• Throat Cancer

    (Cancer, Throat; Cancer, Oropharyngeal; Oropharyngeal Cancer; Nasopharyngeal Cancer; Cancer, Nasopharyngeal)

    Definition

    Throat cancer is a disease in which cancer cells grow in an abnormal way in the throat. The throat is the hollow tube that runs from behind the nose and mouth, down the neck, to the opening of the esophagus and windpipe.
    Cancer occurs when cells in the body (in this case throat cells) divide without control or order. Normally, cells divide in a regulated manner. If cells keep dividing uncontrollably when new cells are not needed, a mass of tissue forms, called a growth or tumor. The term cancer refers to malignant tumors, which can invade nearby tissues and spread to other parts of the body. A benign tumor usually does not invade or spread.
    Throat Cancer
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    Causes

    Unknown

    Risk Factors

    These risk factors increase your chance of developing throat cancer. Tell your doctor if you have any of these risk factors:
    • Age: 40 or older
    • Sex: male
    • Smoking or use of any tobacco products (such as chewing, snuffing)
    • Excessive alcohol consumption
    • Family history and genetic predisposition
    • Vitamin A deficiency
    • Diet low in fruits and vegetables
    • Suppressed immune system
    • Infections caused by certain viruses such as:
    • Radiation exposure
    • Excess consumption of cured meats or fish
    • Marijuana use
    • Exposure to certain materials such as in:
      • Nickel refining
      • Woodworking
      • Working with textile fibers

    Symptoms

    If you have any of these symptoms do not assume it is due to throat cancer. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:
    • Sore throat
    • Feeling that something is caught in the throat
    • Difficulty chewing or swallowing
    • Difficulty moving the jaw or tongue
    • Voice changes or hoarseness
    • Change in voice quality; referred to as “hot potato” voice
    • Pain in the head, throat, or neck
    • Lump in the neck
    • Unexplained weight loss

    Diagnosis

    The doctor will ask about your symptoms and medical history, and perform a physical exam. The doctor may feel for any lumps in the neck. You may be referred to an otolaryngologist, a doctor who specializes in head and neck surgery.
    Tests:
    • Laryngoscopy—a thin, lighted tube inserted through the mouth to examine the inside of the throat
    • Panendoscopy—extensive exam of the oral cavity, oropharynx, larynx, esophagus, and trachea using a fiberoptic scope
    • Fine needle aspiration—use of a thin needle to remove a sample of throat tissue to test for cancer cells
    • Magnetic resonance imaging (MRI) scan—a test that uses magnetic waves to make pictures of the inside of the throat
    • Positron emission tomography (PET) scan—a special scan using radioactive glucose that circulates throughout the body; x-ray is then taken and the radiation shows up, showing cancer cells
    • Computed tomography (CT) scan—a type of x-ray that uses a computer to make pictures of the inside of the throat
    • Incisional biopsy—surgical removal of a sample of throat tissue to test for cancer cells

    Treatment

    Once throat cancer is found, staging tests are done to find out if the cancer has spread. Treatment depends on the stage of the cancer.

    Surgery

    This is surgery to remove the cancerous tumor and nearby tissue, and possibly nearby lymph nodes. In very rare cases, surgery to remove large tumors of the throat may also require removal of tissue for swallowing. As a result, food may enter the windpipe and reach the lungs, which might cause pneumonia. In cases when this is a risk, your surgeon may remove the larynx or voice box. She will attach the windpipe to the skin through a hole in the neck, which is used for breathing.

    Radiation Therapy

    This is the use of radiation to kill cancer cells and shrink tumors. Radiation may be:
    External radiation therapy—radiation directed at the tumor from a source outside the body
    Internal radiation therapy—radioactive materials placed into the throat in or near the cancer cells

    Chemotherapy

    This is the use of drugs to kill cancer cells. Chemotherapy may be given in many forms including pill, injection, and/or via a catheter. The drugs enter the bloodstream and travel through the body killing mostly cancer cells, but also some healthy cells.

    Combined Modality Therapy

    Often times, chemotherapy and radiation therapy are used together to kill cancer of the larynx and pharynx (throat). This combined approach may be better than surgery or radiation alone.

    Prevention

    To reduce your chance of getting throat cancer, take the following steps:
    • Don't smoke or use tobacco products. If you do smoke or use tobacco products, get help to quit.
    • Drink alcohol only in moderation. Moderate alcohol intake is two drinks per day for men and one drink per day for women.
    • Eat a healthful diet, one that is low in saturated fat and rich in whole grains, fruits, and vegetables.
    • See your doctor and dentist regularly for check-ups and cancer screening.

    RESOURCES

    American Cancer Society http://www.cancer.org/

    CancerCare http://www.cancercare.org/

    CANADIAN RESOURCES

    BC Cancer Agency http://www.bccancer.bc.ca/

    Canadian Cancer Society http://www.cancer.ca/

    References

    Forastiere AA. Head and neck cancer: overview of recent developments and future directions. Semin Oncol . 2000 Aug;27(4 Suppl 8):1-4.

    Forastiere AA, Trotti A. Radiotherapy and concurrent chemotherapy: a strategy that improves locoregional control and survival in oropharyngeal cancer. J Natl Cancer Inst . 1999 91(24):2065-2066.

    General information about oropharyngeal cancer. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/pdq/treatment/oropharyngeal/patient . Accessed July 2, 2008.

    What are the risk factors for oral cavity and oropharyngeal cancers? American Cancer Society website. Available at: http://www.cancer.org/docroot/CRI/content/CRI%5F2%5F4%5F2X%5FWhat%5Fare%5Fthe%5Frisk%5Ffactors%5Ffor%5Foral%5Fcavity%5Fand%5Foropharyngeal%5Fcancer%5F60.asp?sitearea= . Updated September 28, 2007. Accessed July 2, 2008.

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