different types of cancer can affect the ear. These include the following:

Skin cancers

  • Basal cell carcinoma affects the basal layer cells of the epidermis, or the outermost layer of skin.
  • Squamous cell carcinoma affects the squamous cells of the epidermis. It’s the most common type of ear cancer. It grows deeper into the cells of the body and is more likely than basal cell carcinoma to spread to other tissues. Squamous cell carcinomas that affect the outer cartilage of the ear have about a 15 percent chance of spreading, according to a 2016 case report.
  • Melanoma affects the skin’s melanocyte cells. These cells give the skin a brown color when you’re exposed to the sun. While melanoma is a less common form of skin cancer than basal or squamous cell carcinoma, it tends to be aggressive. It’s considered the most serious form of skin cancer. Melanoma of the ear accounts for 1 percent of melanoma cases, notes a 2006 review.

Adenoid cystic carcinoma

This very rare type of cancer typically affects the salivary glands, but can also be seen in the ear. A 2013 case report estimates that these tumors account for only 5 percent of cancers of the external auditory canal (the passageway from the outside of the head to the eardrum).

Parotid tumors

Malignant growths of the parotid gland can spread to the ear canal. This gland is the largest salivary gland in the body.

The symptoms of ear cancer vary depending on what part of your ear is affected.

Outer ear

The outer ear includes the earlobe, ear rim (called the pinna), and the outer entrance to the ear canal.

Signs of skin cancer in the outer ear include:

  • scaly patches of skin that remain, even after moisturizing
  • pearly white lumps under the skin
  • skin ulcers that bleed

Ear canal

Signs of skin cancer in the ear canal include:

  • lump in or near the entrance to the ear canal
  • hearing loss
  • discharge from the ear

Middle ear

Signs of skin cancer in the middle ear include:

  • discharge from the ear, which may be bloody (most common symptom)
  • hearing loss
  • ear pain
  • numbness on the affected side of the head

Inner ear

Signs of skin cancer in the inner ear include:

Researchers aren’t exactly sure what causes ear cancer. So few cases exist, it’s hard to figure out how it may originate. But researchers do know that certain things may increase your chances of developing ear cancer. These include:

  • Being light-skinned. This increases your risk of skin cancer in general.
  • Spending time in the sun without (or with inadequate amounts of) sunscreen. This puts you at greater risk for skin cancer, which can then lead to ear cancer.
  • Having frequent ear infections. The inflammatory responses that accompany ear infections may somehow impact cellular changes that prompt cancer.
  • Being older. Certain types of ear cancer are more common in older individuals. In one study, data suggested that squamous cell carcinoma of the temporal bone is most common in the seventh decade of life.

If you have any suspicious growths on the outside of your ear or in your middle ear, your doctor can remove some of the tissue and send it to a lab to check for cancer cells.

This procedure is called a biopsy. A biopsy may be done under local or general anesthesia (so you don’t feel any pain), depending on the location of the affected area.

Cancerous growths on the inner ear can be more difficult to reach. This makes it harder for your doctor to biopsy without damaging surrounding tissue. Your doctor may have to rely on imaging tests, such as an MRI or CT scan to get an idea if cancer is present.

Treatment generally depends on the size of the cancerous growth and where it’s located.

Skin cancers on the outside of the ear are generally cut out. If large areas are removed, you may need reconstruction surgery.

Ear canal or temporal bone cancers require surgery followed by radiation. How much of the ear is removed depends on the extent of the tumor.

In some cases, the ear canal, bone, and eardrum have to be removed. Depending on how much is removed, your doctor may be able to reconstruct your ear.

In some cases, hearing isn’t significantly affected. In other cases, you may need to use a hearing aid.

Ear cancer is exceedingly rare. Survival rates vary depending on the location of the tumor and how long it’s progressed.

It’s important to have any growths around your ears examined by a healthcare provider. Do the same for any ear drainage or unexplained ear pain.

Seek the advice of an ear, nose, and throat specialist (ENT) if you have what seems to be a long-term (or recurrent) ear infection, especially one without a cold or other congestion.

Many doctors misdiagnose ear cancers as ear infections. This misdiagnosis gives the tumor opportunity to grow. Thus, it becomes harder to effectively treat.

Get a second opinion if you suspect ear cancer. Early detection is key to a good outlook.