Throat Cancer

Throat Cancer: Types & Symptoms 

Throat cancer is a broad term encompassing cancers that impact various parts of the throat. Typically, individuals with throat cancer have manifestations in their larynx (voice box) or oropharynx (the part of the throat behind the tongue). Healthcare providers commonly employ surgery to address throat cancer, with the specific surgical approach contingent on factors such as the type of throat cancer, its location, and the extent of its spread.

There exist multiple types of throat cancer, with laryngeal cancer and oropharyngeal cancer being the two most prevalent forms.

Common Types Of Throat Cancer 

Throat cancer is a diverse category of malignancies affecting different throat regions. The prevalence varies between laryngeal and oropharyngeal cancer, with specific demographic trends and survival rates associated with each subtype. Awareness of these distinctions is vital for understanding the nature and impact of throat cancer.

1.     Laryngeal Cancer:

Laryngeal cancer manifests in the voice box and exhibits a higher incidence in men compared to women. It typically afflicts individuals engaged in heavy smoking and alcohol intake. It is divided into three types:

a)   SupraglotticCancer:

Supraglottic cancer originates in the upper part of the larynx and affects structures such as the epiglottis. It represents a subset of laryngeal cancers and may present with symptoms like a persistent sore throat, difficulty swallowing, or voice changes. Depending on the stage and characteristics of the cancer, treatment approaches may include surgery, radiation therapy, and targeted therapies.

b)  GlotticCancer:

Glottic cancer specifically targets the vocal cords in the larynx’s middle part. As the most common type of laryngeal cancer, it often presents with symptoms such as hoarseness, chronic cough, or difficulty breathing. The treatment plan for glottic cancer may involve surgery to remove the affected vocal cords, radiation therapy, and voice rehabilitation.

c)   SubglotticCancer:

Subglottic cancer initiates in the lower part of the voice box, below the vocal cords. It is relatively rare compared to other types of laryngeal cancers. Symptoms may include breathing difficulties, a persistent cough, or throat discomfort. Treatment approaches typically include surgery to remove the affected tissue, radiation therapy, and, in some cases, chemotherapy.

2.                Oropharyngeal Cancer:

Oropharyngeal cancer targets the throat region just behind the tongue. Men are twice as likely as women to develop oropharyngeal cancer, and it can affect individuals of any age. Human papillomavirus is known to cause this oropharyngeal cancer. It’s estimated that 30% of all oropharyngeal cancers are HPV related. Symptoms may change in voice, blood in sputum/cough, and a lump in the neck.

3.                Hypopharyngeal Cancer:

Hypopharyngeal cancer affects the region above the food pipe and behind the voice box. It is often associated with challenges in early detection, and symptoms may include difficulty swallowing persistent coughing, and voice changes. Due to its location, hypopharyngeal cancer may necessitate a comprehensive treatment approach, potentially involving surgery, radiation therapy, and chemotherapy.

4.               Nasopharyngeal Cancer:

Nasopharyngeal cancer is a relatively rare type of throat cancer that occurs in the area behind the nose. It is more prevalent in specific populations, including individuals of East Asian descent. The Epstein-Barr virus is often associated with nasopharyngeal cancer. Symptoms may include nasal congestion, hearing loss, and a lump in the neck. Treatment typically involves a combination of radiation therapy and chemotherapy.

Understanding the specific characteristics and challenges associated with each type of throat cancer is crucial for accurate diagnosis and the development of effective treatment plans tailored to patients’ individual needs. Early detection and a multidisciplinary approach involving oncologists, surgeons, and other specialists contribute to improved outcomes for individuals facing these diverse forms of throat cancer.

Identifying Throat Cancer Symptoms:

Throat cancer encompasses various types, each affecting distinct parts of the throat in unique ways. Recognizing potential symptoms is essential for early detection. Some common indicators of throat cancer include:

• Persistent Sore Throat: A prolonged sore throat lasting more than two weeks.

• Pain or Difficulty Swallowing (Dysphagia): Discomfort or challenges in swallowing food.

• Voice Changes: Persistent hoarseness or alterations in voice lasting beyond two weeks.

