Throat cancer occurs when the cells present in the throat region undergo mutation, start dividing abnormally, and form a tumor. The throat region comprises various organs, such as the esophagus, trachea (windpipe), larynx (voice box), tonsils, and epiglottis. Throat carcinoma, carcinoma of the throat, and throat tumor are different throat cancer names.
Throat carcinomas are best treated when they are diagnosed early. It is necessary for one to learn about different types of throat cancer, their symptoms, and the possible causes. This can help in catching this cancer early and receiving appropriate treatment.
At HCG, we have a full-fledged head and neck oncology department that is supported by advanced technology, unmatched clinical expertise, and a compassionate team of clinicians and non-clinicians. This allows us to provide patients with the highest quality throat cancer treatment in India.
Throat cancer and tonsillitis are two different conditions. Nonetheless, they may present with similar symptoms. Both conditions need prompt medical attention in order to be managed effectively.
Throat cancer refers to the cancerous growth in the throat region, and the possible causes include tobacco and alcohol consumption, HPV infection, and predisposition to certain inherited genetic conditions. Throat carcinoma or throat tumor will also need specialized treatment plans, which include surgery, chemotherapy, and radiation therapy.
Tonsillitis, on the other hand, refers to the inflammation of the tonsils, which is commonly caused by certain viral or bacterial infections. Tonsillitis is often treated with antibiotics, sufficient fluid intake, and ample rest.
Both of these conditions often present with swelling and pain in the neck, difficulty swallowing, hoarseness in the voice, coughing, and more. If any of these symptoms last for more than two weeks, one should see a doctor and seek the necessary medical intervention.
Based on the location of its origin, throat carcinoma is broadly classified into different types and sub-types that present with unique characteristic features.
Pharyngeal cancer refers to cancer that arises from the tissue of the pharynx. Pharyngeal cancer is classified into the following types:
Nasopharyngeal cancer affects the nasopharynx, the upper portion of the pharynx, which is present right behind the nose.
Oropharyngeal cancer forms in the oropharynx, the middle portion of the pharynx, which is present right behind the mouth. Tonsil cancer is the most common form of oropharyngeal cancer.
Hypopharyngeal cancer forms in the hypopharynx, the bottom portion of the pharynx, which is present right above the larynx (voice box).
Laryngeal cancer, or larynx cancer (voice box cancer), is a type of cancer that arises from the larynx tissue. Depending on the location of origin, the following are the different types of larynx cancer.
Glottic cancer refers to cancer forming in the glottis, which is the middle part of the larynx and contains the vocal cords. This is one of the most common types of larynx cancer, and it constitutes up to 60% of laryngeal cancers.
Supraglottis refers to the upper portion of the larynx, and cancer arising from here is called supraglottic cancer. Supraglottic cancer contributes to about 30% of the laryngeal cancers diagnosed.
Subglottic cancer arises from the subglottis, the lower part of the larynx.
Oropharyngeal cancer is a type of cancer that arises from the middle part of the pharynx. Previously, doctors predominantly linked oropharyngeal cancers with excessive consumption of tobacco and alcohol. However, in recent times, the incidence of oropharyngeal cancers has been largely associated with oral HPV infection.
If detected early, this type of pharyngeal cancer can be treated successfully, and patients go on to live a normal life. Below is the table that summarizes the difference between HPV-associated oropharyngeal cancer and non-HPV-associated oropharyngeal cancer:
Nasopharyngeal cancer is a rare type of pharyngeal cancer. It forms in the upper part of the throat. There are three main types of nasopharyngeal cancer:
This nasopharyngeal cancer type also starts in the squamous cells; however, they do not contain keratin. Common risk factors associated with non-keratinizing squamous cell carcinoma are EBV infection, smoking, alcohol consumption, and a family history of this cancer type.
This nasopharyngeal cancer type also starts in the squamous cells; however, they do not contain keratin. Common risk factors associated with non-keratinizing squamous cell carcinoma are EBV infection, smoking, alcohol consumption, and a family history of this cancer type.
