Head and neck cancer result from excessive tobacco and alcohol consumption. The survival has not improved in the last decades despite better loco-regional control, mainly because of secondary cancers. Head and neck cancer is associated to a high rate of synchronous esophageal and lung tumors and an annual 4% rate of new metachronous malignancies. The role of panendoscopy is evolving: a flexible esophagoscopy with Lugol's iodine staining should be performed and a chest CT-scan should replace bronchoscopy. During follow-up, metachronous malignancy should be searched for in the head and neck region; investigation beyond the head and neck is questionable since prognosis is poor.