Prof Jens Overgaard discusses three major influences on head and neck cancer: smoking, traditionally the primary cause of this disease; the human papillomavirus (HPV), which is the cause of a newer rapidly emerging subclass of the disease; and the comorbidities commonly seen in our growing elderly population. It is especially important for head and neck cancer to be treated early and consequently a system has been adopted in Denmark which fast tracks treatment for head and neck patients. Prof Overgaard explains how this system has successfully reduced waiting times, outlines how hypoxic modification increases the efficacy of radiotherapy and talks about the benefits of post mastectomy radiotherapy for breast cancer patients.