This is a rare type of nasopharyngeal cancer that arises from the basal cells that line the skin’s deepest layer. We have very little information on the risk factors associated with this cancer type.
Along with the already discussed types of throat cancer, there are other less common types of throat cancer too.
An adenoid cystic carcinoma is a rare form of adenocarcinoma that mostly occurs in the salivary glands.
Lymphomas can also occur in the throat region, and they are characterized by swollen lymph nodes.
Melanomas may also occur in the throat region. It is an aggressive and very rare form of cancer.
The sarcoma of the throat forms in the muscle fibers present in the neck. This cancer type is also rare.
Pain is one of the most common symptoms of throat carcinoma. This pain may either come and go or be persistent. This pain can get worse while talking, swallowing, and yawning. Early throat cancer may not present with any pain; however, as the disease advances, patients start experiencing pain.
That said, pain can result from various other throat conditions. Therefore, for any pain that lasts for more than two weeks, it is necessary to see a doctor for a conclusive diagnosis. The following are the common and rare sites where throat cancer pain is observed.
Patients with oropharyngeal cancer often experience pain in the oropharyngeal wall, which is located right behind the mouth.
The soft palate, which is the back part of the roof of the mouth (close to the uvula), is another common throat cancer pain area.
Tonsils are one of the rare throat cancer pain areas. This pain may also be accompanied by swelling.
Throat carcinoma patients may also experience pain at the base of the tongue.
It is necessary to make an appointment with a doctor when one begins to experience unusual symptoms related to the throat. In most cases, these symptoms are caused by other, less severe throat conditions, too. Nonetheless, it is important to see a specialist for a definitive diagnosis.
The symptoms of throat cancer vary from patient to patient. Some patients may not experience any symptoms in the early stages and will only start experiencing symptoms once the disease advances.
That said, some patients do experience early symptoms, and it is important for these symptoms to not be ignored and to be checked by a doctor.
The following are the most common symptoms of throat cancer:
Coughing is one of the early signs of throat cancer. As one of the starting symptoms of throat cancer, a cough can occur for various reasons: the tumor may be blocking the airway, it may be causing irritation or inflammation and mucus production, or it may have spread to the lungs. In some cases, the patients may also cough up blood (hemoptysis).
That said, a cough could be a symptom of other less-severe throat problems like infection, and hence, one should see a doctor for a conclusive diagnosis.
In patients with throat cancer, the voice may sound strained, raspy, or rough. They may also have difficulty speaking, such as having a slur or not being able to pronounce some words. Change in voice is one of the common throat tumor symptoms.
Difficulty swallowing is one of the common signs of throat cancer. Someone suspected of having throat cancer may experience a burning sensation and feel like they have something stuck in their throat.
A sore throat that does not go away with medication is one of the first-stage throat cancer symptoms. This discomfort could either be localized or be present throughout the throat. Throat cancer forms in the tissues of the throat and causes irritation and inflammation. This causes a sore throat.
It is one of the first symptoms of throat cancer, and it is often confused as a symptom of many other less severe throat conditions. If a sore throat lasts for more than two weeks, it must be tested.
A high-pitched whistling noise when breathing is another sign of the presence of a tumor in the throat. When the tumor or the inflammation caused by the tumor narrows the airways, patients start wheezing.
Ear pain is another symptom of throat cancer. The nerves of the throat and ears are connected, and this causes referred pain. Other possible reasons why throat cancer patients experience ear pain include the inflammation caused by the throat tumor and the metastasis of cancer to nearby lymph nodes.
Throat cancer can cause the lymph nodes to enlarge. These enlarged lymph nodes are tender to touch and can be painful.
Patients with throat cancer may often feel the need to clear their throat due to the persistent sensation of something stuck in their treatment.
Patients suspected of having throat cancer may also experience severe weight loss. When there is significant weight loss that is unintentional, one must see a doctor. This is one of the end-stage throat cancer symptoms.
Being aware of first-stage throat cancer symptoms and end-stage throat cancer symptoms can aid timely detection and treatment of throat cancer.
