Throat Cancer

What is throat cancer?

“Throat cancer” is the general term for cancer that affects your throat (pharynx) or voice box (larynx). It’s uncommon compared to other cancer types. But when people do develop this condition, tumors usually form in the middle part of their throat (oropharynx) or voice box.

Throat cancer doesn’t usually cause symptoms right away. When symptoms do become noticeable, they’re often like those in less serious conditions, like a sore throat or earache. This can make it easy to delay seeing a healthcare provider.

But it’s important not to ignore potential signs of throat cancer, especially if symptoms last two weeks or more. Most throat cancers are treatable. Some are curable. But getting diagnosed and treated as soon as possible is key.

Types of this condition

There are several types of throat cancer:

• Oropharyngeal cancer affects the middle part of your throat. It’s the most common form of throat cancer in the U.S.
• Laryngeal cancer affects your voice box. It can start in the upper part (supraglottic cancer), the middle part where your vocal cords are (glottic cancer) or in the lower part (subglottic cancer).
• Hypopharyngeal cancer affects the part of your throat that’s above your esophagus and windpipe.
• Nasopharyngeal cancer affects the part of your throat that’s behind your nose.

Symptoms of throat cancer

Many throat cancer symptoms are also signs of other less serious conditions, like colds or allergies. Symptoms of less serious conditions usually improve once you’re on the mend. But symptoms of untreated throat cancer don’t get better.

Signs and symptoms of throat cancer include:

• Sore throat
• Ear pain (may feel like an earache)
• Difficulty swallowing or pain when you swallow
• A lump in your neck, throat or the back of your mouth
• Changes in your voice, like hoarseness
• Ongoing cough or coughing up blood
• Weight loss (usually because eating and swallowing are painful)

If you have symptoms that last two weeks or more, talk to a healthcare provider so they can diagnose the issue.

What are the first signs of throat cancer?

The first signs of throat cancer vary depending on where the tumor is. For example, the first signs of oropharyngeal cancer are often a neck lump, ear pain and painful swallowing. A common first sign of laryngeal cancer is hoarseness that doesn’t get better.

Throat cancer doesn’t usually cause symptoms in the beginning. It’s common for the cancer to progress before you notice changes. That’s why it’s essential to see a healthcare provider if symptoms don’t improve within a couple of weeks.

Throat cancer causes

Throat cancer happens when something triggers genetic mutations (changes) in the cells in your throat. The mutation turns healthy cells into cancerous cells that grow and multiply. Without treatment, they can spread to other parts of your body. Researchers are investigating what triggers these changes.

Risk factors

Factors that increase your chance of developing throat cancer include:

• Smoking or using tobacco products. Tobacco use is the single largest risk factor for developing throat cancer.
• HPV infection. You can contract the human papillomavirus (HPV) during oral sex. In developed nations, HPV infection is now the most common cause of new throat cancer cases.
• Drinking too much alcohol. Researchers link some throat cancers to alcohol consumption. The risk is especially high if you also use tobacco.
• Epstein-Barr virus infection. The same virus that causes mononucleosis (mono) can increase your risk. (This is most common in nasopharyngeal cancers.)
• Exposure to toxic substances. Long-term exposure to carcinogens like asbestos, wood dust and formaldehyde can increase your throat cancer risk.
• Eating too much or too little of certain foods. Eating too many preserved meats and not enough fruits and veggies also increases your risk.

How to lower your risk

There’s no sure way to avoid throat cancer. But you can reduce your risk by:

• Not smoking cigarettes or using any tobacco products (if you smoke, ask your healthcare provider about how to quit)
• Getting the HPV vaccine
• Abstaining from alcohol or drinking only in moderation
• Eating meals that include lots of vegetables, fruits and whole grains, like those found in the Mediterranean diet

How doctors diagnose this condition

Healthcare providers use several tests to diagnose throat cancer. Tests include:

• Physical exam. Your provider will check for signs of throat cancer, like a lump in your neck. They’ll ask about any activities you participate in that may increase your risk, like smoking.
• Tests that use a scope. Your provider may insert a scope into your throat to look for cancer in your throat (endoscopy) or voice box (laryngoscopy).
• Biopsy. Your provider may remove suspicious tissue during a scope test. They’ll send it to a lab to test for cancer cells. A biopsy is the only way to know for sure if you have throat cancer.
• Imaging tests. A CT scan and an MRI can show cancer in your throat and voice box. A PET scan can show if the cancer has spread beyond your throat.

