Throat Cancer

What is throat cancer

Throat cancer (laryngeal cancer) is a general term that usually refers to cancer of the pharynx and/or larynx (voice box). Regions included when considering throat cancer include the pharynx (nasopharynx, oropharynx, hypopharynx [cancers that occur in the tissues of the throat adjacent to the larynx], glottis, supraglottis, and subglottis); about half of throat cancers develop in the larynx (the part of the throat with the vocal cords), and the other half in the pharynx. Consequently, any cancers (growth and/or spread of abnormal cells that form tumors or metastasize to other parts of the body) that develop in these regions of the throat are considered throat cancers.
Although it is not clear exactly what causes throat cancers, the cancerous cells develop when genetic mutations allow the cells to grow uncontrollably to form tumors (masses of cancer cells) that may metastasize (spread) to other areas in the body. Some of the factors that can lead to genetic mutations in the cells of the throat include cigarette smoking, infections with the human papillomavirus (HPV), and exposure to toxic substances like asbestos or large quantities of alcohol.

Throat cancer symptoms and Signs

Throat cancers may not cause any symptoms if they are very small and have not spread at the time of diagnosis. Sometimes, an area of irritation or discoloration on the lining issues of the throat is the only sign of an abnormality. Depending upon the extent of spread of the cancer, other symptoms can include:

• swelling of nearby tissues;
• enlarged lymph nodes;
• trouble breathing;
• difficulty speaking;
• neck or throat pain;
• ear pain;
• painful swallowing;
• headache.

Throat cancer diagnosis

The person’s individual history (especially the presence of potential risk factors) and physical examination may provide a physician with enough suspicious information that the physician will consider throat cancer as a possible diagnosis. Consequently, the physician may strongly suggest doing additional tests to confirm or exclude the diagnosis of throat cancer. Although imaging tests such as CT, MRI, PET scan, and others like chest X-rays, laryngoscopy, and barium swallows provide very useful information about extent and location of the cancer, the definitive diagnosis of throat cancer is made by biopsy of the tumor. Biopsy may be done by surgical incision in the neck, fine needle aspiration of the tumor, or by an endoscopic biopsy.

Throat cancer treatment

The treatment for throat cancer depends upon the extent and seriousness of the disease. As stated by the MD Anderson Cancer Center and others, treatment is tailored to the individual to provide him or her with the best chance for a successful outcome. Treatment strives to preserve the patient’s ability to eat, speak, and live a normal healthy life. Treatment plans for throat cancers usually include one or more of the following techniques: surgery, radiation therapy, chemotherapy, proton therapy, targeted therapies, and possibly participation in throat cancer clinical trials. Brief descriptions of the major components for throat cancer therapy are as follows:

Surgery

There are many types of surgery for throat cancer, including minimally invasive, transoral laser microsurgery, endoscopic, laser, robotic, and tumor excision surgery, like supracricoid partial laryngectomy to allow more normal function in swallowing and speech without a stoma (a surgically made opening in the neck that allows breathing).

Chemotherapy

These are drugs used to shrink tumors and/or kill cancer cells after surgery and/or radiation treatment. Chemotherapy (for example, cetuximab [Erbitux]) often is used in combination with other therapies.

Radiation therapy

Brachytherapy involves placement of radioactive beads close to a tumor. 3-D radiation beam therapy and intensity-modulated radiotherapy may be tailored to the specific shape of the tumor.

Proton therapy

This radiation doses using pencil beam technology directed at the tumor while preserving nearby healthy tissue.

Targeted therapies

These drugs are used to stop the growth of cancer cells by interfering with proteins and/or other receptors on cancer cells.

Cancer clinical trials

This involves the use of experimental drugs or other methods that may show promise in survival and/or reduction in clinical symptoms.
Side effects of treatment vary from person to person. However, some of the most common side effects include inflammation of mucous membranes, dry mouth, skin changes (especially after radiotherapy), nausea and vomiting (especially with chemotherapy), fatigue, sore throat, difficulty swallowing, increased sticky phlegm production, loss of appetite, loss of taste, hair loss, and breathing difficulties. In many patients who develop side effects, most effects will last from a few weeks to a few months although in a few patients they may remain indefinitely.

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