We still do not know what exactly causes throat cancer. However, we do know that there are a few factors that increase the risk of throat cancer. Having these risk factors does not necessarily guarantee a cancer diagnosis. The following are the important risk factors for throat cancer.
1. Smoking or tobacco consumption,Alcohol consumption
2. A diet low in fruits and vegetables
3. Exposure to asbestos (laryngeal cancer)
4. Chewing betel quid and gutka (oropharyngeal cancer)
5. Having Fanconi anemia or dyskeratosis congenita
6. Poor oral hygiene
7. Human papillomavirus (HPV)
8. Epstein-Barr virus (EBV)
9. Being overweight or obese
10. Being older
Many studies have found a strong association between HPV and throat cancer. HPV, or Human papillomavirus, refers to a form of sexually transmitted infection. When it becomes chronic, HPV may lead to the formation of various forms of cancer, namely oropharyngeal cancer, cervical cancer, vaginal cancer, vulvar cancer, anal cancer, and penile cancer. HPV infection is usually transmitted through oral sex.
HPV-associated oropharyngeal cancer or throat cancer occurs when HPV infects the cells present in the back of the throat, causes mutations in them, and triggers the formation of a tumor in the throat. In most cases, the HPV infection clears up by itself. However, in some cases, the infection persists and leads to cancer formation.
The risk of HPV-associated throat cancer is high among those who consume tobacco and alcohol. Its likelihood is also high among those with a compromised immune system. Common HPV-throat cancer symptoms include sore throat, cough, hoarseness, swollen lymph nodes, earache, etc.
In the early stages, throat cancer is localized and can be treated more effectively. However, as the disease progresses, it spreads to nearby and distant organs and is referred to as metastatic throat cancer. The following are the metastatic or end-stage throat cancer symptoms:
Often, throat cancer spreads to the lungs, and when this happens, patients start having trouble breathing and coughing up blood.
Throat cancer may also spread to bones in advanced stages. Secondary bone cancer occurring this way can cause bone or joint pain and fractures in cancer patients.
For throat cancer diagnosis, specialists recommend multiple diagnostic tests. These tests can help our specialists arrive at an accurate diagnosis and play a significant role in ensuring that patients with throat carcinoma receive the appropriate treatment.
When patients present themselves with throat cancer symptoms, doctors initially recommend a physical examination and medical history assessment. During a physical examination, the doctor will carefully examine the patient's throat, neck, and mouth to look for any signs of abnormality or lumps that may indicate throat cancer. The doctor may also thoroughly assess the patient’s medical history to determine the cause of the symptoms.
Doctors recommend blood tests to assess the patient's overall health, check for specific markers, and rule out other conditions.
A biopsy involves obtaining a throat tissue sample and examining it under a microscope for the presence of cancer cells. A biopsy is helpful in arriving at a conclusive diagnosis of throat cancer by providing crucial details, such as the stage and grade of the tumor. There are different types of biopsies, including:
An endoscopic biopsy uses an endoscope, a thin, flexible tube with a camera, to visualize and obtain a tissue sample from the affected area.
An incisional biopsy involves the removal of a small part of the tumor or affected tissue for analysis.
Image-guided biopsy involves using imaging tests, like a CT scan or MRI, to guide the needle for sample collection. The sample collected will be sent to the laboratory for evaluation
Imaging tests help visualize the throat and surrounding structures to determine the extent and location of the cancer. Imaging tests provide oncologists with crucial information like the stage of the disease, the exact location of the tumor, its shape and size, etc. Along with the diagnosis, imaging tests are also recommended for treatment planning, treatment response monitoring, and relapse evaluation.
A barium swallow is a special X-ray test that evaluates the esophagus and the throat region for abnormalities. During this procedure, patients are made to swallow barium solution, which coats the internal organs and makes them visible on the X-rays.
Ultrasound is another commonly recommended test for the diagnosis of throat cancer.It uses sound waves to create detailed images of the throat and nearby lymph nodes
Specialists may also recommend X-rays to identify any abnormal growths or changes in the throat.
