Throat cancer happens when cells grow in an uncontrolled way in part of the throat. Treatment is possible, but the outlook will depend on where cancer starts and how soon a person receives a diagnosis.
It 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.
It is relatively rare. According to the NCI, the lifetime risk of developing cancer in the mouth or throat is around 1.2%. In 2019, the NCI estimate that 53,000 people will receive a diagnosis of oropharyngeal cancer, which includes throat cancer. They expect 10.860 people to die from this disease in 2019.
In adults, exposure to tobacco and the human papillomavirus (HPV) increase the risk.
This article will look at some common types, causes, symptoms, and treatments of throat cancer and the outlook for someone with a diagnosis.
The throat, or pharynx, has many parts, and cancer can develop in most of them.
Hypopharyngeal cancer affects the lower part of the pharynx, or throat.
Many types of throat cancer begin as squamous cell carcinoma. This means cancer starts in the squamous cells that line the throat. As well as in the throat and mouth, this type of cancer can also start behind the nose.
Mouth cancer is another type of head and neck cancer. Find out here what it involves.
There are many different types of throat cancer. 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
- patches and open sores
Symptoms will depend on the type of cancer. A person with hypopharyngeal cancer 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.
Tonsil cancer is another type of head and neck cancer. Learn more here.
Experts do not know exactly what causes throat cancer, but some factors appear to increase the risk.
Alcohol: Consuming more than one drink a day may increase the risk.
Tobacco use: This includes smoking or chewing tobacco and taking snuff.
Poor nutrition: Vitamin deficiencies may play a role.
Gastroesophageal reflux disease (GERD): Acid from the stomach leaks back into the food pipe.
Epstein-Barr virus (EBV)
HPV infection: This increases the risk of various types of cancer.
Inherited conditions: Fanconi anemia is one example.
Exposure to some chemicals: Substances used in the petroleum and metalworking industries may contribute.
Sex: These cancers traditionally affect around four times as many men as women.
Age: Over 50% of diagnoses occur after the age of 65 years.
Race and ethnicity: It is more common among black Americans and white Americans than in Asian or Hispanic Americans.
Science has not confirmed that all of these factors cause or even increase the risk of throat cancer, but there is evidence that they may do so.
They have found, however, a strong link with smoking and with consuming a lot of alcohol.
Are you looking for ways to give up smoking? Get some tips 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 see what is happening inside the throat.
Other imaging tests, such as an X-ray, a CT, or an MRI scan, can help the doctor 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 gives an idea of how far cancer has spread. Staging for throat cancers will depend on the type.
Overall, however, cancer usually progresses as follows:
Localized: Malignant changes have occurred in one location but have not spread beyond this site.
Regional: Cancer has spread to nearby tissues, structures, or lymph nodes.
Distant: Cancer has spread to other parts of the body, such as the liver.
The grade of the cancer also affects treatment and outlook. A high grade cancer is more aggressive than a low grade one. It is more likely to grow quickly.
When a doctor knows the stage and grade of the cancer, they will talk to the individual about their treatment options.
Precancerous changes are also possible. These are not cancerous, but they could become malignant later. Doctors call this "carcinoma in situ."
Find out more here about carcinoma in situ and the changes to look out for.
Treatment will depend on various factors, including:
- the location, stage, and grade of the cancer
- the age and overall health of the individual
- availability and affordability of treatment
- personal preferences
Common treatments 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.
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.
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. The NCI provide information on what to do if a person would like to try a clinical trial.
What does chemotherapy involve? Find out here.
Adverse effects of treatment include:
This is a common side effect. Some tips that may help a person manage fatigue 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.
Mild exercise: A 15–30-minute outdoor walk can boost a person's energy levels and sense of well-being.
Some people experience pain during and after treatment. Persistent pain can make it hard to sleep and affect a person's mood. It may also delay healing.
Pain relief medication, relaxation techniques, and other approaches may help. A doctor can advise on suitable choices.
Find out more about pain, how to describe it, and treatment options.
Some people experience problems with memory and other thought processes during or after cancer treatment.
Actively planning each day and noting important tasks on a calendar may help a person keep track of plans and appointments.
Some cancer treatments can damage the nerves, leading to discomfort, including:
- weakness in some part of the body
Additional complications may include balance problems and constipation.
What is neuropathy, and what can you do about it? Find out here.
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.
People who undergo surgery that changes the structure of the mouth and throat may need therapy to help them speak and swallow.
It is important to attend all follow-up sessions and to ask the doctor about any symptoms that persist. They may be able to help.
Impact of 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 may restore the appearance and function of these structures, but there is a risk of complications.
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 to their doctor, as they may be able to help.
The survival rate depends on the stage of cancer, the type, and where it occurs. Scientists use past statistics to calculate the chances of surviving at least another 5 years after a cancer diagnosis.
Someone with a diagnosis of oropharyngeal cancer will have a 65.3% chance of living at least another 5 years.
Hypopharyngeal cancer is less likely to produce symptoms at an early stage, making it harder to spot. The American Cancer Society note that the 5-year survival rate is 31% overall. In the early stage, it is 52%, and in the latest stage, it is 19%.
However, this depends on the type of cancer and where it starts.
If cancer starts in the supraglottis, above the vocal chords, there is a 60% chance of surviving another 5 years with an early diagnosis, falling to 30% if the person has a late stage diagnosis.
If it starts in the glottis, the part of the larynx that includes the vocal chords, there is an 83% chance of living another 5 years after an early diagnosis, but a 42% chance with a late diagnosis.
Sometimes cancer goes away with treatment and stays away, but sometimes it comes back. In 2016, researchers noted that the chance of laryngeal cancer returning within 3 years of starting treatment was 20.5%.
With advances in treatment and other types of medical progress, the outlook for various types of cancer tends to improve over time.
There are different types of throat cancer, and they have different outlooks. In most cases, an early diagnosis will mean a better chance of survival.
Ways of reducing the risk include:
- avoiding or quitting smoking
- limiting alcohol consumption
- talking to a doctor about HPV vaccination
It is also important to be aware of possible symptoms and to seek help if they arise.
Learn more here about HPV and how to avoid it.