Throat cancer is a general term that can refer to several types of cancers in the head and neck. Most form in the lining of the throat.
This lining is made up of thin, flat cells known as squamous cells, so most throat cancers are squamous cell carcinomas.
These cancers are located in either the larynx or pharynx. The location plays an important role in the patient¡¯s treatment and prognosis.
The larynx, also called the voice box, allows people to speak.
The pharynx is a tube that runs down from the back of the nasal cavity, connects with the oral cavity (the mouth) and then with the esophagus and trachea. The pharynx is involved in both breathing and swallowing.
The pharynx has three main parts: the upper section, called the nasopharynx; the middle, the oropharynx; and the lower section, the hypopharynx. The hypopharynx is next to the larynx and together they are sometimes referred to as the laryngopharynx.
Types of throat cancer
Oropharyngeal cancer forms in the oropharynx, the area where the pharynx and the mouth connect. It is by far the most common type of throat cancer in the United States. Cases are rising due to the human papillomavirus (HPV), an infection that can cause several different cancers. Read more about HPV and oropharyngeal cancer.
Nasopharyngeal cancer arises in the nasopharynx, which sits behind the nasal cavity and is the top section of the pharynx. It is rare in the United States but very common in Asia. Learn more about nasopharyngeal cancer.
Hypopharyngeal cancer is another rare form of throat cancer. The hypopharynx connects with the larynx. Patients with this cancer often get the same treatment as laryngeal cancer patients. Learn more about hypopharyngeal cancer.
Laryngeal cancer impacts the larynx, or voice box. The voice box contains the vocal cords and allows us to speak. It also acts as a valve that opens for us to breathe and makes sure things we swallow go into the stomach. Learn more about laryngeal cancer.
Throat cancer risk factors
Anything that increases your chance of getting throat cancer is a risk factor. Risk factors for throat cancer include:
- HPV infection: Human papillomavirus can cause several different cancers, including oropharyngeal cancer. This is the number one cause of throat cancer in the United States. Learn more about HPV.
- Sexual history/number of sexual partners: HPV is often spread through sexual contact, so sexual history can impact a person¡¯s throat cancer risk.
- Gender: Men are significantly more likely to get throat cancer than women.
- Tobacco use: Tobacco users have an increased risk of throat cancer. Learn more about tobacco and cancer.
- Alcohol use: People who drink heavily have an increased risk of throat cancer.
- Age: Historically, most throat cancer cases occur over the age of 60, but HPV-related cancers are commonly diagnosed in patients in their 50s and younger.
- Infection with the Epstein-Barr virus: This virus, which can cause mononucleosis, is a risk factor for nasopharyngeal cancer only.
Learn more about throat cancer:
Learn more about clinical trials for throat cancer.
¡®How I knew I had throat cancer¡¯: Four survivors share their symptoms
For high school football coach Mark Teague, the only symptom of throat cancer he noticed was a small lump beneath his jaw.?
¡°I¡¯d been aware of it for a while,¡± says Teague, who was diagnosed with HPV-related throat cancer at age 49. ¡°But I¡¯d had sinus problems all my life, so I didn¡¯t think anything of it. I just assumed it was another swollen lymph node.¡±
George Brownfield had a similar experience.
¡°I found a little lump on my neck one day while shaving,¡± says the senior systems analyst, who was diagnosed with the same disease at age 48. ¡°I remember thinking, ¡®Hey, why does that side of my neck look so puffy?¡¯ and going to my general practitioner. He told me it was probably an infection and prescribed some antibiotics.¡±
The most common throat cancer symptoms: painless neck lumps and swollen lymph nodes
Mark and George¡¯s experiences are not unusual. Most people with throat cancer don¡¯t have any symptoms. But when they do, a swollen lymph node or a painless lump in the neck are among the most common.
Why?