Specialists recommend CT scans to obtain cross-sectional images of the throat. These images provide detailed information on multiple tumor parameters, such as the stage of the tumor, its size, and shape, and its exact location.
Magnetic resonance imaging (MRI) is another commonly recommended imaging test for throat cancer diagnosis (गले का कैंसर की पहचान). It uses powerful magnets and radio waves to generate detailed images of the throat and surrounding tissues.
A positron emission tomography (PET) scan uses radiotracers to look for cancer. During this procedure, a radiotracer is injected into the patient’s body to create detailed images of the internal structures. When injected into the bloodstream, this radiotracer will travel to regions that have increased metabolic activity. Cancerous tissues appear as bright spots during the scan.
Endoscopy involves inserting an elongated tube with a light and camera source to examine the entire throat structure. At times, endoscopy is also used to obtain a biopsy sample.
Pharyngoscopy involves inserting an endoscope inside the mouth to examine the pharynx more closely.
A panendoscopy involves using an endoscope to examine the entire throat, including the larynx, pharynx, and esophagus. This procedure helps identify the exact location and extent of the cancer.
Laryngoscopy uses a flexible and elongated endoscope to examine the larynx.
Once the throat cancer diagnosis is confirmed, the oncologists will begin staging. The staging of throat cancer is crucial for determining the extent of the disease and planning personalized treatment plans. The stages of throat cancer are categorized as follows:
The cancer is localized to a small area of the throat or vocal cords.
The cancer is still localized but has a larger size than the stage 1 tumor.
Cancer has started spreading to nearby tissues and may affect multiple lymph nodes nearby.
The cancer has advanced significantly, spreading to nearby lymph nodes, structures, and distant organs.
There are multiple treatment approaches available for the management of throat carcinoma. Before recommending treatment for throat cancer, specialists consider various factors, such as the type of throat cancer, the disease stage, the tumor grade, the patient’s age, and the patient’s overall health status. In most cases, early-stage cancers can be treated with surgery alone. However, as the disease progresses, it will need a multimodal approach, which will involve radiation therapy, chemotherapy, and targeted therapy.
For early-stage or small throat tumors, specialists recommend surgery, where the tumor and a small portion of healthy tissue that surrounds it (margin) will be removed. This procedure may or may not be followed by other cancer treatments.
Laryngectomy is recommended as a treatment approach for larynx cancer, and this procedure involves the partial or complete removal of the larynx or voice box. This procedure may or may not be followed by radiation therapy or chemotherapy.
Pharnygectomy involves the partial or complete removal of the pharynx. This surgical procedure may or may not be followed by radiation therapy or chemotherapy.
If the cancer has spread from the throat to the nearby lymph nodes, cancer surgeons may have to remove those lymph nodes as well. This helps in preventing the cancer from spreading further. Neck dissection is often performed along with throat cancer surgery to achieve better clinical outcomes.
Radiation therapy is another important treatment recommended for throat cancer. During radiation therapy, the tumor is targeted with high-intensity radiation beams. These radiation beams kill cancer cells by destroying their DNA structure. Radiotherapy for throat cancer is often administered in combination with surgery or chemotherapy.
Chemotherapy is another commonly recommended throat cancer treatment. Chemotherapy uses powerful drugs to destroy cancer cells throughout the body. As the disease advances, the treatment plan for throat carcinoma often includes chemotherapy.
Throat cancer chemotherapy is found to improve the survival rates among throat cancer patients. Patients in terminal stages will also benefit from throat cancer chemotherapy as it helps in shrinking the tumor and alleviating its symptoms.
Targeted drug therapy is a highly effective treatment approach for cancer, wherein specific protein molecules that are involved in the growth of cancer cells are targeted. Targeted therapy regulates cancer growth by blocking various pathways responsible for the growth of cancer cells.
