The early signs of throat cancer can include pain or difficulty swallowing, a hoarse voice, and the feeling of a lump in the throat. However, cancer in the lower parts of the throat may not show symptoms until the condition progresses.

Throat cancer can affect the larynx (voice box) and either the upper or lower part of the pharynx (throat). As cancer spreads, it may grow into nearby tissues. However, the name of the cancer will always depend on where it starts.

The National Cancer Institute (NCI) classifies throat cancer as a head and neck cancer. It shares some features with oropharyngeal cancer and mouth cancer. It can affect both adults and children.

According to the NCI, cancer in the throat or mouth causes 1.8% of all cancer deaths, making it rare. In its most recent estimates, the American Cancer Society (ACS) projected about 12,620 new cases of throat cancer in 2021 and around 3,770 deaths due to the disease.

In adults, exposure to tobacco and the human papillomavirus (HPV) increases the risk of developing throat cancer.

This article will look at some common symptoms, types, causes, and treatments of throat cancer and the outlook for someone with a diagnosis.

There are several different types of throat cancer and many places within the throat where cancer can develop. The symptoms and progression will depend on the type and location of the cancer.

Common early symptoms of throat cancer might include:

  • pain or difficulty when swallowing
  • ear pain
  • a lump in the neck or throat
  • a persistent sore throat or cough
  • voice changes, especially hoarseness or not speaking clearly
  • swollen lymph nodes

A person with cancer in the lower part of the throat, or hypopharynx, may not have symptoms in the early stages. This can make it harder to spot.

Other conditions can cause these symptoms. However, if they persist or are severe, a person should ask a doctor to check them to rule out a serious condition.

Learn more about other head and neck cancers here.

There are many parts within the pharynx (the tube that extends from the back of the mouth to the windpipe) and the larynx, the part of the throat that contains the voice box. Cancer can develop in any of these areas.

Pharyngeal cancers

  • Nasopharyngeal cancer: This type affects the top part of the pharynx, in the area behind the nose.
  • Oropharyngeal cancer: This type affects the back of the mouth and middle part of the pharynx. This can include the tonsils, base of the tongue, and soft palate. The Memorial Sloan Kettering Cancer Center notes that this is the most common type of pharyngeal cancer.
  • Hypopharyngeal cancer: This type affects the lower part of the pharynx.

Laryngeal cancers

Cancer can develop in any area of the larynx, including:

  • supraglottis, the area of the larynx above the vocal cords that includes the epiglottis
  • glottis, the middle area of the larynx that contains the vocal cords
  • subglottis, the lowest area of the larynx, extending from the vocal cords to the windpipe

The NCI explains that throat cancer often begins as squamous cell carcinoma. This means cancer starts in the squamous cells that line the throat. The institute adds that this type of cancer can also start behind the nose or in the mouth.

Experts do not know exactly what causes throat cancer, but some factors appear to increase the risk, including:

  • tobacco use, including smoking or using chewing tobacco
  • alcohol use exceeding 1 drink per day
  • poor nutrition and vitamin deficiencies
  • gastroesophageal reflux disease (GERD)
  • HPV infection, which can increase the risk of many types of cancer
  • family history of head and neck cancer
  • exposure to some materials, including asbestos or acid mists produced during certain types of manufacturing
  • male sex assigned at birth
  • being older than 40 years

The ACS notes that using both tobacco and alcohol exponentially increases risk. Get tips for quitting smoking here.

Getting an early diagnosis of throat cancer greatly increases the chance of effective treatment.

A doctor will ask the person about symptoms and carry out a physical examination. They may use a laryngoscope, which is a tube with a camera on it, to evaluate the inside of the throat.

Other imaging tests, such as an X-ray, CT, or MRI scan, can help the doctor confirm a diagnosis and see how far the cancer has spread.

A doctor may recommend a biopsy. This involves taking a sample of throat tissue or cells to test for cancer in a lab. A biopsy will also show what kind of cancer is present.

These tests will help the doctor determine the extent of the cancer and the best way to treat it.

Staging

Staging gives an idea of how far cancer has spread. Staging for throat cancer will depend on the type.

For throat cancer, doctors will typically describe cancer stages in these categories:

  • Stage 0 (also called in situ): Abnormal cells have formed that have the potential to become cancerous.
  • Stage 1: The tumor is smaller than 2 centimeters (cm) and has not spread to the lymph nodes.
  • Stage 2: The tumor is between 2 cm and 4 cm and has not spread to the lymph nodes.
  • Stage 3: The tumor is larger than 4 cm or has spread to a small nearby lymph node.
  • Stage 4: Cancer has spread to nearby tissue; to larger or more distant lymph nodes; or to other parts of the body, such as the lungs.

The grade of the cancer also affects treatment and outlook. A high-grade cancer is more aggressive than a low-grade one, meaning it is more likely to grow quickly.

When a doctor knows the stage and grade of the cancer, they will talk with the individual about their treatment options.

