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Summary

Throat cancer is a type of head and neck cancer, which includes an uncontrolled growth of cells in different regions of the throat. Throat cancer may have different names depending on the region of the throat that is affected. Its primary symptoms include difficulty in eating or swallowing, pain in the throat, speech difficulties and persistent coughing. Several risk factors, such as age, gender and even genetic vulnerabilities predispose an individual to develop throat cancer. Use of tobacco and excessive consumption of alcohol are also associated with throat cancer. Prevention is the key; avoiding risk factors like alcohol and tobacco are the main ways to avoid any type of throat cancer. Throat cancer can be diagnosed with a physical examination, blood tests, imaging tests and biopsy. The treatment options for throat cancer include chemotherapy, radiation therapy, targeted therapy and surgical intervention. Invasive cancer treatment is associated with several side effects. These side effects can be managed with help from doctors, counsellors and family members. There is a higher chance of survival if the cancer is detected early on. 

  1. What is Throat cancer
  2. Types of Throat cancer
  3. Stages of Throat cancer
  4. Throat cancer symptoms
  5. Throat cancer causes & risk factors
  6. Prevention of Throat cancer
  7. Diagnosis of Throat cancer
  8. Throat cancer treatment
  9. Throat cancer prognosis and complications
  10. Medicines for Throat Cancer
  11. Doctors for Throat Cancer

What is Throat cancer

Throat cancer refers to the multiplication of cancer cells or abnormal cells in the throat, which results in several complications including speech and eating difficulties. It usually starts as a small growth and may increase in size over a period of time. The growth can accelerate suddenly or may take several months. Throat cancer can affect the larynx (voice box), pharynx or other parts of the throat.

Types of Throat cancer

Throat cancer is a broad term, which includes cancers of different areas in the throat. The throat extends from behind the nose up to the epiglottis, where the food and windpipe begin. Although throat cancers have similar kinds of cells, they can be differentiated based on where the cancer is located in the throat.

  • Nasopharyngeal cancer
    This type of throat cancer is seen in the nasopharynx, which is the upper portion of the throat behind the nose.
  • Oropharyngeal cancer
    This type of throat cancer begins in the upper part of the throat right behind the mouth. Here, cancer typically involves the back of the tongue or the tonsils.
  • Hypopharyngeal cancer
    Hypopharyngeal cancer originates in the lower portion of the throat, which is right above the food pipe and windpipe. It is seen behind the larynx.

Within the voice box, cancer may be present in different regions:

  • Glottic cancer
    Glottic cancer is the one that develops in the vocal cords.
  • Supraglottic cancer
    Supraglottic cancer begins in the upper part of the larynx and includes the cancer of the epiglottis (a thin flap of cartilage, which functions as a protective covering of the windpipe and prevents food from getting aspirated into it).
  • Subglottic cancer
    Subglottic cancer originates in the lower part of the larynx.

Stages of Throat cancer

As cancer progresses, the stage of cancer also advances. Each type of throat cancer may have its own staging system. These stages are:

  • Stage 0
    The cancer cells are yet to grow to form full-fledged cancer and are still just a few cells in the lining of the throat.
  • Stage I 
    This is a very early stage where the cancer is under 2 cm in size and has not reached any lymph nodes.
  • Stage II
    Tumour size may vary between 2-4 centimetres. It has not yet affected the surrounding lymph nodes.
  • Stage III 
    In stage III, throat cancer may have spread to the lymph nodes on the same side of the neck but these lymph nodes are under 3 cm in size. The size of the tumour is greater than 4 cm in diameter.
  • Stage IV 
    In stage IV, cancer spreads to lymph nodes along with the different regions of the throat, head, neck or chest. In severe stage IV, cancer may have spread to distant organs as well. The size of the tumour is larger than 4 cms. 

Throat cancer symptoms

The symptoms of throat cancer depend on the location of cancer and the stage at which it is. Some of the early symptoms of throat cancer include:

Most of these symptoms may be confused with the symptoms of common throat infections. However, throat cancer causes prolonged symptoms, which may be more pronounced only when cancer has progressed.