• Lumps in Throat or Mouth: Lumps in the back of the throat or mouth.

• Neck Lumps: Formation of lumps in the neck, including the back of the neck.

• Ear Pain: Persistent ear pain extends for over two weeks.

Experiencing these symptoms does not automatically indicate throat cancer, as they may be associated with other less severe conditions. However, if any symptom persists for two weeks or more, it is crucial to consult with your healthcare provider for a comprehensive evaluation and diagnosis.

Determining the Possibility of Throat Cancer:

Your healthcare provider is the most reliable source for information regarding throat cancer. Due to the similarity of throat cancer symptoms with those of less severe conditions, seeking professional guidance is imperative. For instance, persistent hoarseness lasting beyond two weeks might be an early sign of laryngeal cancer. Additionally, symptoms like a prolonged sore throat or difficulty swallowing food for an extended period warrant prompt attention and assessment by a healthcare professional. Early detection through consultation with your healthcare provider ensures timely and appropriate management of potential throat cancer or other underlying conditions.

What are the possible treatments for throat cancer?

The treatment of throat cancer depends on various factors, including the type of cancer, its stage, location, and the overall health of the patient. Here are some common treatment modalities for throat cancer:

Surgery:

Surgical procedures are often used to remove the cancerous tissue. The extent of surgery depends on the size and location of the tumor. Types of surgery include:

• Transoral Laser Surgery: Using an advanced endoscopic device and laser, small throat tumors can be removed, avoiding any incision on the neck along with a short hospital stay

• Laryngectomy: Removal of all of the larynx (voice box).

• Pharyngectomy: Removal of part of the throat behind the tongue and above the food pipe.

• Transoral robotic surgery: Using a surgical robot, oropharyngeal and laryngeal tumors can be removed, avoiding any incision on the neck.

• Base of tongue resection: Removal of part of the tongue at the back.

• Neck dissection: Removal of lymph nodes in the neck

• Nasopharyngectomy: Removal of tumors in the nasopharynx that have recurred after chemoradiation.

Radiation Therapy:

High-energy rays, such as X-rays, target and kill cancer cells. Radiation therapy may be employed as the primary treatment or in conjunction with surgery. It is often used for early-stage throat cancers.

Chemotherapy:

Chemotherapy involves using drugs to kill cancer cells or inhibit their growth. It is used in combination with radiation therapy. Chemotherapy is often employed for advanced-stage or metastatic throat cancers.

Targeted Therapy:

Targeted drugs specifically target cancer cells while minimizing damage to healthy cells. These drugs may be used with chemotherapy or as a standalone treatment, particularly in cases where specific molecular abnormalities are identified.

Immunotherapy:

Immunotherapy aims to enhance the body’s immune system to recognize and destroy cancer cells. This treatment may be considered for certain types of throat cancers, and ongoing research explores its effectiveness in different scenarios.

Rehabilitative Therapies:

Following treatment, rehabilitative therapies may be crucial for restoring function and improving quality of life.

a) Speech therapy is joint after procedures affecting the larynx, helping patients adapt to changes in speech or swallowing.

b) Voice prosthesis: This is a silicone artificial device used to rehabilitate speech after laryngectomy. It is implanted at an opening in the neck.

c) Electrolarynx: This is an electronic device that can be charged and carried by the patient. While being used, it is placed in contact with the neck, and it vibrates to produce speech.

Clinical Trials:

Participation in clinical trials may be an option for some patients, especially when conventional treatments are not fully effective or for exploring innovative therapies.

Conclusion

The treatment choice is highly individualized, and a multidisciplinary team of healthcare professionals, including oncologists, surgeons, radiation oncologists, and other specialists, collaborate to determine the most appropriate approach for each patient. The goal is to eradicate the cancer and preserve as much normal function as possible, particularly in critical areas such as speech and swallowing. 

Treatment decisions are made after carefully considering the specific characteristics of the cancer and the patient’s overall health. It’s important for individuals diagnosed with throat cancer to discuss treatment options, potential side effects, and long-term outcomes with their healthcare team.