Throat cancer refers cancer that develops in your throat (pharynx) or voice box (larynx).
Your throat is a muscular tube that begins behind your nose and ends in your neck. Throat cancer most often begins in the flat cells that line the inside of your throat.
Your voice box sits just below your throat and also is susceptible to throat cancer. The voice box is made of cartilage and contains the vocal cords that vibrate to make sound when you talk.
Throat cancer is a general term that applies to cancer that develops in the throat (pharyngeal cancer) or in the voice box (laryngeal cancer).
Though most throat cancers involve the same types of cells, specific terms are used to differentiate the part of the throat where cancer originated.
Signs and symptoms of throat cancer may include:
Make an appointment with your doctor if you notice any new signs and symptoms that are persistent. Most throat cancer symptoms aren't specific to cancer, so your doctor will likely investigate other more common causes first.
Throat cancer occurs when cells in your throat develop genetic mutations. These mutations cause cells to grow uncontrollably and continue living after healthy cells would normally die. The accumulating cells can form a tumor in your throat.
It's not clear what causes the mutation that causes throat cancer. But doctors have identified factors that may increase your risk.
Factors that can increase your risk of throat cancer include:
There's no proven way to prevent throat cancer from occurring. But in order to reduce your risk of throat cancer, you can:
In order to diagnose throat cancer, your doctor may recommend:
Using a scope to get a closer look at your throat. Your doctor may use a special lighted scope (endoscope) to get a close look at your throat during a procedure called endoscopy. A camera at the end of the endoscope transmits images to a video screen that your doctor watches for signs of abnormalities in your throat.
Another type of scope (laryngoscope) can be inserted in your voice box. It uses a magnifying lens to help your doctor examine your vocal cords. This procedure is called laryngoscopy.
Removing a tissue sample for testing. If abnormalities are found during an endoscopy or laryngoscopy, your doctor can pass surgical instruments through the scope to collect a tissue sample (biopsy). The sample is sent to a laboratory for testing.
In the lab, specially trained doctors (pathologists) will look for signs of cancer. The tissue sample may also be tested for HPV, since the presence of this virus impacts the treatment options for certain types of throat cancer.
Once throat cancer is diagnosed, the next step is to determine the extent (stage) of the cancer. Knowing the stage helps determine your treatment options.
The stage of throat cancer is characterized with the Roman numerals I through IV. Each subtype of throat cancer has its own criteria for each stage. In general, stage I throat cancer indicates a smaller tumor confined to one area of the throat. Later stages indicate more advanced cancer, with stage IV being the most advanced.
Your treatment options are based on many factors, such as the location and stage of your throat cancer, the type of cells involved, whether the cells show signs of HPV infection, your overall health, and your personal preferences. Discuss the benefits and risks of each of your options with your doctor. Together you can determine what treatments will be most appropriate for you.
Radiation therapy uses high-energy beams from sources such as X-rays and protons to deliver radiation to the cancer cells, causing them to die.
Radiation therapy can come from a large machine outside your body (external beam radiation), or radiation therapy can come from small radioactive seeds and wires that can be placed inside your body, near your cancer (brachytherapy).
For small throat cancers or throat cancers that haven't spread to the lymph nodes, radiation therapy may be the only treatment necessary. For more-advanced throat cancers, radiation therapy may be combined with chemotherapy or surgery. In very advanced throat cancers, radiation therapy may be used to reduce signs and symptoms and make you more comfortable.
The types of surgical procedures you may consider to treat your throat cancer depend on the location and stage of your cancer. Options may include:
Surgery to remove all or part of the voice box (laryngectomy). For smaller tumors, your doctor may remove the part of your voice box that is affected by cancer, leaving as much of the voice box as possible. Your doctor may be able to preserve your ability to speak and breathe normally.
For larger, more-extensive tumors, it may be necessary to remove your entire voice box. Your windpipe is then attached to a hole (stoma) in your throat to allow you to breathe (tracheotomy). If your entire larynx is removed, you have several options for restoring your speech. You can work with a speech pathologist to learn to speak without your voice box.
Surgery to remove part of the throat (pharyngectomy). Smaller throat cancers may require removing only small parts of your throat during surgery. Parts that are removed may be reconstructed in order to allow you to swallow food normally.
