Throat Cancer

Understanding Throat Cancer

Throat cancer starts in your throat (pharynx) or voicebox (larynx). It’s part of a broader category of head and neck cancers, but throat cancer symptoms, causes, and treatments are different from other head and neck cancers.

Types of Throat Cancer

Your throat is the muscular tube that runs from behind your nose to your neck. It carries food, liquid, and air into your body. Doctors classify it by the part of the throat where the cancer starts, rather than using the term “throat cancer”.

The medical term for cancers of the throat is pharyngeal cancer, but there are different types [1]:

• Nasopharyngeal cancer – Starts in the upper part of the throat behind the nose
• Oropharyngeal cancer– Starts in the middle part of the throat, including the back of the tongue, tonsils, soft palate, and side walls of the throat
• Laryngeal cancer – Starts in the larynx, or voice box
• Hypopharyngeal cancer – Begins in the lower part of the throat, just above the oesophagus and windpipe.
• Supraglottic cancer – Begins in the upper part of the voice box above the vocal cords.
• Glottic cancer – Originates on the vocal cords.
• Subglottic cancer – Starts in the lower part of the voice box, below the vocal cords.

How Common Is Throat Cancer?

Throat cancer is much less common than other cancers. Laryngeal cancer is the most common type, but still accounts for only about 1% of all cancer case [2]. About 90% of throat cancers start in squamous cells, flat, thin cells that line the throat [3].

Throat cancers are highest among people who live in Southeast Asia and Eastern Europe, due to tobacco and alcohol use. In North America and Western Europe, rates are moderately high, with human papillomavirus (HPV) also adding to the risk [2,3].

Causes and Risk Factors

Doctors aren’t certain what causes throat cancer, but these things increase your risk [3]:

• Regular tobacco use (smoking and chewing)
• Heavy alcohol consumption
• Being male and over 50
• Certain types of HPV infection, which are linked to oropharyngeal cancer, often at a much earlier age
• Epstein-Barr virus (EBV), which is linked to nasopharyngeal cancer
• Family history
• Certain environmental exposures, like dusts, chemicals, and fumes

Early Signs and Symptoms of Throat Cancer

Signs and symptoms of throat cancer can vary depending on which part of your throat is affected [1]. They include:

• A cough, sore throat, or tickle in your throat that doesn’t go away
• Pain or difficulty swallowing
• Hoarseness or voice changes
• White or red spots in your throat
• A lump in your neck or throat
• Ear pain
• Unintentional weight loss

Some of these symptoms are easy to overlook, but it’s important to tell your doctor about any you notice. Finding throat cancer early leads to better treatment options and higher survival rates.

How Throat Cancer Is Diagnosed

If your doctor suspects throat cancer, they might recommend: 

• A physical examination to look at your throat and neck. They may also refer you to an ear, nose, and throat specialist.
• Imaging tests, like a CT, PET-CT, MRI, or ultrasound
• An endoscopic exam, where an endoscope, a thin, flexible tube with a light and a camera, is guided down your throat to get a closer look. The endoscope can also collect a tissue sample (biopsy) to test for cancer.

Staging and Grading of Throat Cancer

If a biopsy shows cancer, doctors then stage and grade it. This information guides your treatment plan.

The stage describes the extent of the cancer, including the size and location of the tumour, whether nearby lymph nodes are involved, and whether the cancer has spread to distant parts of the body. The staging system differs according to where the cancer started and, for oropharyngeal cancer, whether it is HPV-related.

The grade describes how abnormal the cancer cells look under a microscope and how closely they resemble healthy cells from the tissue where the cancer started. The grading system can differ depending on the type of cancer

Staging and grading for HPV-positive oropharyngeal cancers use a separate system. It generally has more favourable groupings and a better response to treatment.

How Throat Cancer Is Treated

Treatment depends on the stage and grade of your cancer. It might include surgery, radiotherapy, chemotherapy, or other drugs, or a combination of these:

• Surgery to remove all or part of the tumour, while aiming to preserve your ability to swallow, breathe normally, and speak
• Radiotherapy, which uses high-energy radiation to kill cancer cells
• Chemotherapy, which uses strong medicine to kill cancer cells or shrink tumours
• Targeted therapies act on specific molecules involved in cancer growth, while immunotherapies help the immune system recognise or attack cancer cells

Surgery or radiotherapy can sometimes affect your swallowing or speech or cause side effects like throat pain, changes in voice, or difficulty eating. Tell your medical team about any side effects, because rehabilitation, like speech therapy, can help support your body during treatment and protect your long-term quality of life.

Recovery, Survival, and Long‑Term Outlook

Your recovery and long-term outlook depend on many factors, including the stage, location, treatment type, and your overall health. Cancers found and treated early often have much better outcomes and higher survival rates. For example, early-stage vocal cord cancers have high cure rates, while more advanced or hypopharyngeal cancers have lower rates. Also, HPV-positive oropharyngeal cancers tend to respond very well to treatment.

Your doctor can give you more information about what to expect for your specific situation, as everyone’s situation varies. 

Supporting Your Body During Throat Cancer Care

Throat cancer treatments can affect eating, swallowing, and speech. A team of specialists can help you manage these.

• A speech-language pathologist can guide you through exercises and therapies to improve swallowing and speaking. 
• An oncology dietitian can advise on what to eat to get the calories, protein, and fluids your body needs to recover. If eating is difficult, they might also recommend oral nutrition supplements, fortified foods and beverages that provide calories and protein in small servings.
• A physical therapist can provide targeted exercises to improve mobility and reduce pain in your neck and shoulders that might result from surgery or radiation.
• Some people might also benefit from dental or prosthetic specialists, depending on their treatment.

Your care team will work with you to create a plan that addresses your physical and nutritional challenges of throat cancer treatment and recovery. Contact them with any questions or concerns.