Throat cancer is a broad term which comprises of pharyngeal cancer which develops in the throat; (laryngeal cancer) which develops in the voice box; and cancer which develops in the tonsils and epiglottis.
Our throat is a muscular duct or tube like structure which starts behind the nose and ends in the neck. The voice box is made up of cartilage and is present below the throat. It also encloses the vocal cords, which vibrate when a person is talking in order to make sound. Epiglottis is also a piece of cartilage which functions as a cover for our windpipe and is also susceptible to throat cancer. Tonsil cancer is also a type of throat cancer which involves the tonsils present in the posterior part of the throat. The risk of throat cancer can be reduced by avoiding tobacco, alcohol and smoking. Treatment for throat cancer comprises of radiation therapy, surgery, chemotherapy and target drug therapy.
Types of Throat Cancer
The majority of the throat cancers involve the same cell type. However, there are specific terms used for differentiating the regions of the throat where the cancer started, such as:
- Nasopharyngeal cancer starts in the nasopharynx which is the part of the throat present behind the nose.
- Oropharyngeal cancer starts in the oropharynx, which is that part of the throat present immediately posterior to the mouth and also includes tonsils.
- Laryngopharyngeal cancer (hypopharyngeal cancer): This is that cancer which starts in the laryngopharynx or hypopharynx which is the lower region of the throat and is present superior to the esophagus and windpipe.
- Glottic cancer develops in the vocal cords.
- Supraglottic cancer develops in the upper region of the larynx and also includes cancer which is present in the epiglottis.
- Subglottic cancer is that throat cancer which develops in the lower part of the voice box and just below the vocal cords.
Causes of Throat Cancer
According to experts, throat cancer occurs where there are genetic mutations in the cells of the throat resulting in rapid and uncontrollable division of the cells; so, unlike normal, healthy cells, which die after a specific period of time, these cells continue to accumulate to form a tumor in the throat. This tumor can later on spread to the surrounding tissues.
Risk Factors for Throat Cancer
- Chewing tobacco.
- Excessive alcohol intake.
- HPV, which is a human papillomavirus.
- Poor diet, which does not include fruits and vegetables.
Signs and Symptoms of Throat Cancer
- Voice changes, e.g. hoarseness.
- Swallowing difficulties.
- Sore throat.
- Ear ache.
- Presence of a lump in the throat.
- Presence of a sore which doesn't heal.
- Weight loss.
Investigations for Throat Cancer
- Biopsy which can be done during endoscopy or laryngoscopy.
- Computerized Tomography (CT) scan.
- Magnetic Resonance Imaging (MRI) scan.
- Positron Emission Tomography (PET) scan.
Treatment for Throat Cancer
Treatment for throat cancer depends on the location of the cancer, stage of the throat cancer, cell type and the patient's overall health and personal choice.
Radiation Therapy for Throat Cancer
Radiation therapy is a treatment which involves the use of high-energy beams, like x-rays, to kill cancer cells. Radiation therapy can be done from an outside source (external beam radiation) or from an internal source such as placement of small radioactive wires or seeds inside the body, near the site of cancer (brachytherapy).
Radiation therapy is beneficial for throat cancer, which is in the early stages and this may be the only treatment required. In case of advanced throat cancers, radiation therapy can be done in combination with chemotherapy or surgery.
In throat cancers which are extremely advanced, radiation therapy is done to alleviate the signs and symptoms of the cancer.
Surgery for Throat Cancer
Surgical procedures for throat cancer include:
- Surgery for throat cancer which is in its early-stage, i.e. when the cancer is limited to the throat's surface or vocal cords is done via endoscopy. The surgeon inserts the endoscope into the throat or voice box. Certain surgical tools or a laser are then passed through the scope and with the help of these tools, the surgeon scrapes off, excises or vaporizes cancers (in case of laser) which are present superficially.
- Laryngectomy is surgery done for removing the entire or a part of the voice box. In case of smaller tumors, the surgeon may remove the affected part of the voice box, thus preserving the patient's ability to speak. For larger tumors, the surgeon may have to remove the entire voice box, in which case tracheotomy is done where the windpipe is connected to a hole in the throat so the patient can breathe. Speech can be restored with the help of a speech therapist who can teach the patient to speak without his/her voice box.
- Pharyngectomy is a surgery done to remove the entire or a part of the throat. Throat cancers which are small may require only removal of a part of the throat. The parts removed can be reconstructed so that the patent is able to swallow food normally. Surgery done to remove the entire throat often includes removing the voice box also. The throat can be reconstructed for swallowing food.
- Neck dissection is a surgery which is done to remove lymph nodes which are affected by cancer. When the throat cancer metastasizes deep inside the neck, then surgery is done to remove few or all of the lymph nodes to test for cancer cells.
Chemotherapy for Throat Cancer
Chemotherapy involves the use of drugs or chemicals to destroy cancer cells. Chemotherapy can also be done along with radiation therapy for treating cancer of the throat.
Targeted Drug Therapy for Throat Cancer
This type of treatment comprises of drugs which treat throat cancer by targeting certain defects of the cancer cells. Drugs used in targeted therapy include cetuximab (Erbitux). Targeted drug therapy can also be used in combination with radiation therapy or chemotherapy.
Post Treatment Care for Throat Cancer
Patients require help or rehab after the treatment of throat cancer is complete. They need to seek the help of specialists, such as a speech therapist, for learning to speak, to recover the ability to eat, swallow etc.