HEALTH - CANCER OF THE PHARYNX (PHARYNGEAL THROAT CANCER)
What is Throat Cancer?
Throat cancer (pharyngeal) is a disease in which malignant cancer cells form in the tissues of the nasopharynx. The nasopharynx is the upper part of the pharynx (throat) behind the nose. The pharynx is a hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes from the throat to the stomach). Air and food pass through the pharynx on the way to the trachea or the esophagus. The nostrils lead into the nasopharynx. An opening on each side of the nasopharynx leads into an ear. Throat cancer most commonly starts in the squamous cells that line the oropharynx (the part of the throat behind the mouth).
Throat cancer (pharyngeal) frequently spreads (metastasizes) beyond the
nasopharynx. Most people with throat cancer have regional
metastases, meaning cancer cells from the initial tumor have migrated
to nearby areas, such as lymph nodes in the neck. Cancer cells that
spread beyond the head and neck (distant metastases) most commonly
travel to the bones and bone marrow, lungs and liver.
Health: Causes of Throat Cancer (Pharyngeal - Pharynx)
Throat cancer occurs when cells in your throat develop genetic mutations. These mutations cause cells to grow uncontrollably and continue living after healthy cells would normally die. The accumulating cells can form a tumor in your throat.
It's not clear what causes the mutation that causes throat cancer. But doctors have identified factors that may increase your health risk.
Types of throat cancer
Throat cancer is a general term that applies to cancer that develops in
the throat (pharyngeal cancer) or in the voice box (laryngeal cancer).
The throat and the voice box are closely connected, with the voice box
sitting just below the throat. More specific terms to describe the
types of throat cancer include:
- Nasopharyngeal cancer begins in the nasopharynx — the part of your throat just behind your nose.
- Oropharyngeal cancer begins in the oropharynx — the part of your throat that is right behind your mouth.
- Hypopharyngeal cancer (laryngopharyngeal cancer) begins in the hypopharynx (laryngopharynx) — the lower part of your throat, just above your esophagus and windpipe.
- Glottic cancer begins in the vocal cords.
- Supraglottic cancer begins in the upper portion of the larynx and includes cancer that affects the epiglottis, which is a piece of cartilage that blocks food from going into your windpipe.
- Subglottic cancer begins in the lower portion of your voice box, below your vocal cords.
Health: Risk Factors of Throat Cancer (Pharyngeal - Pharynx)
Researchers have identified some risk factors that appear to increase your risk of developing throat cancer, including:
- Sex. Men have about double the risk of developing cancer of the nasopharnyx as women do.
- Race. This type of cancer more commonly affects people in Asia and northern Africa. In the United States, Asian immigrants have a higher risk of this type of cancer than do American-born Asians, which may be related to differences in diet. The Inuits of Alaska also have an increased risk of throat cancer. Additionally, blacks are significantly more likely to develop throat cancer than are whites.
- Age. Most cases of throat cancer occur in people between the ages of 30 and 55.
- Salt-cured foods. Chemicals released in steam when cooking salt-cured foods, such as fish, preserved vegetables and Chinese herbs, may enter the nasal cavity, increasing the risk of nasopharyngeal carcinoma. In China, throat cancer has been linked to the high consumption of salted fish, and as people in Southeast China are adopting a more Western diet, their rates of throat cancer have been declining.
- Preserved meats. Preserved meats contain high levels of nitrates, which may increase the risk of throat cancer.
- Epstein-Barr virus. This common virus usually produces mild signs and symptoms, such as those of a cold. Sometimes it can cause infectious mononucleosis. Epstein-Barr virus is also linked to several rare cancers, including nasopharyngeal carcinoma. In fact, the Epstein-Barr virus can be found in almost all throat cancer cells.
- Family history. Having a family member with nasopharyngeal carcinoma increases your risk of the disease, though researchers aren't sure if this association is due to genetic or environmental factors.
- Tobacco use. Which includes smoking and chewing tobacco.
- Alcohol use. Excessive drinking
- Poor dental hygiene.
- Human Papillomavirus (HPV). A sexually transmitted virus.
- Poor diet. A diet lacking in fruits and vegetables.
- Asbestos exposure. A naturally occurring fiber that's used in certain manufacturing industries.
