Overview of throat cancer
Throat cancer refers to cancer of the larynx, vocal cords, and other parts of the throat, such as the tonsils and oropharynx. Throat cancer is frequently grouped into two categories:
- Pharyngeal cancer
- Laryngeal cancer
Cancer is a class of diseases in which abnormal cells increase and divide uncontrollably in the body. These abnormal cells form malignant growths called tumours.
Throat cancer is relatively rare compared to other cancers. The National Cancer Organization estimates that of adults in the United States:
- About 1.2 per cent will be diagnosed with pharyngeal and oral cavity cancer in their lifetime.
- About 0.3 per cent will be diagnosed with laryngeal cancer in their lifetime.
Types of throat cancer
It is a general term for cancer that develops in the throat (pharyngeal cancer) or the larynx (laryngeal cancer). The throat and larynx are carefully connected, with the larynx located just below the throat.
Though most throat cancers involve the same types of cells, specific terms are used to differentiate the part of the throat where cancer started.
- Nasopharyngeal cancer begins in the nasopharynx, the share of the throat just behind the nose.
- Oropharyngeal cancer starts in the oropharynx, the part of the throat just behind the mouth that includes the tonsils.
- Hypopharyngeal cancer (laryngopharyngeal cancer) begins in the hypopharynx (laryngopharynx), the lower part of the throat, just above the esophagus and trachea.
- Glottic cancer begins in the vocal cords.
- Supraglottic cancer begins in the upper part of the larynx and includes cancer that affects the epiglottis, which is a piece of cartilage that prevents food from entering the trachea.
Symptoms of throat cancer
Signs and symptoms of throat cancer may include:
- Voice changes such as hoarseness or cracking
- Difficulty swallowing or breathing
- A sore throat, cough, or earache that doesn’t go away
- Lump in the neck
- Unexplained weight loss
Causes of throat cancer
Experts don’t know exactly what causes throat cancer, but some factors seem to increase the risk.
- Alcohol: Consuming more than one drink a day can increase your risk.
- Tobacco use: This includes smoking or chewing tobacco and inhaling snuff.
- Poor nutrition: vitamin deficiencies can play a role.
- Gastroesophageal reflux disease (GERD): acid from the stomach leaks into the esophagus.
- Epstein-Barr virus (EBV)
- HPV infection: increases the risk of several types of cancer.
- Exposure to some chemicals – Substances used in the petroleum and metallurgy industries can contribute.
- Sex: These cancers traditionally affect about four times more men than women.
- Age: more than 50% of diagnoses occur after 65 years.
- Race and Ethnicity: It is more common among Black Americans and White Americans than Asians or Hispanic Americans.
- Science has not long-established that all of these factors cause or even increase the risk of throat cancer, but there is evidence that they can.
However, they have found a strong link between smoking and heavy alcohol use.
Throat cancer diagnosis
At your appointment, your doctor will ask about your symptoms and medical history. If you’ve been experiencing symptoms such as a sore throat, hoarseness, and persistent cough with no improvement and no other explanation, they may suspect throat cancer.
To check for throat cancer, your doctor will perform a direct or an indirect laryngoscopy or will refer you to a specialist for the procedure.
A laryngoscopy gives your doctor a closer view of your throat. If this test reveals abnormalities, your doctor may take a tissue sample (called a biopsy) from your throat and test the sample for cancer.
Different approaches are used to obtain tissue for a biopsy, depending on the location of the tumour. Contrary to a common misconception, biopsies do not increase the chance that cancer will spread.
- Conventional incisional biopsy – This is the most commonly used traditional type of biopsy. The doctor surgically removes some of the tissue where cancer is suspected.
- Excisional biopsy: A type of biopsy that removes most or all of the tissue suspected of having cancer. This is often done with tonsillectomy in the operating room.
- Fine needle aspiration (FNA) biopsy: This type of biopsy may be used if you have a lump in your neck that you can feel. A fine needle is inserted into the area, and then the cells are removed and examined under a microscope. This is often combined with an ultrasound to verify the location of the needle.
Imaging tests, which may include:
- CT or CAT scans (computerized axial tomography)
- Positron emission tomography (PET)
- Magnetic resonance imaging (MRI) scans
- Chest and dental x-rays
Throat cancer treatment options
Throat cancer treatment can depend on many factors, including the specific type of cancer, its location, and its stage. Treatment options include:
- Targeted therapy
Treatment for metastatic throat cancer may be contingent on where cancer has spread and may include chemotherapy and radiation therapy. Some treatments for metastatic cancer can be considered palliative and are intended to relieve symptoms and improve quality of life.
Factors that can increase your risk of throat cancer include:
- Tobacco use, including smoking and chewing tobacco
- Excessive alcohol use
- Viral infections, including human papillomavirus (HPV) and Epstein-Barr virus
- A diet lacking in fruits and vegetables
- Gastroesophageal reflux disease (GERD)
- Exposure to toxic substances at work
There is no established way to prevent it. But to lower your risk of this disease, you can:
- Stop or don’t start smoking. If you smoke, stop it. If you don’t smoke, don’t start. Quitting smoking can be very difficult, so get help. Your doctor can discuss the benefits and risks of the many strategies to quit smoking, such as medications, nicotine replacement products, and counselling.
- Drink alcohol only in moderation. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women of all ages and men 65 and older, and up to two drinks a day for men 65 and younger.
- Choose a fit diet full of fruits and vegetables. The vitamins and antioxidants in fruits and vegetables can reduce your risk of throat cancer. Eat a variety of fruits and vegetables.
- Protect yourself from HPV. Some throat cancers are believed to be caused by the human papillomavirus (HPV), a sexually transmitted infection. You can reduce your risk of getting HPV by limiting the number of sexual partners and using a condom every time you have sex. Also consider the HPV vaccine, which is available to boys, girls, and young women and men.