Throat cancer causes & risk factors

Causes

The cause of any type of cancer is primarily the uncontrolled growth of cells in a particular region. Similarly, in throat cancer, the cells divide unchecked and uncontrollably in different areas. The cells start dividing due to genetic mutations, damage and other changes in their DNA. These mutations result in cells growing at a much faster rate and living beyond their normal lifespan. The accumulation of such cells leads to the formation of a lump or a tumour in the throat.

The cause of these mutations is not specifically known.

Risk Factors

While the exact causes of throat cancer may not be well known, there are certain risk factors, which have been implicated in increasing the risk of developing throat cancer:

  • Consumption of excessive alcohol.
  • Use of tobacco (smoking and chewing tobacco).
  • Unhealthy diet.
  • A family history of cancer.
  • Presence of goitre.
  • Infection by HPV (Human Papilloma Virus), which is sexually transmitted.

Other risk factors include:

  • Gender
    Men are more likely to develop throat cancer than women. 
  • Age
    Most people get diagnosed with throat cancer after the age of 65. 
  • Environmental factors
    Constant exposure to chemicals, such as asbestos, nickel and sulfuric acid fumes can increase the risk of developing throat cancer.  

Prevention of Throat cancer

Not all types of throat cancers can be prevented. However, there are preventive measures that can be taken in order to reduce the risk.

  • Stop smoking
    Use of tobacco has been strongly linked to throat cancer and oral cancer as well. Smoking and chewing tobacco are highly injurious to health and can result in serious health problems. For habitual smokers, the risk is immense and hence, quitting smoking or tobacco use of any other kind is imperative. Although the process of quitting may not be easy, there are several rehabilitation centres, which offer assistance to help rid oneself of this habit.
  • Reduce alcohol consumption
    Reducing the intake of alcohol can prevent cancer and reduce its risk significantly. Alcohol results in dehydration of the throat lining and excessive consumption may result in its constant irritation and abnormalities in the cells. Hence, it is recommended to consume alcohol in moderation.
  • Follow a healthy diet
    To reduce the risk of any type of cancer, doctors recommend following a healthy diet. Consumption of fruits and vegetables and a diet rich in antioxidants can help in lowering the risk of cancer. The American Cancer Society recommends eating more plant foods such as fruits, vegetables, whole grain bread and cereals instead of refined grains and processed foods.
  • Prevent infection by HPV
    The risk of having an HPV infection is significantly higher in people who have multiple sexual partners. People who smoke are more susceptible to the infection, as smoking weakens the immune system. There are vaccines, which can help in reducing the risk of infection with certain types of HPV. 

Diagnosis of Throat cancer

Throat cancer is diagnosed with the help of multiple tests:

  • Physical examination
    A physical examination of the throat can help the doctor to find any swelling, lumps or tender areas in the throat. The doctor may also use a device with a camera fitted on one end to examine the larynx. This procedure is called laryngoscopy.
  • Video stroboscopy
    In this procedure, a flexible tube is inserted through one of the nostrils. This tube has a camera fitted on one end that goes down the throat and gives a clear view of the vocal cord region on the monitor.
  • Biopsy
    A biopsy may be done to examine the cells of the throat in order to identify cancerous cells. A sample of the tissue is collected and examined under a microscope.
  • Scanning/imaging tests
    Scanning tests include ultrasound, computed tomography (CT) scan, magnetic resonance imaging (MRI) scan or positron emission tomography (PET) scan and X-rays. These tests help the doctor in determining how big the tumour is and the extent to which it has spread. 

Throat cancer treatment

The course of treatment of throat cancer depends upon the location, type and size of cancer. Treatment options include:

  • Radiation therapy
    Radiation therapy for cancer uses controlled doses of rays like gamma rays to target and destroy cancer cells in specific regions.
  • Chemotherapy
    Chemotherapy involves the use of certain drugs, which help in eliminating cancer cells. Chemotherapy is often used in combination with radiotherapy for cancer treatment.
  • Surgery
    By surgical intervention, the tumour can be removed. In order to get rid of a tumour, other tissues or parts like the thyroid may have to be removed. This depends upon the size of a developing tumour. Neighbouring lymph glands may also have to be removed in order to prevent further spread of cancer.
  • Multimodality treatments
    This involves the use of radiotherapy or chemotherapy after surgery. It is usually administered for large tumours.
  • Rehabilitation therapy
    Rehabilitation therapy goes hand in hand with the medical treatment of cancer. It includes assistance in terms of diet, speech and mental health. Counsellors, social workers and psychologists can help a person in recovering from the mental stress of undergoing intensive cancer treatment. 

