What is Throat Cancer?

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What is Throat Cancer?

Throat cancer is categorized under the broad group of head and neck cancer and refers to cancers in the larynx or voice box including that of vocal cords, and other parts of the throat, such as the oropharynx (middle part of the throat), hypopharynx (lower part of the throat) and tonsils. The main risk factors associated with throat cancer are the use of tobacco and alcohol. Human papillomavirus (HPV), especially the high-risk strains of HPV, can also cause some types of oral and throat cancer, mainly the oropharyngeal cancers

Let us understand throat cancer in detail through this article:

• What are the causes of Throat Cancer?
• What are the types of Throat Cancer?
• What are the stages of Throat Cancer?
• What are the symptoms of Throat Cancer?
• How do you diagnose Throat Cancer?
• What are the treatments for Throat Cancer?
• How to prevent Throat Cancer?

What are the causes of Throat Cancer?

The causes of throat cancer include:

• Excessive consumption of tobacco and/or alcohol 
• Chewing and/or smoking tobacco
• Human papillomavirus (HPV) infection.
• Acid reflux disease, is a digestive disorder in which stomach acid or bile irritates the lining of the food pipe. ( Know more about- What is Acid Reflux? )
• Epstein-Barr virus (EBV) infection
• Nutritionally poor diet
• Family history of cancer

Other risk factors include:

• Gender – Men are at a higher risk and are five times more likely to contract it than women.
• Age – It occurs at a higher frequency after the age of 65.
• Race – African-American men are at higher risk of throat cancer.
• Chemical exposure – Being around certain chemicals like asbestos, nickel, and sulfuric acid fumes increases the risk of throat cancer.

What are the types of Throat Cancer?

The two primary types of throat cancer based on the nature of the tumor are:

• Squamous cell carcinoma: This type of throat cancer affects the flat cells that form the inner lining of the throat.
• Adenocarcinoma: This type of throat cancer is uncommon and it affects the glandular cells – mainly minor salivary glands located in this region.

Two categories of throat cancer, depending on where they occur, are:

• Pharyngeal cancer: This cancer develops in the pharynx (the hollow tube that runs from the back of the nose to the top of the windpipe). The variations of pharyngeal cancers that develop in the neck and throat include:

– nasopharynx cancer (upper part of the throat)

– oropharynx cancer (central part of the throat)

– hypopharynx cancer (lower part of the throat)

• Laryngeal cancer: This cancer forms in the larynx (voice box).

What are the stages of Throat Cancer?

There are five stages of throat cancer and very broadly can be explained as follows:

• Stage 0: The tumor is only on the topmost layer of cells of the affected part of the throat.
• Stage 1: The tumor is less than 2 cm and is restricted to the part of the throat where it originates.
• Stage 2: The tumor is between 2 and 4 cm or may have grown to adjacent subsites/areas of the throat
• Stage 3: The tumor is larger than 4 cm and/or has grown into other structures surrounding the throat or has spread to at least one lymph node.
• Stage 4: The tumor has spread to the distant organs of the body.
• Depending upon the sub-site of throat cancer, involvement of nodes can happen in stages 1-3

What are the symptoms of Throat Cancer?

Throat cancer may show the following symptoms:

• Persistent Sore throat ( Know more about- What to do to clean throat? )
• Persistent cough
• Difficulty in breathing
• Difficulty swallowing food.
• Hoarseness of voice. ( Know more about- What is Hoarseness ( Hoarse Voice )? )
  
• The feeling of a lump in the mouth, throat, or neck
• Bleeding in the mouth or nose.
• Pain in the ear, jaw, and throat.
• Weight loss 
• The appearance of white patches or sores in the mouth and throat. 
• Headaches
• Swollen eyes, jaw, throat, or neck. ( Know more about- What is Swollen eyes? )

How do you diagnose Throat Cancer?

Throat cancer can be diagnosed in the following ways:

• Laryngoscopy – Laryngoscopy is a visual examination of the inside of the throat with the help of a thin endoscope inserted through the nostrils under local anesthesia. It gives a closer view of your throat. If this test reveals any abnormalities, your doctor may then proceed to take a tissue sample, called a biopsy, from your throat and test it for cancer.
• Biopsy – The following types of biopsies can be performed:
• Endoscopic biopsy – An endoscope is used to remove a tissue sample. A thin, long tube is inserted through your mouth or nose and takes a small sample from the abnormal area or the growth. This is the most common way of obtaining a biopsy sample from suspected throat cancer.
• Fine needle aspiration cytology (FNAC) – For this, your doctor inserts a thin needle directly into a tumor to remove a group of cells for testing. It is mainly used to characterize enlarged lymph nodes. The amount of sample obtained by FNAC is less than a biopsy hence the sensitivity to detect cancer is also lower. 
• Conventional/open biopsy – This type of biopsy is needed when endoscopic biopsy under local anesthesia fails to give a diagnosis. The examination is done under general anesthesia in an operating room and with the help of a flexible/rigid endoscope a biopsy sample is obtained. Sometimes, an incision may be required to remove a piece of tissue.
• Imaging tests – Imaging including computerized tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET), may help determine the extent of your cancer beyond the surface of your throat or voice box and are helpful in treatment planning

What are the treatments for Throat Cancer?

Treatment of throat cancer depends on the location and extent of the tumor as well as the general condition of the patient. It’s very important to consider the quality of life and the profession of the patient before deciding on the most appropriate treatment in order to achieve best oncologic results as well as rehabilitation after treatment. Following therapies in various combinations can be used in different situations after discussion in multidisciplinary tumor board which comprises of many specialists that discuss various treatment options and make a consensus plan that would give the best results for the patient: 

• Radiation therapy – It uses energy beams to destroy cancer cells. If the patient’s tumor is very small, then it may be cured using radiation therapy only. Most of the times, though, the radiation therapy is used in combination with chemotherapy or as an adjunct to surgery. Radiation therapy may also be used to treat recurrent throat cancer that have previously been treated with surgery or even radiation. Careful assessment and planning is needed if second time radiation is being considered.
• Chemotherapy- This therapy includes the use of chemotherapy drugs to destroy cancer cells and is usually given in combination with radiation. Chemotherapy can also be used after the surgery in certain situations to take care of tumor cells that might be circulating in the body. For advanced stages of cancer which has spread to other areas, palliative chemotherapy or targeted therapy may be used.

• Chemoradiation – This treatment combines radiation therapy and chemotherapy. It may be used as a first-line treatment for laryngeal cancer and may help patients avoid surgery and preserve the larynx (voice box). It may be a treatment option for patients who choose not to have surgery or who are not healthy enough for surgery. ( Know more about- What is Chemotherapy?)
• Surgery- Although most throat cancers are treated by radiation or chemoradiation, with the advent of endoscopic and robotic surgery, it is the preferred treatment for early-stage throat cancers. If the patient’s tumor is very small, the doctors may use an endoscopic / robotic approach. Apart from this, in locally advanced tumors, part of the throat / voice box may have to be removed. It is then repaired so that the person can swallow food properly. Surgery is also the treatment of choice for patients who have residual or recurrent disease after chemoradiation. Even when the voice box is removed, there are ways for voice rehabilitation including a voice prosthesis that can be placed during surgery. Nearby lymph nodes may also be resected during surgery to achieve clearance of cancer. Tissues removed during surgery are subjected to detailed pathological examination (biopsy) based on results of which further treatment can be planned. (Know more about- What is Thyroidectomy? )

One of the most important treatments of Thyroid Disorders is Thyroidectomy. This procedure is done by general surgeons across different cities and hospitals in India, with great success and precision. 

• Targeted therapy – Laryngeal and hypopharyngeal cancers typically have an excess of the epidermal growth factor receptor (EGFR), a protein found on the surface of many cancer cells that helps them grow and divide. As laryngeal and hypopharyngeal cancers have more EGFR proteins than other cancers, drugs that target this protein may be used in combination with radiation therapy to treat some throat cancers. Targeted therapy drugs may also be used independently or in combination with chemotherapy to treat certain advanced or recurrent throat cancers.
• Immunotherapy – Immunotherapy drugs are designed to help the body’s immune system identify and destroy tumor cells and are typically recommended when the tumor doesn’t respond to first-line treatments.

How to prevent Throat Cancer?

There is no definitive or guaranteed way to prevent throat cancer. But some of the following measures can reduce the risk of developing throat cancer significantly:

• Quit tobacco – chewing as well as smoking.
• Reduce alcohol consumption.
• Include healthy foods in your diet like green vegetables, fresh fruits, etc.
• Exercise regularly and maintain a healthy body weight.
• Avoid having unprotected sex to reduce the risk of HPV infection.
• Avoid workplace chemicals.

We hope we were able to answer your questions about Throat Cancer through this article.

If you want more information and treatment for Throat Cancer, you can contact an Oncologist / Cancer Specialist.

We only aim to give you information through the article. We do not recommend medication, treatment in any way. Only a doctor can give you the best advice.