Surgery to remove more of your throat usually includes removal of your voice box as well. Your doctor may be able to reconstruct your throat to allow you to swallow food.
Surgery carries a risk of bleeding and infection. Other possible complications, such as difficulty speaking or swallowing, will depend on the specific procedure you undergo.
Chemotherapy uses drugs to kill cancer cells.
Chemotherapy is often used along with radiation therapy in treating throat cancers. Certain chemotherapy drugs make cancer cells more sensitive to radiation therapy. But combining chemotherapy and radiation therapy increases the side effects of both treatments.
Discuss with your doctor the side effects you're likely to experience and whether combined treatments will offer benefits that outweigh those effects.
Targeted drugs treat throat cancer by taking advantage of specific defects in cancer cells that fuel the cells' growth.
As an example, the drug cetuximab (Erbitux) is one targeted therapy approved for treating throat cancer in certain situations. Cetuximab stops the action of a protein that's found in many types of healthy cells, but is more prevalent in certain types of throat cancer cells.
Other targeted drugs are available and more are being studied in clinical trials. Targeted drugs can be used alone or in combination with chemotherapy or radiation therapy.
Immunotherapy uses your immune system to fight cancer. Your body's disease-fighting immune system may not attack your cancer because the cancer cells produce proteins that help them hide from the immune system cells. Immunotherapy works by interfering with that process.
Immunotherapy treatments are generally reserved for people with advanced throat cancer that's not responding to standard treatments.
Treatment for throat cancer often causes complications that may require working with specialists to regain the ability to swallow, eat solid foods and talk. During and after throat cancer treatment, your doctor may have you seek help for:
Your doctor can discuss the potential side effects and complications of your treatments with you.
Throat cancers are closely linked to smoking. Not everyone with throat cancer smokes. But if you do smoke, now is the time to stop because:
Stopping smoking can be very difficult. And it's that much harder when you're trying to cope with a stressful situation, such as a cancer diagnosis. Your doctor can discuss all of your options, including medications, nicotine replacement products and counseling.
Alcohol, particularly when combined with smoking or chewing tobacco, greatly increases the risk of throat cancer. If you drink alcohol, stop now. This may help reduce your risk of a second cancer. Stopping drinking may also help you better tolerate your throat cancer treatments.
No alternative treatments have proved helpful in treating throat cancer. However, some complementary and alternative treatments may help you cope with your diagnosis and with the side effects of throat cancer treatment. Talk to your doctor about your options.
Alternative treatments you may find helpful include:
Being diagnosed with cancer can be devastating. Throat cancer affects a part of your body that is vital to everyday activities, such as breathing, eating and talking. In addition to worrying about how these basic activities may be affected, you may also be concerned about your treatments and chances for survival.
Though you may feel like your life — your survival — is out of your hands, you can take steps to feel more in control and to cope with your throat cancer diagnosis. To cope, try to:
Go to all of your follow-up appointments. Your doctor will schedule follow-up exams every few months during the first two years after treatment, and then less frequently. These exams allow your doctor to monitor your recovery and check for a cancer recurrence.
Follow-up exams can make you nervous, since they may remind you of your initial diagnosis and treatment. You may fear that your cancer has come back. Expect some anxiety around the time of each follow-up appointment. Plan ahead by finding relaxing activities that can help redirect your mind away from your fears.
Make an appointment with your family doctor if you have any signs or symptoms that worry you. If your doctor suspects you may have cancer or another disease that affects your throat, you may be referred to an ear, nose and throat (ENT) specialist.
Because appointments can be brief, and because there's often a lot of information to discuss, it's a good idea to be prepared. Here's some information to help you get ready, and what to expect from your doctor.
Your time with your doctor is limited, so preparing a list of questions can help you make the most of your time together. List your questions from most important to least important in case time runs out. For throat cancer, some basic questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask other questions that occur to you.
Your doctor is likely to ask you a number of questions. Being ready to answer them may allow time later to cover points you want to address. Your doctor may ask:
If you use tobacco, stop. Avoid doing things that worsen your symptoms. If you have throat pain, avoid foods and drinks that cause further irritation. If you're having trouble eating because of throat pain, consider nutritional supplement drinks. These may be less irritating to your throat while still offering the calories and nutrients you need.
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