Immunotherapy for throat cancer involves re-engineering the patient’s immune system to make it capable of recognizing the cancer cells and launching an attack against them. Immunotherapy is often coupled with other throat tumor treatment approaches like chemotherapy and radiation therapy.
Cancer treatments often leave patients exhausted. This exhaustion can delay recovery and negatively impact the quality of life.
Opting for multidisciplinary rehabilitation can help patients regain their strength and return to their routine activities at a faster rate. Rehabilitation is an important part of recovery after cancer treatment.
Depending on the severity of the case, throat cancer patients may need the following rehabilitation services:
1. Speech and swallowing therapy
2. Physical therapy /facial exercises
3. Occupational therapy
4. Nutritional counseling
5. counseling
Palliative care or supportive care focuses on improving the quality of life for cancer patients in the terminal stages. Radiation therapy, cytoreductive surgery, and pain management are some of the common strategies recommended under palliative care. These approaches help reduce the pain and discomfort caused due to the disease.
Alternative medicine, also known as complementary medicine or Eastern medicine, involves ancient healing practices. Cancer patients may opt for alternative medicine along with the treatments recommended by oncologists, as it may help them relax and show a better response to the treatment.
Acupuncture is a Chinese healing practice that involves inserting needles into specific points of the body. Acupuncture is believed to relieve pain and help cancer patients relax; however, more research is needed in this area.
Massage therapy may improve overall well-being by enhancing blood circulation, relaxing the body muscles, and reducing pain.
Meditation, or focused breathing, is a mind-body practice that may help cancer patients become more mindful of what they are going through. Practicing mindfulness can help alleviate stress and promote mental well-being among cancer patients.
Relaxation techniques, like art therapy, music therapy, and aromatherapy, may help cancer patients by reducing stress and improving overall well-being.
Throat cancer treatment often leads to swallowing difficulties. This is caused by the swelling of the throat and surrounding tissues. Those with swallowing difficulties should consult speech and swallowing therapists for specialized strategies to regain their swallowing abilities. They may also consult oncodieticians for diet plans that include foods that can be eaten without much difficulty.
Surgical procedures, such as neck dissection, can result in scarring or alter the shape of the face. In such cases, doctors may recommend reconstructive surgeries for appearance-related concerns. Patients who have a hard time coping with these changes may also see counselors and support groups for emotional support.
Surgical throat cancer treatment can affect speech, and patients can experience changes in their voice quality and clarity. In such cases, patients can reach out to speech therapists for specialized techniques and exercises that will improve voice quality and articulation or for alternative methods of communication, such as voice prostheses.
Certain throat cancer treatments may lead to breathing difficulties in some patients. Patients who have undergone surgery and radiation therapy are prone to having breathing difficulties, and in such cases, the patients would be supported with assisted breathing.
In some throat cancer patients, radiation therapy can lead to skin hardening or tightening around the neck. This is referred to as radiation fibrosis. Such patients may use moisturizers regularly and see oncodermatologists and physiotherapists who can check their skin condition and recommend appropriate treatment.
Throat cancer diagnosis and treatment need a comprehensive approach. At HCG, we have a dedicated department for the diagnosis, treatment, and management of throat cancer. Each case at HCG is looked at by our multidisciplinary team of experts. Specialists from different disciplines come together to study each case carefully, thoroughly understand the diagnosis, and come up with a personalized care plan for each patient. HCG is backed by leading-edge technologies, renowned specialists, and state-of-the-art facilities, and leaves no stone unturned to deliver the highest quality cancer care.
Presently, there are no known ways to prevent throat cancer. On the brighter side, most of the risk factors associated with this cancer type are related to our lifestyle habits. Therefore, it is possible to reduce the risk of this cancer, if not completely prevent it. The following are some of the important throat cancer prevention measures that can be helpful in reducing the risk of throat cancer:
Tobacco consumption increases the risk of throat cancer significantly. Refraining from tobacco consumption can reduce the risk of this cancer remarkably.
Cutting down on alcohol consumption and refraining from it completely can bring down one's risk of throat cancer significantly.
