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    Throat Cancer: Causes, Symptoms, Diagnosis & Treatment

    The actor-filmmaker Rakesh Roshan has been diagnosed with squamous cell carcinoma of the throat. It was shared by actor Hrithik Roshan on the social media. Read on to know more about this condition.

    Squamous cell carcinoma is a type of cancer of the head and neck. It is estimated that India contributes to nearly 60 per cent of head and neck cancer which includes the mouth, nose and throat.

    throat cancer

    In oncology, squamous cell cancer of the neck and head share similarities in incidence, cancer type, pathological factors, predisposing factors, cancer treatment and cancer prognosis.

    What Is Throat Cancer?

    Throat cancer is a type of cancer which affects the voice box, vocal cords and other parts of the throat like tonsils and oropharynx. When there is an uncontrolled cell growth in the throat, it leads to throat cancer. Many types of throat cancers start as squamous cell carcinoma because it occurs in the squamous cells that line the throat.

    Types Of Throat Cancer

    1. Squamous cell carcinoma is a type of throat cancer that affects the cells' lining the throat.

    2. Adenocarcinoma is another rare type of throat cancer that affects the glandular cells.

    3. Sarcoma is a less common type of throat cancer that occurs in the muscle fibres of the neck.

    Throat cancer is grouped into two categories which are pharyngeal cancer and laryngeal cancer.

    1. Pharyngeal cancer- It develops in the pharynx, a hollow tube that runs from behind your nose to the top of your windpipe. It develops in the neck and throat which includes - nasopharynx cancer, oropharynx cancer and hypopharynx cancer.

    2. Laryngeal cancer- It occurs in the larynx which is your voice box containing the vocal cords that help you speak. It is one of the 10 leading causes of cancer in Indian men [1] . Laryngeal cancer develops in three parts of the voice box - glottis, supraglottis, and subglottis.

    Symptoms Of Throat Cancer

    Each type of throat cancer is different and the symptoms depend on the stage and location of the cancer [2] , [3] .

    • Voice changes like hoarseness and unable to speak clearly
    • Difficulty in swallowing or breathing
    • Swollen lymph nodes
    • Sore throat
    • Ear pain
    • Wheezing
    • Coughing up blood
    • Swelling of the eyes, jaw, throat and neck
    • Unexplained weight loss
    • Bleeding in the mouth or nose

    Causes And Risk Factors For Throat Cancer

    Lifestyle habits like smoking and chewing tobacco for a long time, drinking alcohol regularly, poor nutrition, poor dental hygiene, exposure to asbestos [4]  and genetic syndromes are some of the causes that increase the risk of throat cancer[5] , [6] .

    Another risk for throat cancer is infection of the human papillomavirus infection (HPV) which is spread through sexual contact, mainly oral sex.

    Other risk factors include gender, especially men are at a higher risk than women. Most people get it over the age of 65 and African-Americans have a high risk of getting throat cancer.

    Stages Of Throat Cancer

    Stage 0 - The cancerous tumour is situated on the top layer of cells in the affected area of the throat.

    Stage 1 - The tumour is less than 7 cm.

    Stage 2 - The tumour is slightly larger than 7 cm.

    Stage 3 - In this stage, the cancer has grown and spread in other parts of the throat.

    Stage 4 - The cancer has spread to the lymph nodes or distant organs.

    Diagnosis Of Throat Cancer

    Your doctor will examine you and ask you about your symptoms, your lifestyle habits including smoking and drinking, sexual history and your family medical history.
    Once throat cancer is suspected by the doctor, tests and procedures are done which include:

    • Conventional incisional biopsy - It is done by collecting tissue samples examined under a microscope to look for cancer cells. Biopsy procedure can be done with fine needles, surgery or an endoscope.
    • Fine needle aspiration (FNA)- If you have a lump in your neck, this type of biopsy is done by inserting a thin needle to withdraw the cells from the area.
    • Endoscopy - An endoscope is a thin long tube which is inserted through the nose, mouth or an incision [7] .
    • Imaging tests- This is done to find a tumour in the throat. Some of the imaging tests include MRI (Magnetic Resonance Imaging), CT scan (Computed Tomography), PET scan (Positron Emission Tomography), chest X-ray, and barium swallow [8] .

    Treatment Of Throat Cancer

    The treatment options are surgery, chemotherapy and radiation therapy [9] . The treatment method will depend on the type and extent of cancer.

    1. Surgery

    If the tumour is small in the throat, the doctor will perform a surgery to remove it. The doctor will recommend surgical procedures like endoscopic surgery, cordectomy, laryngectomy, pharyngectomy and neck dissection.

