What is Throat Cancer?

The human throat mainly comprises of three parts, i.e., the pharynx, the larynx, and the tonsils. 

The pharynx is a tube that collectively consists of the parts that lie behind and above the mouth and the nasal cavity. These parts primarily control the respiratory system and the digestive system while supporting some of the vocal functionalities. The parts of larynx primarily focus on overall vocalisation and preventing food aspiration in the windpipe. 

The tonsils, on the other hand, serve a unique purpose of being the first line of defence for our immune system by eliminating the pathogens that enter through the mouth or stimulating an emergency response to the brain.

The windpipe is lined with flat cells while the cartilage structure called the epiglottis separates it from the gastrointestinal tract (oesophagus). Now, when these flat cells or the cartilage cells start to multiply abnormally and exponentially, they start to form lumps known as tumours that become cancerous, and this condition is termed as Throat Cancer.

Throat cancer may also occur in the tonsils causing abnormal cell growth and tumour formations in the tonsil region. These abnormal cells can spread to their surrounding tissues and aggravate the condition.

Even though it may occur in any of the specific parts of the throat, throat cancer typically develops in the following stages:

Stage 0: The tumour has only reached the top cell layer in the affected part of the throat.

Stage I: The tumour has grown but is less than 2 cm and limited to its origin.

Stage II: The tumour has grown between 2 and 4 cms and possibly affected the adjacent healthy tissues.

Stage III: The tumour is larger than 4 cm in size or has breached into the adjacent structures in the throat, or has affected one of the lymph nodes.

Stage IV: The tumour has breached into the lymph nodes or distant organs.

What Are the Types of Throat Cancer?

Throat cancer is typically characterised by the organ it originates and grows into, even if it spreads to the adjacent parts. Based on the two primary types of the throat, its cancer is also classified in the following two types:

Hypopharyngeal cancer:

The hypopharynx is a part of the pharynx, and it works as the entrance into the oesophagus. When cancerous cells form in the tissues of the hypopharynx, it is termed as a ‘hypopharyngeal cancer’ of the throat. Depending on the region it emerges from, pharyngeal cancers are further classified as:

• Nasopharynx cancer, which starts in the mouth or the upper region of the throat
• Oropharynx cancer, which develops from behind the mouth or the middle region of the throat
• Hypopharynx cancer, in the bottom part of the throat or slightly above the oesophagus and windpipe

Laryngeal cancer:

When the flat cells lining the larynx start forming cancerous tumours, they spread to the adjacent tissues in the throat, causing laryngeal cancer. It has a higher chance of affecting the lymph nodes and other parts such as the neck, the lungs, and other parts of the body.

Based on the exact subpart of the larynx that is affected first, laryngeal cancer is further classified as:

• Glottic cancer: it develops in the middle section of the larynx known as the glottis that contains the vocal cords.
• Supraglottic cancer: it occurs in the tissues above the glottis and affects the epiglottis cartilage that preventions food aspiration in the oesophagus (gastrointestinal tract).
• Subglottic cancer: it typically occurs below the vocal box in the glottis, which is connected to the trachea (windpipe).

What are the Signs & Symptoms of Throat Cancer?

Since throat cancer is of various types, the signs of their development may also vary accordingly. This also makes it difficult to be detected in its early stages. However, some of the common symptoms of throat cancer may include:

• A visible lump anywhere on the throat
• A significant change in natural vocal pitch and tones
• Having trouble swallowing anything, i.e., dysphagia
• Drastic loss in body weight
• Soreness in throat
• constant mucus blockages in the throat 
• persistent coughing which may also throw out blood
• Swelling in the lymph nodes
• Constant hoarseness or wheezing sounds while breathing
• ear pain

What are the Causes of Throat Cancer?

Research shows that men are more prone to develop throat cancers than women. It causes a mutation in the cells which multiplies them in uncontrollable amounts. Throat cancer is quite rare, and the exact causes of this mutation process are still unknown. However, there are certain factors which may increase the risks of developing a cancerous condition. Some of these factors include:

• Smoking or chewing tobacco is the primary cause
• Excessive alcohol consumption 
• Vitamin deficiencies caused by an unhealthy diet 
• Acid reflux disorder which leaks body acids into the food pipe
• Sexually transmitting herpes viruses like the Epstein-Barr virus (EBV) or human papillomavirus (HPV)
• Degradation of cells after the age of 60 years
• Topography and genetic conditions – as it is more common in Americans than Asians
• Congenital disorders like Fanconi anaemia
• Direct contact with chemicals used in petroleum or metalworking factories

Researchers are yet to confirm the exact causes of throat cancer, but the factors mentioned above have a promising link with the disease, especially smoking and drinking.