Staging

Cancer staging allows healthcare providers to determine how advanced throat cancer is. It’s an important part of your diagnosis. The staging systems vary based on the type. Usually, providers stage throat cancers from I (one) — least advanced — to IV (four) — most advanced.

For example, stage I throat cancer means a tumor is small and hasn’t spread to your lymph nodes or other tissue. Stage IV cancers have spread (metastasized).

How is throat cancer treated?

Healthcare providers use different therapies to treat throat cancer. If you smoke or use tobacco, they may recommend you stop before starting cancer treatment. This improves treatment effectiveness and reduces the risk of side effects.

Surgery

The goal of surgery is to remove as much cancer as possible while preserving your ability to breathe, speak and swallow. Your provider may remove small tumors when they collect tissue for your biopsy. For larger tumors, you may need open surgery to remove all or part of your voice box (laryngectomy) or throat. Your provider may need to do a neck dissection to remove cancerous lymph nodes.

Radiation therapy

The most common form of radiation therapy for throat cancer uses a machine that sends powerful energy beams to destroy cancer cells. It may be the only treatment you need for small tumors that haven’t spread. Or you may need radiation therapy alongside other treatments, like surgery and chemotherapy.

Chemotherapy

Chemotherapy uses drugs to destroy cancer cells. Healthcare providers often combine chemotherapy with radiation therapy to treat throat cancer. They may also use chemotherapy before surgery to shrink tumors. They may use it after surgery to kill any remaining cancer cells.

Targeted therapy and immunotherapy

Your healthcare provider may recommend less common treatments for throat cancer, like targeted therapy or immunotherapy. Targeted therapy blocks proteins cancer cells use to grow. Immunotherapy helps activate your immune system to fight cancer.

Providers typically recommend these treatments for some advanced throat cancers and cancers that come back (recur) after treatment.

When should I see my healthcare provider?

Schedule an appointment with a healthcare provider if you have unexplained head and neck symptoms that haven’t improved within a few weeks. Don’t assume it’s cancer. But it’s important not to take chances. Let your provider know what’s happening.

What can I expect if I have throat cancer?

Your outcome (prognosis) depends on lots of factors unique to you. Healthcare providers can sometimes cure throat cancer that hasn’t spread to nearby tissues or lymph nodes. But more advanced cancers are harder to treat. They’re more likely to come back after treatment.

Other factors that matter include your overall health, the tumor’s location and your HPV status. HPV-related throat cancers tend to respond better to treatment than other types.

What is the survival rate for throat cancer?

Cancer survival rates track how many people are alive five years after their diagnosis. With throat cancer, survival rates vary depending on cancer type, location and stage.

For example, nearly 7 out of 10 people with cancer in their mouth or throat are alive five years after their diagnosis. But that number is closer to 8 to 9 out of 10 if the tumor hasn’t spread. Of course, these numbers are about a general population. They don’t reflect the factors unique to your diagnosis.

Your healthcare provider understands how these numbers may apply to you better than anyone else. Ask them what your diagnosis means for your life expectancy.

Is there anything I can do to feel better?

If you’ve been treated for throat cancer, you may need help managing the long-term effects. Both radiation therapy and surgery can affect your ability to swallow, speak or hear. Rehabilitation with a speech-language pathologist may be essential to your recovery. You may need reconstructive surgery if you’re uncomfortable with your appearance after surgery.

Your healthcare provider may also recommend palliative care to help manage treatment side effects. Unlike hospice care, palliative care is available no matter your cancer stage or prognosis.