Side effects of the treatment procedures include:

  • Nausea and vomiting
    Nausea and vomiting occur due to chemotherapy drugs and radiation therapy.
  • Speech difficulties
    Throat surgery can have an effect on speech. There may be side effects like voice changes, which may or may not improve with time.
  • Scarring
    In case tissue of other parts of the throat is removed, it may result in scarring or some degree of deformity. 

Lifestyle management

In some cases, cancer may have advanced and a definite cure may not be possible. In such cases, palliative care is used in order to manage the pain and symptoms. Some aspects of palliative care include:

  • Pain management
    This is planned by keeping in mind the requirements of the person and the intensity of the treatment. Pain relief medications may be used to minimise the pain.
  • Support from family members 
    This plays a crucial role, as the support provided by family members and friends can help the person greatly in getting through the treatment.
  • Counselling 
    Counselling from a professional psychologist who specialises in dealing with people with cancer can be very helpful in providing mental support. Psychological and spiritual counselling can help in providing comfort.

The course of treatment followed can produce side effects, which require care and management:

  • To deal with the tiredness, which comes with cancer treatment, one may engage in mild exercise such as short outdoor walks and doing other activities, which do not cause exertion.
  • Cancer treatment may also have some impact on memory. People with cancer can write down the tasks or things that they have to do and keep a checklist or reminders as well. Help can be taken from friends and family members for doing tasks like shopping or driving.
  • The treatment of throat cancer is followed by regular checkups. Visits to the doctor may be scheduled every few months in order to track the progress and manage any other ongoing symptoms. 

Throat cancer prognosis and complications

Prognosis

Early detection of cancer can help greatly in preventing it from spreading and improving the success rate of the treatment. There is a higher risk of throat cancer recurrence in people who smoke or consume alcohol even after the treatment. Careful and vigilant management of the symptoms can limit the complications. 

Complications

Complications associated with throat cancer include:

  • Difficulty in eating.
  • Loss of voice.
  • Permanent scarring.
  • Metastasis (the spread of cancer to the other body parts).
  • Disfigurement due to surgery.
  • Difficulty in breathing due to airway obstruction.
Dr. Arabinda Roy

Dr. Arabinda Roy

ऑन्कोलॉजी

Dr. Ashutosh Gawande

Dr. Ashutosh Gawande

ऑन्कोलॉजी

Dr. C. Arun Hensley

Dr. C. Arun Hensley

ऑन्कोलॉजी

Medicines for Throat Cancer

Medicines listed below are available for Throat Cancer. Please note that you should not take any medicines without doctor consultation. Taking any medicine without doctor's consultation can cause serious problems.

Medicine NamePack SizePrice (Rs.)
FolitraxFolitrax 10 Mg Tablet158.0
ImutrexImutrex 10 Mg Tablet64.0
MeditrexMeditrex 10 Mg Tablet161.0
MerexMerex 1000 Mg Injection750.0
MethocelMethocel 1000 Mg Injection904.0
Mexate TabletMexate 10 Mg Tablet64.0
Mext TabletMext 10 Mg Tablet161.0
NeotrexateNeotrexate 2.5 Mg Tablet51.0
OncotrexOncotrex 10 Mg Tablet157.0
RemtrexRemtrex 15 Mg Injection65.0
HitrexHitrex 15 Mg Injection51.0
MethMeth 2.5 Mg Tablet50.0
MethocipMethocip 50 Mg Injection48.0
MethofastMethofast 15 Mg Injection52.0
Mexate Combipack 25 Mg InjectionMexate Combipack 25 Mg Injection55.0
RhutraxRhutrax 15 Mg Tablet249.0
RhutrexRhutrex 10 Mg Tablet156.0
TrexTrex 2.5 Mg Tablet36.0
TrexoparTrexopar 15 Mg Injection55.0
UnitrexateUnitrexate 15 Mg Injection48.0
VibziVibzi 5 Mg Tablet67.0
Mext FMext F 7.5 Mg/1 Mg Tablet45.35
TruxofolTruxofol 7.5 Mg/1 Mg Tablet50.0

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