Treatment for cancer of the outer ear

You might have surgery or radiotherapy, or a combination of both to treat cancer of the outer ear.

This page is about treatment for cancer that starts in the skin flap of your outer ear. Although the ear canal is part of the outer ear, its treatment is different.

You can read about treatment for cancer that starts in the ear canal on the pages about cancer of the ear canal, middle ear and inner ear.

Treatment decisions

A team of doctors and other professionals discuss the best treatment and care for you. They are called a multidisciplinary team (MDT).

The treatment you have depends on:

  • where in the ear the cancer is
  • the type of cancer you have
  • the size of the tumour
  • whether it's spread beyond the area it started in (the stage)
  • your general health

Surgery

The type and amount of surgery you have depends on the stage of your cancer.  

Excision biopsy

This is the most common type of surgery for cancer of the outer ear. The surgeon removes your cancer and a border of healthy tissue around it. A pathologist looks at the tissue under a microscope.

You might need to have further surgery if cancer cells are found in the border of tissue. Removing a border of healthy tissue around the cancer helps to lower the risk of the cancer coming back.

Mohs surgery

Mohs micrographic surgery is a specialist technique.

The doctor removes a little cancer tissue and it is immediately examined under a microscope. They only remove more tissue (and examine it) if the tissue contains cancer cells.

The surgeon continues in this way until they have removed all of the cancer. The aim is to keep as much healthy skin as possible.  

Wide local excision

You might have a wide local excision if your cancer wasn't completely removed when you had the biopsy. A larger area of the skin and tissue of the ear is removed.

You might need to have a skin graft or flap if a very large area is involved. This is when your surgeon takes skin or tissue from another part of your body to repair the area.

Lymph node and salivary gland surgery

Your surgeon might remove nearby lymph nodes if your lymph nodes are swollen. This operation is called lymph node dissection.

You might also need to have one of your salivary glands removed. Your mouth might feel drier after this. But there are a number of salivary glands in your mouth so you will still make some saliva.

Removal of the whole ear with reconstruction

This is a very rare operation. Your surgeon will only suggest it if your cancer is affecting most of your outer ear. Your surgeon might be able to rebuild (reconstruct) your ear. This is only carried out by specialist surgeons.

Surgeons carry out a reconstruction either by using living tissue or using a false (prosthetic) ear. There are pros and cons to each type of surgery. Your specialist surgeon will talk to you about the best operation for you.

Living Tissue

Making an ear out of living tissue can be complicated and is usually a longer procedure. It needs at least 2 operations.  

False ear

The false ear is made of flesh coloured hard rubber (silicone). The silicone ear is a less complicated operation, but the ear is removable.

The surgeon puts pins in the bone behind your ear and you attach the prosthetic ear to those. The ear can become unclipped from the pins if it is knocked. It's not permanently fixed and you have to remove it daily to clean it.

The colour of the silicone might change in time so that it doesn’t match your skin. Most people need to have a new silicone ear about every 18 months.

Your hearing should not be affected with either of these operations. This is because the middle ear is not removed. If the cancer has grown into the ear canal your surgeon may need to remove this. But you should still be able to hear after the operation.

Radiotherapy

Radiotherapy uses high energy rays to treat cancer. You might have radiotherapy:

  • as your only treatment, if the cancer on the outer flap of your ear (the pinna) is small
  • after surgery, particularly if your surgeon couldn't remove a border of healthy tissue from around the cancer

Radiotherapy after surgery can lower the chance of your cancer coming back.

The length of the radiotherapy course depends on the size of your cancer. Some people have radiotherapy for between 4 to 6 weeks. But your course might be shorter than this. You usually have treatment every day from Monday to Friday.

Before you start, your radiotherapy doctor plans your treatment. This means working out the dose of radiotherapy you need and exactly where you need it. Your planning appointment takes from 15 minutes to 2 hours. The treatment you have daily only takes a few minutes.

Side effects

The side effects of radiotherapy include:

  • reddening of the skin of the ear
  • sore and tender ear
  • swelling around the ear

Your doctor, nurse or radiographer will go through all the side effects with you and tell you what you can do to help relieve them. 

Rarely, the ear can become sore some time after treatment has finished. Tell your doctor as soon as possible if your ear changes colour or becomes sore. 

Follow up

You have regular check ups once your treatment has finished. Your doctor will examine your ear and ask about your general health. You can ask any questions you have and tell your doctor if anything is worrying you.

How often you have check ups depends on your situation. They usually start off every 2 or 3 months and gradually become less often.

Coping

Coping with a diagnosis of cancer can be difficult. Being well informed about your cancer and its treatment can help. It can make it easier to make decisions and cope with what happens.

Talking to other people who have the same thing can also help.

Our discussion forum Cancer Chat is a place for anyone affected by cancer. You can share experiences, stories and information with other people.

You can call our nurse freephone helpline on 0808 800 4040. They are available from Monday to Friday, 9am to 5pm. Or you can send them a question online.

Last reviewed: 
15 Feb 2022
Next review due: 
15 Feb 2025
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