Throat Cancer

Throat cancer symptoms

• Symptoms that suggest the possibility of throat cancer include:
  • A lump in the neck
  • Hoarseness for 2 weeks or more
  • Pain in the ear, pain in the throat while eating and drinking or difficulty with eating and drinking
  • A lump below or in front of the ear
  • A persistent mouth ulcer
  • Middle ear fluid on one side (unilateral serous otitis)
  • A persistent cough
  • Blood stained phlegm
  • The sensation of something stuck in the throat
  • Breathing difficulties
• Almost all (95%) of head and neck cancer is squamous cell carcinoma (SCC)
• SCC occurs most often in middle-aged to elderly people who have exposed themselves to cigarette smoke and alcohol – the carcinogens act to together to promote the development of cancer
• Additional cancers are found in 10-20% of patients who present with head and neck cancer

Cancer of the throat

• Throat cancer can start in the oesophagus (food pipe), larynx (voice box), thyroid gland or cells lining the throat (squamous cells)
• The larynx is situated at the top of the windpipe (trachea)
• Below the larynx is the butterfly-shaped thyroid gland, with its two lobes sitting on either side of the trachea
• The thyroid gland regulates many metabolic processes, including growth and energy expenditure

Throat cancer can spread

• Throat cancer that originates in the squamous cells can invade deeper tissues including muscle
• Some types of thyroid cancers can quickly invade nearby structures, such as the trachea
• If it is not treated, the enlarging tumour can compress the trachea and cause breathing problems
• Throat cancer may metastasise (spread) to other tissues or organs of the body such as the lung

Risk factors for throat cancer

• Risk factors may include:
  • Smoking – Tobacco use
  • Regular and heavy consumption of alcohol
  • Chronic goitre (enlargement of the thyroid gland)
  • Radiation exposure
  • Family history of cancer (i.e. genetic predisposition)

Throat cancer diagnosis

• Throat cancer is diagnosed using a number of tests including:
  • Medical history
  • Physical examination, which may include using a mirror to examine the larynx (laryngoscopy)
  • Video-laryngoscopy – an  ENT specialist test, where a small tube with a camera at the tip is passed through the nose and down the throat to view the larynx and vocal cord movements
  • Biopsy – a sample of suspect tissue is removed for examination in a laboratory
  • X-rays
  • Ultrasound
  • CT scan
  • MRI (magnetic resonance imaging) scan
  • PET (position emission tomography) scan
  • Blood tests
  • Thyroid scan – a special x-ray of the thyroid following an injection of radioactive material

Throat cancer treatment options

• Treatment depends on the size, type and location of the cancer and whether it has spread, but can include:
  • Surgery – the tumour is surgically removed
  • This may require surgery on the thyroid, tissue or muscle, or the larynx or tongue, depending on the location and size of the tumour
  • Nearby lymph glands may also need to be taken out if the cancer has spread
  • Radiation therapy – small, precise doses of radiation target and destroy cancer cells
  • Chemotherapy – the use of cancer-killing drugs, often in combination with radiotherapy – chemotherapy can be helpful in controlling cancers that have spread (metastases) because the whole body is treated
  • Multi-modality or adjuvant treatments – such as surgery followed by radiotherapy, or chemo-radiotherapy, especially in the case of large tumours
  • Long term monitoring – this may include regular examinations and x-rays to make sure the cancer hasn’t come back
  • Rehabilitation therapy – this may include assistance from a dietitian, speech therapist and physiotherapist – social workers, counsellors and clinical psychologists can help patients come to terms with the post-operative changes to their finances, social and professional lives, and appearance

If you are concerned about throat cancer contact your doctor who will arrange for you to see an ENT specialist