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Health: Symptoms of Throat Cancer (Pharyngeal - Pharynx)
In its early stages, throat cancer may not cause any symptoms. Possible noticeable symptoms of throat cancer may include:
- A lump in your neck caused by a swollen lymph node
- Bloody discharge from your nose
- Nasal congestion on one side of your nose
- Hearing loss in one ear
- Frequent ear infections
- Headaches
- Double vision
- Face and neck pain
- Trouble breathing or speaking
- Pain or ringing in the ear
- A sore throat
- Cough
- Changes in your voice, such as hoarseness
- Difficulty swallowing
- Ear pain
- Weight loss
Health: Diagnosis of Throat Cancer (Pharyngeal - Pharynx)
The following tests and procedures may be used:
- Physical exam of the throat: An exam in which the doctor feels for swollen lymph nodes in the neck and looks down the throat with a small, long-handled mirror to check for abnormal areas.
- Nasoscopy: A procedure to look inside the nose for abnormal areas. A nasoscope is inserted through the nose. A nasoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer.
- Neurological exam: A series of questions and tests to check the brain, spinal cord, and nerve function. The exam checks a person's mental status, coordination, and ability to walk normally, and how well the muscles, senses, and reflexes work health wise. This may also be called a neuro exam or a neurologic exam.
- Head and chest x-ray: An x-ray of the skull and organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
- MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
- CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
- PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do. PET scans may be used to find throat cancer that have spread to the bone.
- Laboratory tests: Medical procedures that test samples of tissue, blood, urine, or other substances in the body. These tests help to diagnose disease, plan and check treatment, or monitor the disease over time.
- Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer.
Health: Staging of Throat Cancer (Pharyngeal - Pharynx)
The process used to find out whether cancer has spread within the nasopharynx or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The results of the tests used to diagnose throat cancer are often also used to stage the disease.
The following stages are used for throat cancer (pharyngeal - pharynx):
Stage 0 (Carcinoma in Situ)
In stage 0, abnormal cells are found in the lining of the nasopharynx. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.
Stage I
In stage I, cancer has formed and is found in the nasopharynx only.
Stage II
Stage II nasopharyngeal cancer is divided into stage IIA and stage IIB as follows:
- Stage IIA: Cancer has spread from the nasopharynx to the oropharynx (the middle part of the throat that includes the soft palate, the base of the tongue, and the tonsils), and/or to the nasal cavity.
- Stage IIB: Cancer is found in the nasopharynx and has spread to lymph nodes on one side of the neck, or has spread to the area surrounding the nasopharynx and may have spread to lymph nodes on one side of the neck. The involved lymph nodes are 6 centimeters or smaller.
Stage III
In stage III nasopharyngeal cancer, the cancer:
- is found in the nasopharynx and has spread to lymph nodes on both sides of the neck and the lymph nodes are 6 centimeters or smaller; or
- has spread into the soft tissues (oropharynx and/or nasal cavity) and to lymph nodes on both sides of the neck and the lymph nodes are 6 centimeters or smaller; or
- has spread beyond the soft tissues into areas around the pharynx and to lymph nodes on both sides of the neck and the lymph nodes are 6 centimeters or smaller; or
- has spread to nearby bones or sinuses and may have spread to lymph nodes on one or both sides of the neck and the involved lymph nodes are 6 centimeters or smaller.
Stage IV
Stage IV nasopharyngeal cancer is divided into stage IVA, stage IVB, and stage IVC as follows:
- Stage IVA: Cancer has spread beyond the nasopharynx and may have spread to the cranial nerves, the hypopharynx (bottom part of the throat), areas in and around the side of the skull or jawbone, and/or the bone around the eye. Cancer may also have spread to lymph nodes on one or both sides of the neck, and the involved lymph nodes are 6 centimeters or smaller.
- Stage IVB: Cancer has spread to lymph nodes above the collarbone and/or the involved lymph nodes are larger than 6 centimeters.
- Stage IVC: Cancer has spread beyond nearby lymph nodes to other parts of the body.
Health: Recurrent Throat Cancer (Pharyngeal - Pharynx)
Recurrent throat cancer (pharyngeal) is cancer that has recurred (come back) after it has been treated. The cancer may come back in the nasopharynx or in other parts of the body.
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Natural Alternative Treatment Options: NATURAL CANCER TREATMENT
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Health: Conventional Treatment of Throat Cancer (Pharyngeal - Pharynx)
Different types of treatment are available for patients with throat cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. Before starting treatment, patients may want to think about taking part in a clinical trial. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment.
