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Throat cancer occurs when cancer cells develop in the throat (pharynx) or voice box (larynx).
The throat (pharynx) is the muscular tube located behind the nose, down to the back of the neck. The flat cells lining inside of the throat is where the cancer cells normally begin.
Pharynx consists of three parts: the nasopharynx (the upper part of the throat behind the nose), the oropharynx (the middle part), and the laryngopharynx, also known as the hypopharynx (the lower part).
The voice box (larynx) is the vocal cords that vibrates and make sounds when the person speak, it is located below the throat, and there is a possibility it could be affected by the cancer of the throat. The voice box (larynx) also consists of three parts: the supraglottic (the upper part), the glottic (the middle part), and the subglottic (the lower part).
Different types of throat cancer
The different types of cancers are depending on the location of the origin of the cancer. They are as follows:
- Nasopharyngeal cancer: It originates in the nasopharynx and affects the tissue that connects the back of your nose to the back of your mouth.
- Oropharyngeal cancer: It originates in the oropharynx and it affects the middle part of your throat (pharynx) just beyond your mouth, including the base of tongue, tonsils, the soft palate, and the side walls of your throat.
- Hypopharyngeal cancer or laryngopharyngeal cancer originates in the hypopharynx (or laryngopharynx) and it affects the lower part of the throat, just behind the voice box.
- Laryngeal cancer originates at the larynx and it affects the voice box (larynx).
Symptoms
Signs and symptoms of throat cancer are as follows:
- Throat pain
- Persistent sore throat
- Cough / Coughing up blood
- Voice changes, such as voice hoarseness
- Dysphagia (swallowing difficulties)
- Ear pain
- Lumps in the neck or throat
- Unexplained weight loss
If you notice any signs and symptoms that are persistent then you could make an appointment with your doctor. Investigation may be recommended due to that throat cancer symptoms are not specific.
Causes
The genetic mutation of cells in the throat causes the cells to grow uncontrollably. The cancer cells will keep on living while the healthy cells will die. Continuous multiplication of cancer cells will eventually create a tumor in the throat.
Cause of mutation have not yet determined by the specialists, but risk factors had been identified that increase the risk of having a throat cancer.
Risk factors
Factors that may increase throat cancer risk include:
- Smoking or tobacco use (chewing tobacco and snuff)
- Excessive alcohol consumption
- Viral infections: Human Papillomavirus (HPV) and Epstein-Barr virus (EBV)
- Poor diet
- Gastroesophageal reflux disease (GERD)
- Exposure to toxic substances
- Family history of cancer
Diagnosis
The doctor may recommend the following procedures to diagnose throat cancer:
- Endoscopy: A long, thin tube with a small camera inside. The scope will be inserted to the nose, this is to visualize the throat for any signs of abnormalities at the throat.
- Laryngoscopy: An endoscopy of the larynx. The procedure is to visualize and examine the voice box.
- Tissue Biopsy: Tissue sample is being remove for testing. A small portion of a tissue sample is being remove during endoscopy or laryngoscopy, and then sent to the pathology for testing for any signs of cancer. HPV is also tested to determine the specific type of cancer and the treatment options to be provided.
- Diagnostic Imaging Procedure – includes Positron Emission Tomography (PET), Computerized Tomography (CT), and Magnetic Resonance Imaging (MRI). This is to determine the extent of the cancer.
Staging
After the diagnosis, the next step is to know the extent of the cancer. The stages of cancer are indicated by Roman numerals ranging from I to IV. The lowest stage indicates a cancer is confined at the one part of the throat. The highest stage – stage IV – indicates that the cancer had spread and advanced.
Treatment
The type, location and stage of cancer are some of the factors used as well as general health and personal choice of treatment. Treatment options would be discussed with the specialist.
Radiation therapy
High-energy radiation beams from sources like X-rays and protons are used in radiation treatment to target cancer cells and kill them. This procedure could be done by two different types of radiation therapy, a brachytherapy uses small radioactive seeds and wires that can be inserted within the body and placing it at the cancer or nearer or using a large machine that emits radiation from the outside (external beam radiation).
Radiation therapy may be the only treatment required for throat cancers that haven’t progressed to the lymph nodes.
Radiation therapy and chemotherapy or surgery may be used for more advanced throat cancer. This procedure could also be utilized to reduce the signs and symptoms and improve the discomfort in cases of advanced throat cancer.
Surgery
Surgery is recommended depending on the size of the tumor, location, and stage of the throat cancer.
- Surgery is used to treat throat cancer that is minor or that has not progressed to the lymph nodes. Endoscopy is a surgical procedure that can be used to treat throat cancer that has only spread to the vocal cords or throat’s outer layer. A hollow endoscope may be inserted into the voice box or neck by the doctor, who will then pass a laser or specialized surgical instruments via the scope. The doctor can remove extremely superficial cancer with these instruments by scraping, cutting, or, in the case of the laser, vaporizing it.
- Surgical removal for smaller throat cancers might just be needed by removing a small portion of the throat then the patient could return to normal swallowing of food, by repairing the part of the throat that had been removed.
- Surgical removal of the voice box may be indicated if more part of the throat is needed to be removed. The throat could be repaired for patient to return to normal swallowing of food.
- Total or Partial Laryngectomy: – surgically removes a small portion or all the part of the larynx.
- Lymph nodes dissection: – removal of an area or all of lymph nodes. In case that throat cancer had spread at the neck.
Chemotherapy
Chemotherapy uses drugs to kill cancer cells. It can be used in combination with radiation therapy as the chemotherapy makes cancer cells more responsive to radiation therapy and therefore increasing the side effects of both.
Targeted Drug Therapy
This is used for treatment by targeting specific aspects of the cell. One specific drug that is used is cetuximab. Targeted therapy can be used alone or in combination with chemotherapy or radiation therapy.
Immunotherapy
Immunotherapy is the use of drugs to help the immune system fight against cancer. As cancer cells create proteins, it makes it difficult for the immune system to attack cancer cells. As a result, cells in the immune system cannot recognize that cancer cells that are harmful. Immunotherapy becomes effective by interfering with that natural process. This treatment is usually used for those who have advanced stage cancer and do not respond to standard treatments.
