Throat cancer: what it is and how to treat it

Throat cancer: what it is and how to treat it

Throat cancer falls under the category of head and neck cancers. Its specific name depends on the area of the throat that is affected: oropharyngeal, hypopharyngeal, nasopharyngeal, laryngeal or voice box cancer.  

If you or a loved one has recently been diagnosed with throat cancer, it is important that you keep reading this article and inform yourself of its symptoms, how to prevent it and what alternative therapies are available to help with the symptoms.

What is throat cancer?

Throat cancer refers to the growth of cancerous tumors in any area of the muscular tube that starts behind the nose and ends in the neck:

  • Oropharyngeal
  • Hypopharyngeal
  • Nasopharyngeal
  • Laryngeal

Unlike benign tumors, cancerous tumours may extend to other surrounding tissues or organs in the body. This type of cancer usually starts in the flat cells that cover the inside of the throat.

Symptoms


In some cases of throat cancer, signs and symptoms may become noticeable in the early stages, such as:

  • Cough
  • Changes to the voice, such as hoarseness or difficulty talking clearly
  • Difficulty swallowing
  • Earache
  • A growth or lump in the throat that doesn’t go away
  • Sore throat
  • Weight loss

Causes

The specific cause of the genetic mutation in the cells that gives way to this type of cancer, is still unknown. However, risk factors have been identified that may increase the chances of developing this disease:

Risk factors

  • Tobacco and alcohol consumption
  • Deficient diet
  • Human Papillomavirus (very rare)
  • Genetic predisposition
  • Exposure to toxic substances
  • People over the age of 65 are most likely to be affected by this type of cancer
  • People with gastroesophageal reflux disease

Prevention

There is no definitive way to prevent throat cancer, but it is possible to reduce your chances of contracting this disease by avoiding the associated risk factors, including:

  • This year, a group of researchers from Mexico managed to eradicate HPV (by means of photodynamic therapy), which is great news since this virus is a risk factor for many different types of cancer, including cervical cancer [link to IDO 2007].

Diagnosis and exams

Many throat cancers can be detected in the early stages. Generally, the symptoms manage to alert the presence of this cancer relatively early on. If cancer is suspected, tests will need to be carried out to confirm the diagnosis and the doctor will request the following:

  • Medical history and a full medical exam: the doctor will ask about symptoms, possible risk factors and the medical history of the patient and their family.
  • Direct (flexible): a thin, flexible tube with a light on the end (called a fiberoptic laryngoscope) is inserted through the mouth or nose, allowing the doctor to observe the larynx and its surroundings.
  • Indirect laryngoscopy: the throat is observed by placing small mirrors in the mouth. It is important that the doctor examines the mouth and tongue, as well as the neck.
  • Panendoscopy: tumors are detected in the larynx and hypopharynx using a rigid hypopharyngoscope. The esophagus and trachea are also examined. This process is usually carried out under general anaesthetic.
  • Biopsy: a tissue sample is removed to be examined under a microscope. This may be an endoscopy (using special instruments, an endoscope, to extract small tissue fragments), or a fine needle aspiration biopsy (using a needle to obtain cells from the lymph nodes in the neck).
  • Computerized tomography (CT or CAT) scan: x-rays are used from different angles, creating a three-dimensional image of the inside of the body. Provides a detailed view that indicates if there are any abnormalities or tumors.
  • Magnetic resonance imaging (MRI): instead of x-rays, magnetic fields are used to produced detailed images of the body and its interior. Before the exam, a special dye is administered that allows for a clearer image of the inside of the body.
  • Barium swallow study: the patient drinks a liquid called barium, which covers the walls of the throat and the esophagus. While the patient is drinking this liquid, a series of x-rays are taken, which allows any irregularities to be identified in the throat.
  • Chest x-ray: the chest is examined to determine whether the cancer has spread to the lungs.
  • Positron emission tomography (PET) scan: consists of injecting a radioactive sugar substance into the body, which is absorbed by cells that use up a lot of energy (cancerous cells). This study is also called a PET-CT scan because it is combined with a computerized tomography (CT) scan, which generates images to identify the places where this cell activity is present.