Having healthy food habits is one of the important throat cancer prevention measures. A diet rich in vitamins, minerals, and antioxidants is helpful in reducing the risk of throat cancer. Including fresh fruits and vegetables in the diet helps keep various diseases, including cancer, at bay.
The internet is full of articles on “throat cancer prevention foods”, “throat cancer prevention diet”, etc. While some foods do reduce the risk of throat cancer, there is no single food or diet that can completely prevent it. Foods that have anti-inflammatory properties and anti-cancer properties and foods that are rich in antioxidants should be consumed regularly to reduce the risk of throat carcinoma.
A large percentage of oropharyngeal cancers are caused by chronic HPV infections. Protecting oneself from HPV infections through safe sex practices, opting for HPV vaccination, and receiving timely treatment when diagnosed with HPV infection can be helpful in reducing the risk of throat cancer.
After years of research and studies, scientists have identified multiple factors that contribute to the increased risk of throat cancer. Being identified with these risk factors does not necessarily guarantee a cancer diagnosis; however, it only increases the risk. The following are important risk factors for throat cancer:
Tobacco contains numerous harmful chemicals with cancer-causing properties. Prolonged exposure to these carcinogens through active and passive smoking can increase throat cancer risk.
Multiple studies have linked excessive alcohol consumption to an increased risk of throat cancer, and this makes it one of the important risk factors for throat cancer. Alcohol is especially harmful along with tobacco, as alcohol causes the cells in the mouth and throat to more readily absorb the harmful chemicals present in tobacco. These chemicals then damage the DNA of the throat cells and trigger tumor formation.
A diet low in fruits and vegetables can lead to inflammation in the body, which in turn can increase the risk of throat cancer. A lack of crucial vitamins like A, B, C, and E in the diet can negatively impact the body’s ability to repair the damage caused by harmful chemicals and keep itself healthy.
Asbestos exposure is another important risk factor for laryngeal cancer, a type of throat cancer. Asbestos is a form of mineral fiber, and it gets stuck in the larynx when inhaled. Asbestos causes irritation, which leads to inflammation and scarring. Over time, this can trigger cancer formation.
Studies have shown that chewing betel leaves and gutka increases oropharyngeal cancer risk. Carcinogens present in gutka, paan masala, etc., can damage the DNA structure and lead to oropharyngeal cancer.
Having certain inherited genetic disorders, like Fanconi anemia and dyskeratosis congenita, can increase one’s throat cancer risk.
Poor oral hygiene contributes to increased throat cancer risk. Many studies have found that poor oral hygiene aids the carcinogenic potential of tobacco and alcohol and thereby increases the risk of throat cancer.
Chronic HPV infection is an important risk factor for throat cancer. HPV infection is a sexually-transmitted disease, and the transmission of this virus occurs through oral sex. In most cases, this infection goes away in 1–2 years without any treatment. However, in some cases, these infections become chronic, cause mutations in the throat cells, and lead to cancer formation. HPV-associated throat cancers are often diagnosed in their early stages, and they can be treated successfully.
Epstein-Barr Virus (EBV), which belongs to the herpes family, can also cause mutations in the throat cells and lead to throat cancer. Not everybody with an EBV infection will be diagnosed with throat cancer, but they will carry an increased risk.
In rare cases, having GERD, or acid reflux, can lead to the formation of certain types of cancer, namely esophageal cancer, and stomach cancer. When patients experience regurgitation, the esophagus gets damaged and inflamed because of the low pH of stomach acid. If this is left untreated, it may eventually lead to cancer. However, there is very little information on the prevalence of throat cancer in individuals with GERD.
Being overweight or obese could also be a risk factor for throat cancer. Overweight and obese individuals are more prone to inflammation and hormonal imbalance, which are two common contributors to increased cancer risk.
Like all cancers, the risk of throat cancer also increases with age. Individuals over 50 are more likely to be diagnosed with throat cancer.
Exposure to hazardous chemicals, such as paint, sulfuric acid fumes, nickel, asbestos, etc., is found to increase throat cancer risk.