How is Throat Cancer Diagnosed?

For diagnosing your throat’s condition, you may have to undergo procedures such as:

Laryngoscopy: 

This procedure uses an endoscope which is a thin tube-like instrument with a camera and a flashlight on the front end.

The doctor will insert this endoscope through your mouth and into your throat, and its camera will transmit real-time images of the interior parts.

The doctor will refer these images for proceeding with your diagnosis.

Biopsy: 

If the endoscopy procedure yields the possibility of the presence of a cancerous tumour on an organ, the doctor will proceed to collect a tissue sample from that tumour for further analysis.

This procedure can be performed by:

• A conventional surgery, where the doctor makes a small incision on the throat to remove a sample
• A fine-needle aspiration technique where a thin needle is inserted directly in the tumour to extract a small number of sample tissues
• An endoscopy surgery where the doctor inserts the cannula through the mouth or the nose.

Imaging tests:

Musculoskeletal imaging techniques help your doctor analyse the extent of spread of the tumour cells and diagnose other parts that are also affected directly or indirectly by the malignant cells. The most standard images procedures include:

• Magnetic resonance imaging (MRI)
• Positron emission tomography (PET scan)
• Computed tomography (CT scan)
• X-rays

What are the Treatment Options For Throat Cancer?

Throat cancer treatment aims are directly removing the tumourous growth inside the throat and getting rid of all malignant cells from their root. Deciding the right treatment option mainly depends on the following factors:

• The location, stage, size and type of the tumour
• Your medical history and current health
• Your personal and financial choice 

Surgical Treatment:

Based on the stage, location and size of the cancerous tumour, your surgeon may take one of the following surgical approaches:

Early-Stage Surgery:

When the malignant cells are limited over the surface of the throat of the vocal cords and haven’t affected the adjacent cells and tissues, they can be directly removed via minimally invasive procedures such as endoscopy. 

Here, the doctor will insert the endoscopy tube near the affected area and either surgically scrape off or thermally vaporise the malignant cells with a laser.

Laryngectomy:

This surgery is performed on the vocal box when the cords are affected by cancer cells and fail to function.

The goal of this surgery is to preserve as much of the vocal box as possible or entirely replace it.

You’ll have to visit a speech therapist to learn to speak without the vocal box.

Pharyngectomy:

When the tumour emerges from the flat cells lining the throat, that portion of your throat is required to be removed with this procedure.

In case of large tumours, the surgeon may also remove your vocal box partially or entirely.

The throat is reconstructed to enable swallowing functions.

Neck Dissection:

If the malignant cells have spread deep within the throat structures and the organs surrounding them, your surgeon may perform a neck dissection to remove some of the lymph nodes and diagnose them for cancer growth.

Laser Treatment Options:

Radiation Therapy:

Here, high-energy beams like X-rays are used to target cancer cells and kill them with the thermal energy produced by the beam.

It is typically performed in two distinct ways:

External Beam Therapy: A large external machine is used to precisely focus a high-energy beam over the cancer cells.

Brachytherapy: Tiny radioactive seeds or wires are inserted within the body to burn and kill the cancer cells.

Chemotherapy:

Chemo involves medicinal drugs that kill or weaken cancer cells.

This technique is also used to make the cancer cells more vulnerable to the energy beams of radiation treatment.

However, combining these two treatments may have side-effects and isn’t recommended unless their benefits overweigh those side-effects.

Targetted Drug Therapy:

Targetted drugs are specifically used to target a particular weakness of the cancer cells, preventing them from growing or even killing them.

These targetted drugs can be used in combination with other treatments like chemotherapy.
If you’re experiencing any of the symptoms mentioned above or have a genetic history of throat cancer, it is always prudent to have a throughout check-up from a head & neck cancer specialist. And if you’re looking for the best cancer specialist in Pune to discuss your cancer-related problems, then visit Deccan Clinic’s website and book an appointment with the best cancer specialist in Pune.