Treatments

The patient that has been diagnosed with throat cancer has various treatment options. In general,  their effectiveness depends largely on the stage at which it has been detected.

It is important to consider, in detail, at each one of the patient’s alternatives, weighing up the benefits against the possible risks and side effects of each one of the treatment options.

  • Surgery: depending on the type, stage and location of the cancer, as well as other affected tissues, different operations may be employed to remove the cancer and sometimes other tissues near the throat.
    • Endoscopic surgery: using an endoscope (a long, thin tube with a light and camera at the end), to allow for surgical instruments to be passed through for biopsies or so that superficial tissue layers can be removed, as well as using lasers to vaporize or remove tumors.
    • Cordectomy: partial or total removal of the vocal cords. Used to treat cancer located in the very small, superficial glottis. Part of the vocal cord in removed, the patient may be left hoarse, and if both vocal cords are removed, speaking is usually no longer possible.
    • Partial or total laryngectomy: consists of removing all or part of the larynx. If the entire larynx is removed, the trachea will have to be repositioned so that the patient can be breath through a hole in the neck (tracheotomy).
    • Total or partial pharyngectomy: consists of removing all or part of the pharynx. Usually, the larynx is removed as well. After this procedure, reconstructive surgery may be required to improve the patient’s ability to swallow.
    • Removal of lymph nodes: if the cancer has spread to the lymph nodes in the neck, it is possible that they may need to be removed. This procedure it carried out at the same time as when the main tumor is removed.
    • Thyroidectomy: if the cancer has spread to the thyroid glands, they will be partially or completely removed. To know more about the thyroids or thyroid cancer, click here [link to IDC 2011].

  • Radiotherapy: uses X-rays, gamma rays or high-energy particles to destroy cancer cells. It can be used as the main treatment (for early stage throat cancer) and to treat patients who cannot undergo surgery. It can also be used as a complementary treatment after surgery to eliminate any remaining cancer cells.
  • Chemotherapy: anti-cancer medicines are injected into a vein or administered orally. These drugs enter the bloodstream and reach all areas of the body, which makes this treatment useful for treating cancer that has spread.
  • Targeted therapy: this is a type of treatment uses certain drugs that work in a different way than those used for conventional chemotherapy, since they directly target genes, cancer-specific proteins, or tissue conditions that contribute to the growth and survival of cancer cells. This therapy focuses on specific cancer cells, without damaging normal cells. It may be useful for treating people who cannot tolerate the side effects of chemotherapy.

Complementary treatments

These are carried out in parallel to conventional treatments and in general, focus on relieving side effects from treatments such as chemotherapy. These treatments can significantly improve patients’ quality of life.

The following therapies go alongside traditional treatments:

  • Acupuncture: surgical needles are inserted into strategic points in the body to help the patient overcome the pain and fatigue caused by certain cancer treatments.
  • Meditation: aims to calm the patient’s mind and emotions to reach a state of natural peace, and help them cope with treatment.
  • Physical therapy: based on moderate therapeutic exercise and relaxation techniques to improve sleep and restore vital energy.
  • Psychosocial therapy : focuses on the emotional aspect of the patient and their interaction with their environment.
  • Use of cannabinoids*: medicinal cannabis has been proven to be beneficial in treating the side effects caused by cancer treatment. Cannabinoids can reduce nausea and vomiting, stimulate appetite and relieve the pain that some chemotherapy and radiotherapy treatments can produce. The role of cannabinoids in the death of tumor cells, and thus reducing the chances of them spreading and metastasizing, is also being researched. (*Always check to see if it is legal in your jurisdiction before obtaining any cannabis-based product.)

If you are interested in receiving more information about alternative treatments for cancer, subscribe to our newsletter here