Treatment will depend on various factors, including:

  • the location, stage, and grade of the cancer
  • the age and overall health of the individual
  • the availability and affordability of treatment
  • personal preferences

Common treatments for throat cancer include:

  • Surgery: A surgeon will remove the tumor and other cancerous tissue. This may affect the shape and function of the voice box, the epiglottis, and other structures.
  • Laser surgery: This may be an option in the early stages.
  • Radiation therapy: Targeted doses of radiation aim to kill the cancer cells.
  • Chemotherapy: Drugs aim to target and kill cancer cells.
  • Targeted therapy: These drugs attack specific cancer cells or proteins that affect cancer growth. This type of treatment aims to reduce the risk of adverse effects by targeting specific cells and not healthy ones.
  • Immunotherapy: This is a new approach that boosts the immune system’s ability to defend the body against cancer.

Doctors often prescribe a combination of therapies. Some treatments, such as radiation and chemotherapy, may cause unwanted side effects. However, most of these resolve after treatment ends.

People with throat cancer should ask their doctor what to expect and how to manage side effects if they occur.

Clinical trials

Some people join a clinical trial. This can give access to new treatments that may not yet be widely available. A clinical trial can only happen if experts have strong evidence that a treatment is likely to be safe. A person should talk with their doctor or care team about opportunities to take part in a clinical trial.

Treatments for throat cancer can cause a range of challenging side effects and changes to daily life.

Tiredness

Treatments such as chemotherapy and radiation therapy can cause severe fatigue. Some tips that may help a person manage their energy levels include:

  • Planning days around how they feel: If the person has more energy in the morning, for example, they can plan to be active at that time and rest later.
  • Prioritizing important tasks first: When a person does have energy, they should focus on their most important tasks first. They should rest when they feel tired and not push themselves to the point of exhaustion.
  • Mild exercise: A 15–30-minute outdoor walk can boost a person’s energy levels and sense of well-being.

Mouth and teeth symptoms

Radiation therapy to the throat targets cancer cells, but it can also cause side effects including:

  • changes in taste
  • dry mouth
  • voice hoarseness
  • skin discoloration
  • weakening of teeth
  • sores or pain inside the mouth

A person can work with their care team to take steps that may help reduce these effects.

Difficulty breathing

Inflammation from radiation therapy may make breathing difficult. The National Health Service (NHS) in the United Kingdom also notes that surgical procedures, such as removing part or all of the larynx, can cause difficulty breathing as the area heals.

Doctors will work with a person to make breathing easier, which may include a temporary tracheostomy.

Change or loss of voice

Some surgeries for throat cancer can result in the loss of a person’s natural voice. Doctors will discuss a person’s options for regaining speech, including voice prosthesis.

Physical changes after surgery

Depending on the type and extent of throat cancer, a person may need extensive surgery to the throat, tongue, jaw, and other structures. Reconstructive surgery can restore the appearance and function of these structures, but there is a risk of complications.

People who undergo surgery that changes the structure of the mouth and throat may need rehabilitation to help them speak and swallow. A cancer care team can include speech and occupational therapists who will work with a person to help improve or recover abilities that surgery might have affected.

Doctors will work with a person to determine the right surgical option and what to expect after surgery.

Emotional symptoms

One study found that nearly 1 in 5 people who had treatment for head and neck cancer had depression afterward. The outlook for these people was worse than for those who did not experience depression.

Anyone who has signs of depression, anxiety, or other ongoing symptoms should speak with their doctor about available counseling or support groups.

Follow-up

After treatment for cancer, a person will continue to attend appointments at intervals. The doctor will monitor their progress and check to make sure the cancer has not come back.

It is important to attend all follow-up sessions and to ask the doctor about any symptoms that persist. This will help allow for early detection and treatment of any recurrence or new cancer.

The survival rate for throat cancer depends on the stage of cancer, the type, and where it occurs. Experts use past statistics to calculate a 5-year relative survival rate, which is an estimate of the likelihood a person will live at least another 5 years after a cancer diagnosis.

The American Cancer Society (ACS) provides 5-year relative survival rates based on information from the SEER database, which the NCI maintains. When evaluating all SEER stages combined, the ACS offers these 5-year relative survival rates for people diagnosed with throat cancer between 2010 and 2016:

Type of throat cancer5-year relative survival rate (all stages combined)
Laryngeal (supraglottis)46%
Laryngeal (glottis)76%
Laryngeal (subglottis)52%
Hypopharyngeal32%

It is important to note that these estimates do not indicate a person’s individual outlook. Researchers also may have developed new treatments since the time when studies collected these data. A person’s doctor will evaluate their specific outlook in the context of their diagnosis, medical history, and treatment plan.

There are different types of throat cancer, and they have different outlooks. In most cases, an early diagnosis will mean a better chance of effective treatment.

Symptoms include persistent sore throat or cough, difficulty swallowing, and voice changes. These can also be symptoms of other conditions, so a person should talk with a doctor for an accurate diagnosis.

Treatments are available, but they can cause difficult side effects. A person should speak with their doctor to help manage adverse effects and maintain quality of life.

Quitting smoking and limiting alcohol consumption can reduce the risk of developing throat cancer.