¡°Lymph nodes are essentially tiny little sieves that capture dangerous particles circulating around our bodies,¡± explains head and neck cancer surgeon ¡°Sometimes, cancer cells get caught in there and start growing in place. Eventually, they form tumors that can get big enough to grow out of the lymph nodes.¡±
Other throat cancer symptoms, including (rarely) pain
Other MD Anderson patients have reported different throat cancer symptoms, such as news photographer Damion Smith, who lost his voice, and senior civil engineering inspector Scott Courville, who developed pain in his jaw, felt lumps in his throat and saw little white spots on his tonsils.
¡°Laryngitis, visible abnormalities and pain are far less common symptoms of throat cancer,¡± notes Lango. ¡°Though we do occasionally see patients who report ear pain, a type of ¡®referred¡¯ pain from the tongue or throat. And, sometimes, people say it feels like something is kind of caught back there.¡±
Pain as a symptom of throat cancer is almost always only on one side, though. ¡°It¡¯s usually not in the middle,¡± Lango says. ¡°And it tends to be both dull and persistent. Once it¡¯s there, it¡¯s always there. It never goes away. That¡¯s a sign that it should get checked out.¡±
When to see a doctor for throat cancer symptoms
As a general rule, you should see a doctor about any worrisome symptoms that don¡¯t resolve on their own within two or three weeks. But see a doctor much sooner if you experience any of the following throat cancer symptoms:
- swallowing difficulties
- involuntary weight loss
- breathing problems
- a change in your voice or ability to speak clearly
- bleeding in the throat (which may be coughed or spit up)
¡°All of these symptoms should be considered more urgent,¡± explains Lango. ¡°They might not warrant an immediate emergency room visit, but they do need to be looked into pretty quickly.¡±
Having one or more of these symptoms doesn¡¯t necessarily mean you have throat cancer. But it¡¯s important to be evaluated because throat cancer is easiest to treat when it¡¯s caught in its earliest stages.
¡°You¡¯re much more likely to need a combination of treatments ¡ª such as surgery plus radiation rather than surgery alone ¡ª if you¡¯re diagnosed in the latter stages of throat cancer,¡± notes Lango. ¡°And that can mean both a longer course of treatment and more side effects. So, early diagnosis can make a huge difference.¡±
See a complete list of throat cancer symptoms.?
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Why choose MD Anderson for throat cancer treatment?
Choosing where to go for cancer treatment is one of the most important decisions a patient can make.
Every patient with throat cancer is different. Treatment plans can change drastically based on the cancer¡¯s exact location. Just a few millimeters can make a huge difference. The right treatment plan can greatly reduce the chance of recurrence and help maintain your quality of life, including your ability to speak, swallow and hear.
At MD Anderson you¡¯ll get care from a multidisciplinary team of throat cancer experts.
This team will include a medical oncologist, radiation oncologist and surgical oncologist. All specialize in treating throat cancer, giving them an incredible amount of expertise to call on when planning your care. They will work together closely to discuss your case and develop a treatment plan tailored to you.
Treatments can include many cutting-edge interventions, such as proton therapy, targeted therapy and advanced robotic surgeries. As a leading cancer center, MD Anderson is also developing new throat cancer treatments, such as targeted therapies and immunotherapies.
Caring for throat cancer patients at MD Anderson goes far beyond these treatments. Throat cancer and its care may affect eating, hearing, speaking and appearance. At MD Anderson you¡¯ll be offered a full range of treatments and therapies to help you overcome these challenges.
You may get occupational, physical and speech therapy. If needed, you¡¯ll have access to MD Anderson¡¯s renowned reconstructive surgeons, as well as expert dental surgeons who can design and place custom-made dental implants. You can also work closely with speech pathologists and audiologists who have expertise in restoring speech and swallowing after throat surgery.
MD Anderson also offers dedicated survivorship care for throat cancer patients. This care can help monitor for the disease¡¯s return and offer interventions to maximize your quality of life.
And at MD Anderson you will be surrounded by the strength of one of the nation's largest and most experienced cancer centers. From support groups to nutrition counseling to integrative medicine care, we have all the services needed to treat not just the disease, but the whole person.
I feel there has to be some reason why I was left here. I think part of it was to share my story.
What does throat cancer look like?