Clinical trials are taking place in many parts of the country. Information about ongoing clinical trials is available from the NCI Web site. Choosing the most appropriate cancer treatment is a decision that ideally involves the patient, family, and health care team.
Three types of standard treatment are used:
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.
External radiation therapy to the thyroid or the pituitary gland may change the way the thyroid gland works. The doctor may test the thyroid gland before and after therapy to make sure it is working properly. It is also important that a dentist check the patient's teeth, gums, and mouth, and fix any existing problems before radiation therapy begins.
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.
Surgery
Surgery is a procedure to find out whether cancer is present, to remove cancer from the body, or to repair a body part. Also called an operation. Surgery is sometimes used for throat cancer that does not respond to radiation therapy. If cancer has spread to the lymph nodes, the doctor may remove lymph nodes and other tissues in the neck.
New types of treatment are being tested in clinical trials. These include the following:
Biologic therapy
Biologic therapy is a treatment that uses the patient's immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.
Intensity-modulated radiation therapy
Intensity-modulated radiation therapy (IMRT) is a type of 3-dimensional radiation therapy that uses computer-generated images to show the size and shape of the tumor.
This summary section refers to specific treatments under study in clinical trials, but it may not mention every new treatment being studied. Information about ongoing clinical trials is available from the NCI Web site.
Health: Complications of Throat Cancer Treatment (Pharyngeal - Pharynx)
Treatment for throat cancer often causes complications that may require working with specialists to regain the ability to swallow, eat solid foods and talk. During and after throat cancer treatment, your doctor or health care provider may have you seek help for:
- Caring for a surgical opening in your throat (stoma) if you had a tracheotomy
- Difficulty eating
- Difficulty swallowing
- Stiffness and pain in your neck
- Speech problems
Your doctor can discuss the potential side effects and complications of your treatments with you.
Health: Lifestyle Changes After Treatment of Throat Cancer (Pharyngeal - Pharynx)
Quit smoking
Throat cancer is closely linked to smoking. Not everyone with throat
cancer smokes. But if you do smoke, now is the time to stop because:
- Smoking makes treatment less effective.
- Smoking makes it harder for your body to heal after surgery.
- Smoking increases your risk of getting another cancer in the future.
Quitting smoking can be very difficult. And it's that much harder when you're trying to cope with a stressful situation, such as a cancer diagnosis. Your doctor can discuss all of your options, including medications, nicotine replacement products and counseling.
Quit drinking alcohol
Alcohol, particularly when combined with smoking or chewing tobacco,
greatly increases the health risk of throat cancer. If you drink alcohol, stop
now. This may help reduce your health risk of a second cancer. Stopping
drinking may also help you better tolerate your throat cancer
treatments.
Health: Prevention of Throat Cancer (Pharyngeal - Pharynx)
There's no proven way to prevent throat cancer from occurring. But in order to reduce your health risk of throat cancer, you can:
- Stop smoking or don't start smoking. If you smoke, quit. If you don't smoke, don't start. Quitting smoking can be very difficult, so get some help. Your doctor can discuss the benefits and health risks of the many stop smoking strategies, such as medication, nicotine replacement products and counseling.
- Drink alcohol only in moderation, if at all. For women and older adults, this means one drink a day. For men, moderate drinking means no more than two drinks a day.
- Choose a healthy diet full of fruits and vegetables.
The vitamins and antioxidants in fruits and vegetables may reduce your
risk of throat cancer. Eat a variety of colorful fruits and vegetables to promote good health.
- Use caution around chemicals. When working with chemicals, whether on the job or around your house, carefully follow the directions. Avoid breathing hazardous chemical fumes. Properly ventilate the room where you're working and wear a mask over your nose and mouth.
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Disclaimer: This information is not presented by a medical practitioner. Therefore any content of this site is strictly intended for educational and informational purpose only. Any access to this site is strictly on a voluntary basis and at the sole discretion of the user. No content of this site is intended as a substitute for medical advice, diagnosis or treatment, nor constitute the practice of any medical profession or health care provider. The information provided on this site is here to educate visitors on health issues that may affect their lives. Otherwise, always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition. And never disregard professional medical advice or delay in seeking it because of something you have read.
Sources: NIH News In Health/National Institutes of Health/National Library of Medicine/Dept of Health and Human Services_______________________________________________________________________________________________________
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