    If you are in the early stage of cancer endoscopic surgery is done. If it's in the advanced stage, parts of the pharynx or larynx may have to be removed. If cancer has spread deep down your neck, an operation is done to remove the lymph nodes.

    2. Radiation therapy

    After the tumour has been removed with the help of surgery, the doctor will next go for radiation therapy. This type of therapy uses high-energy rays to destroy malignant cancer cells.

    The types of radiation therapy include intensity-modulated radiotherapy, 3D-conformal radiation therapy and brachytherapy.

    3. Chemotherapy

    Chemotherapy is a drug that kills and slows down the growth of malignant cells. This treatment is done to keep the disease from coming back.

    4. Targeted therapy drugs

    These drugs can inhibit the growth and spread of cancer cells by interfering with specific molecules that are responsible for the growth of the tumour.

    Post-treatment Recovery

    People with throat cancer require speech therapy to relearn how to speak after the treatment. However, there are complications that may arise after cancer treatment which include difficulty in swallowing and breathing, disfigurement of the neck and face, tiredness, sharp pain in the neck, and memory problems [10] . A therapist can help to overcome the difficulty in swallowing and breathing.

    Prevention Of Throat Cancer

    The chances of throat cancer are reduced when you start doing the following things:

    • Quit smoking
    • Reduce alcohol consumption
    • Practice safe sex
    • Maintain a healthy lifestyle

    To Conclude...

    If throat cancer is diagnosed early, there are high chances of survival. The cancer might not be curable if the malignant cells have spread to other parts of the body beyond the neck and head. And, there is a 20.5 per cent chance laryngeal cancer will recur in the first three years of treatment[11] , [12] .

    View Article References
    1. [1] Bobdey, S., Jain, A., & Balasubramanium, G. (2015). Epidemiological review of laryngeal cancer: An Indian perspective.Indian journal of medical and paediatric oncology: official journal of Indian Society of Medical & Paediatric Oncology,36(3), 154-60.
    2. [2] Gussgard, A. M., Jokstad, A., Wood, R., Hope, A. J., & Tenenbaum, H. (2015). Symptoms Reported by Head and Neck Cancer Patients during Radiotherapy and Association with Mucosal Ulceration Site and Size: An Observational Study.PloS one,10(6), e0129001.
    3. [3] Alho, O. P., Teppo, H., Mäntyselkä, P., & Kantola, S. (2006). Head and neck cancer in primary care: presenting symptoms and the effect of delayed diagnosis of cancer cases.Canadian Medical Association Journal. 174(6), 779-784.
    4. [4] Roh, S., Park, S., Tae, G., & Song, J. (2016).A case of laryngeal cancer induced by exposure to asbestos in a construction site supervisor. Annals of Occupational and Environmental Medicine, 28(1).
    5. [5] Poddar, A., Aranha, R. R., K Muthukaliannan, G., Nachimuthu, R., & Jayaraj, R. (2018). Head and neck cancer risk factors in India: protocol for systematic review and meta-analysis. BMJ Open, 8(8), e020014.
    6. [6] Shaw, R., & Beasley, N. (2016). Aetiology and risk factors for head and neck cancer: United Kingdom National Multidisciplinary Guidelines.The Journal of laryngology and otology,130(S2), S9-S12.
    7. [7] Menon, S., & Trudgill, N. (2014). How commonly is upper gastrointestinal cancer missed at endoscopy? A meta-analysis.Endoscopy international open,2(2), E46-50.
    8. [8] Hermans R. (2004). Post-treatment imaging of head and neck cancer.Cancer imaging: the official publication of the International Cancer Imaging Society,4 Spec No A(Spec No A), S6-S15.
    9. [9] Prise, E. L., Etienne, P. L., Meunier, B., Maddern, G., Hassel, M. B., Gedouin, D., ... & Launois, B. (1994). A randomized study of chemotherapy, radiation therapy, and surgery versus surgery for localized squamous cell carcinoma of the esophagus.Cancer,73(7), 1779-1784.
    10. [10] Janelsins, M. C., Kohli, S., Mohile, S. G., Usuki, K., Ahles, T. A., & Morrow, G. R. (2011). An update on cancer- and chemotherapy-related cognitive dysfunction: current status.Seminars in oncology,38(3), 431-438.
    11. [11] Brandstorp-Boesen, J., Sørum Falk, R., Folkvard Evensen, J., Boysen, M., & Brøndbo, K. (2016). Risk of Recurrence in Laryngeal Cancer.PloS one,11(10), e0164068.
    12. [12] Brandstorp-Boesen, J., Sørum Falk, R., Boysen, M., & Brøndbo, K. (2017). Impact of stage, management and recurrence on survival rates in laryngeal cancer.PloS one,12(7), e0179371.

    Read more about: neck cancer throat
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