Most people who are diagnosed with throat cancer won¡¯t see anything unusual if they look in the mirror, open their mouths and say, ¡°Ahhhh.¡±
¡°That¡¯s because there¡¯s usually not much to see,¡± says head and neck surgeon ¡°These tumors are often buried deep in the throat, or hidden under the surface of the tissue. Throat cancers are usually quite small, too, and they can be very difficult to see, even by trained experts. So, only about 20% to 30% of patients will notice something visible.¡±
Symptoms of throat cancer
When a throat cancer is visible to the naked eye, here are some of the features it could have:
- Asymmetry: when one side looks odd or just noticeably different from the other
- Lesions: might appear as red or white patches
- Swelling: may or may not involve lesions
Throat cancers are usually found in the oropharynx, which includes the tonsils, the uvula (the small structure dangling in the middle), the soft palate, and the hind-most portion of the tongue, which is not visible without a scope. But they can also develop in the larynx (voice box) and the nasopharynx (the area behind the nose).
The most common symptom of throat cancer is actually a painless mass on the side of the neck.
¡°Normally, it doesn¡¯t hurt,¡± notes Lango. ¡°But it¡¯s there for longer than it should be, it¡¯s only on one side, and it¡¯s too large to be a swollen lymph node.¡±
Rarely, patients may report pain in the back of the throat or difficulty swallowing. But most have no symptoms at all, and are very surprised to hear that they have throat cancer.????????
Throat cancer and HPV: the viral connection
Almost all throat cancers that doctors see at MD Anderson are squamous cell carcinomas. Roughly 80% of them are caused by the human papillomavirus, or HPV, though this figure may be lower at other hospitals.
¡°I can¡¯t even remember the last time I saw a throat cancer that wasn¡¯t HPV-positive,¡± says Lango. ¡°Before the year 2000, we hardly saw any at all. Now, we¡¯re seeing a ton. It really is an epidemic.¡±
That¡¯s why Lango encourages everyone ages 9-26 to get vaccinated against HPV. The HPV vaccine is most effective when given at ages 11-12. But unvaccinated men and women ages 27-45 should talk to their doctors about the benefits of receiving the vaccine.
¡°The amount of throat cancer caused by tobacco has dropped exponentially in the last 20 years,¡± Lango notes. ¡°That¡¯s partially because people aren¡¯t smoking as much as they used to. But if we could get more young people vaccinated against HPV now, that would really go a long way toward reducing future cases of throat cancer.¡±
Know your throat cancer treatment options
Whether a throat cancer is related to HPV or not, it¡¯s important to seek treatment for it at a comprehensive cancer center like MD Anderson.
¡°A lot of people just go with the first thing they¡¯re offered, not realizing there are other options,¡± says Lango. ¡°That¡¯s why it¡¯s critical to get a second opinion, at the very least.¡±
One reason is that many patients will survive for years after a throat cancer diagnosis. That means they may have to live for decades with the side effects of their treatments, such as dry mouth or difficulty swallowing.
¡°Both of these issues can affect your quality of life and your ability to enjoy food,¡± Lango says. ¡°So, it¡¯s very worthwhile to make sure you¡¯re getting the right treatment.¡±
Throat cancer treatment
With early stage throat cancers, surgery alone might be all that¡¯s needed. With more advanced cases, patients will likely be offered some combination of chemotherapy, surgery and/or radiation therapy.
¡°In the old days, everybody got chemotherapy and radiation,¡± notes Lango. ¡°But trans-oral robotic surgery (TORS) has become a very effective tool to treat some patients. The survival rate is just phenomenal.¡±
Options to reduce the intensity of treatments ¡ª and potentially decrease long-term side effects by participating in ¡°de-escalation¡± clinical trials ¡ª may also be available. Studies may incorporate immunotherapy or highly targeted proton therapy.
¡°Some treatments are conducted through clinical trials because they¡¯re promising, but not yet the standard of care,¡± says Lango. ¡°But some of our patients¡¯ responses were very good. So, the way we treat patients now may not be the same way we treat patients in a couple of years. And classical chemo has been such a mainstay of throat cancer treatment for so long, that not needing to have it is kind of a big deal.¡±
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