What You Need to Know About Throat Cancer

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There are several different types of throat cancer, each named after the part of the throat in which the cancer develops. You may have cancer of the oropharynx, the hypopharynx, the nasopharynx, or the larynx (which contains the voice box). Fortunately, throat cancer is not very common. If you’ve recently been diagnosed, or are concerned you have risk factors, here’s what you need to know about this disease.

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Anatomy of the throat

The pharynx, better known as the throat, runs from the nose down your neck to the trachea (windpipe). It’s divided into two sections: the larynx and hypopharynx. The larynx is the part between the base of the throat and the trachea, and it’s divided into three parts: the supraglottis, the glottis, and the subglottis. The hypopharynx is the bottom of the pharynx. Air and food pass through the throat before going into the windpipe or esophagus, respectively. You can develop cancer in any part of the throat.

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How common is throat cancer?

According to the Surveillance, Epidemiology, and End Results Program (SEER) of the National Cancer Institute (NCI), roughly 13,000 people will be diagnosed with laryngeal cancer in 2018, and 51,540 will be cancers of the oral cavity and pharynx. When diagnosed before it spreads, the five-year survival rate is 78 percent. About half of all cases of laryngeal cancer are diagnosed before they have spread.

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The staging system for throat cancer

Oncologists (cancer doctors) use a standard staging system to describe tumors so that everyone who treats the patient understands the tumor the same way. The TNM staging system refers to the primary tumor (T), whether it has spread to the lymph nodes (N), and if it has metastasized, or spread (M). Tumors are classified as stage 0 (abnormal cells that may progress to cancer) to stage IV (the cancer has spread). The stage of your tumor determines the best approach to treatment.

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Screening for throat cancer

Screening is the process of looking for signs of cancer in people who have no symptoms. Currently, the Food and Drug Administration has not approved any type of screening test for throat cancers, and the U.S. Preventive Services Task Force, an independent body that reviews medical evidence, has not endorsed screening for these cancers in adults who don’t have symptoms.

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Risk factors for throat cancer

Tobacco and heavy alcohol consumption are the two biggest risk factors for throat cancer. Plummer-Vinson Syndrome (a rare throat disorder that make swallowing difficult) is also a risk factor for cancer of the hypopharynx, and gastroesophageal reflux disease (GERD), better known as acid reflux, is associated with an increased risk for cancer in the voice box in older adults. However, to date there’s no evidence that GERD may cause throat cancer.

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HPV is a major risk factor for throat cancer

Human papillomavirus (HPV) is a significant risk factor for many cancers, including cancer of the middle of the throat, according to the NCI. HPV is actually a group of more than 200 related viruses, of which about 12 are responsible for most HPV-related cancers. Most adults get an HPV infection at some point, but the immune system generally resolves them within a year or two. However, in some cases, a persistent infection can cause cell changes that may progress to cancer.

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HPV-related throat cancers are on the rise

According to the NCI, about 70 percent of cancers in the middle of the throat (as well as the tonsils and soft palate) are caused by HPV and, in the U.S., more than 50 percent are linked to HPV type 16. While the rate of HPV-related throat cancer has been rising, the incidence is still low. You can lower your risk by limiting the number of oral sex partners you have and by getting vaccinated. The U.S. Food and Drug Administration has approved three vaccines to prevent HPV infection.

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Symptoms of throat cancer

The symptoms of throat cancer are often vague. However, if you experience hoarseness or earache, have trouble swallowing, or detect a mass in your neck, see your doctor.

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How throat cancer is treated

Throat cancer is treated mainly with surgery and radiation therapy, and sometimes chemotherapy. Most throat cancers are treated with surgery. The type of surgery depends on where the cancer is located and its stage. Your surgeon will perform the least invasive surgery possible to spare your voice box and other structures, while still aiming for the best outcome. You may need further treatment — usually radiation — after surgery, or reconstructive surgery to repair damage from treatment.

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There's help for complications

Throat cancer and its treatment can cause side effects that interfere with your quality of life. According to the Throat Cancer Foundation, the most common complications include trouble swallowing (dysphagia), swollen lymph nodes (lymphadema), fatigue, and anemia. Dry mouth (xerostomia) is one of the most common side effects of radiation therapy because radiation can damage or destroy your salivary glands. Talk to your oncologist about ways to manage these issues; there's help available.