Its types, causes, symptoms, diagnosis and treatment
Things to know about throat Cancer, and Its Management
What is throat cancer?
Throat cancer is characterized by uncontrollable growth of abnormal cells in the region of the throat, voice box, epiglottis, tonsils or oropharynx. Throat cancer is relatively uncommon when compared to other forms of cancer.
The throat consists of a tube-like structure made up of muscles, which starts from behind the nose and ends at the base of neck. It houses structures that enable us to speak, swallow and breath, namely, voice box (larynx), vocal cords, epiglottis, tonsils and oropharynx.
- Voice box, which consists of cartilage and the vocal cords for creating sound by vibrations.
- Epiglottis, which is made of cartilage and functions as a lid for windpipe.
- Tonsils, which are soft structures located towards back of throat.
What are the types of throat cancer?
Based on the location, most common types of throat cancers are pharyngeal cancer and laryngeal cancer. On the basis of the type of cells affected, throat cancer may be classified as –
Squamous cell carcinoma – When the cells lining the throat are affected, it is called as squamous cell carcinoma.
Adenocarcinoma – When the glandular cells become cancerous, it is called as adenocarcinoma. Adenocarcinoma of throat is very rare.
What are the early warning signs and symptoms of throat cancer?
Some of the common signs and symptoms of throat cancer are:
- Abrupt changes like hoarseness of voice
- Long-standing cough
- Poor healingof lump or sores in the throat
- Pain in the ear
- Soreness of throat
- Difficulty in swallowing
- Unexplained weight loss
What are the risk factors for throat cancer?
Throat cancer is more common in men than women. Poor personal habits increase the chances of throat cancer. Some common risk factors are:
- Age, more common in older people (>45–50 years)
- Alcohol abuse
- Gastroesophageal reflux disease (GERD)
- Habits like tobacco chewing and smoking
- Infection from a sexually transmitted virus called human papillomavirus (HPV)
- Poor dietary habits
- Poor oral hygiene
- Prolonged exposure to harmful chemicals
How is throat cancer diagnosed?
Your consulting physician or oncologist would be able to diagnose throat cancer by:
- Obtaining a thorough medical history
- Examining the throat by laryngoscopy or endoscopy
- Conducting laboratory tests:
- – Tissue sample (biopsy or fine-needle aspiration)
- Imaging tests as required
- – X-ray
- – Computerized tomography (CT)
- – Magnetic resonance imaging (MRI)
- – Positron emission tomography (PET)
What are the stages of throat cancer?
Based on the tumor location, involvement in the lymph nodes and spreading, TNM (tumor, node, metastasis) staging of tumor is performed. By staging the throat cancer, your doctor gets a better idea as to –
- Where the tumor is located exactly?
- Is the tumor spreading (also called as tumor metastases), if so, spread to lymph nodes?
- What is the prognosis for the patient – chances of complete recovery and survival?
Staging determines the extent and severity of cancer. The stages range from 0 to 4 based on 3 key pieces of information (TNM):
- The extent of the main tumor (T) i.e its location and effect on the nearby structures
- The spread to nearby lymph nodes (N) i.e spread of the main tumorto nearby lymph nodes, their number and size
- The spread of the main tumorto distant sites or metastasis (M) i.e spread to organs like lungs, liver, or bones
Next, the doctor combines the TNM report and stages throat cancer either as –
Stage 0 – Cancer at this stage is still at the origin of DNA error, usually, in the lining of the throat.
Stage 1 – Stage 1 is an early stage of throat cancer where cancer has not spread to lymph nodes. The tumors are no greater than 2 centimeters.
Stage 2 – Cancer is slowly progressing and tumors are growing in size up to 4 centimeters, however, there is no lymph involvement yet.
Stage 3 – In this stage, the tumor has grown larger than 4 centimeters with or without spreading into the lymph nodes.
Stage 4 – This is the most advanced stage where cancer has spread to major lymph node, or nearby tissues organs, or at least one distant part of the body – such as liver, lungs.
How is throat cancer treated?
Treatment options for throat cancer are based on many factors, like the location and stage of the throat cancer, the type of cells affected and health status of the patient. The Oncologist will discuss the benefits and risks of each treatment option and determine the most appropriate treatment.
- Radiation therapy: Use of high-energy beams that target cancer cells, causing them to die.
- Surgery: Depending on the location and stage of your cancer:
- – Endoscopic surgery for early-stage throat cancer
- – Surgery to remove all or part of the affected area or the whole voice box i.e laryngectomy
- – Surgery to remove part of the throat i.e pharyngectomy
- – Surgery to remove the involved cancerous lymph nodes i.e dissection
- Chemotherapy: Use of medicines to kill cancer cells
- Targeted drug therapy: Use of medicines that target specific defects in cancer cells to inhibit the abnormal cell growth.
- Rehabilitation after treatment for eating, swallowing and speech difficulties
What is the survival rate for throat cancer?
The 5-year survival rate of throat cancer is an estimate of chances of survival for 5 years after being diagnosed with throat cancer. According to American Cancer Society, these values do not provide a complete picture and bear limitations as they are based on data driven from a population with throat cancer. Therefore, survival rates of throat cancer should only be considered as estimates and not be used to predict any consequences for the patient.
- Throat cancer that begins at supraglottis (upper part of larynx) has survival rates of 59%, 59%, 53%, and 34% for stage 1, 2, 3, and 4, respectively.
- Throat cancer that begins at glottis (part of larynx including vocal cords) has survival rates of 90%, 74%, 56%, and 44% for stage 1, 2, 3, and 4, respectively.
- Throat cancer that begins at subglottis (part of larynx below vocal cords) has survival rates of 65%, 56%, 47%, and 32% for stage 1, 2, 3, and 4, respectively.
- Throat cancer that begins at hypopharynx has survival rates of 53%, 39%, 36%, and 24% for stage 1, 2, 3, and 4, respectively.
How can throat cancer be prevented?
Although there is no proven way to prevent throat cancer, one can certainly reduce the risk with lifestyle modifications and precautions such as:
- Quit smoking, seek professional help if required
- Stop alcohol altogether, or consume it only in moderate amounts.
- Eat a well-balanced diet.
- Engage in safe sex practices and protect yourself from HPV.
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- Mayo Clinic. Throat cancer. Available at: https://www.mayoclinic.org/diseases-conditions/throat-cancer/diagnosis-treatment/drc-20366496. Accessed on Feb 20th, 2018
- National Cancer Institute. Laryngeal Cancer Treatment (Adult) (PDQ®)–Patient Version https://www.cancer.gov/types/head-and-neck/patient/adult/laryngeal-treatment-pdq. Accessed on May 12th , 2018
- Laryngeal (larynx) cancer. Available at: https://www.nhs.uk/conditions/laryngeal-cancer/ Accessed on Feb 20th , 2018
- American Cancer Society. Laryngeal and Hypopharyngeal Cancer.Available at: https://www.cancer.org/cancer/laryngeal-and-hypopharyngeal-cancer.html. Accessed on Feb 20th , 2018
- MSKCC. Throat cancer stages. Available at: https://www.mskcc.org/cancer-care/types/throat/throat-cancer-diagnosis/throat-cancer-stages. Accessed on May 12th , 2018