What you need to know about throat cancer

Throat cancer is one of the most common cancers of the head, face and neck. The disease is common in men. Especially in smokers and drinkers. Mortality rate is highly dependent on the stage at which the disease is detected. Therefore, understanding and early detection will bring good results for patients. So let's learn with SignsSymptomsList useful information about throat cancer.

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• 1. An overview of throat cancer
• 2. Anatomy of the throat area
• 3. Risk factors for throat cancer
• 4. Types of throat cancer
• 5. Epidemiology of throat cancer
• 6. Symptoms of throat cancer
• 7. How to Diagnose Throat Cancer
• 8. Stages of Throat Cancer
• 9. Treatment of throat cancer
• 10. Precautions
• 11. Prognosis

1. An overview of throat cancer

Throat cancer refers to tumors that form and grow in the pharynx, beginning at the back of the nose and ending in the mouth of the esophagus. Laryngeal cancer (voice box) is also considered a group of throat cancers. Another form of oropharyngeal cancer is tonsil cancer, which affects the tonsils .

Most pharyngeal cancers are squamous cell carcinomas, with multiple linings in the oropharynx.

>> Cancer of the tonsils is a common malignancy of the ENT region. The disease is quite common in Vietnam. Cancer of the tonsils has vague symptoms at first. The patient may just have difficulty swallowing and a sensation of something stuck in the throat, or occasionally a sharp pain in the ear. Let's find out more carefully with SignsSymptomsList here. 

2. Anatomy of the throat area

Anatomy pictures of nasopharyngeal region

In terms of structure, the pharynx has a tubular shape with lateral walls, then closed and opened forward, divided into 3 parts including: nasopharyngeal, oropharyngeal and hypopharynx.

• Nasopharyngeal (pharynx) is the highest part of the pharynx, located just behind the posterior nasal opening, above in contact with the base of the skull. The lower part joins the pharynx and is separated by the soft palate.
• Oropharynx (oropharynx): is an open structure and oral cavity, located between the nasopharynx and hypopharynx, anteriorly bounded by the palatal arch, the fundus of the tongue and part of the tonsils. The lower part is separated from the hypopharynx by an imaginary horizontal line through the hyoid bone.
• The hypopharynx is the lowest point of the pharynx that is continuous with the lower esophagus (oropharynx). Anteriorly, the pharynx is in contact with the larynx.

3. Risk factors for throat cancer

Throat cancer occurs when cells in the pharynx are mutated. These mutations cause cells to grow uncontrollably and continue living after normally healthy cells die. The accumulated cells can form a tumor in the throat.

It is not clear what causes the mutation that causes nasopharyngeal cancer. But doctors have identified factors that may increase the risk, including:

3.1 External factors

• Smoking : People who smoke tobacco or smokeless tobacco are both at increased risk of throat cancer.
• Alcohol use: Regular or heavy drinking puts you at risk of throat cancer. When combined with alcohol and tobacco will significantly increase the risk of throat cancer.
• Human papillomavirus (HPV): HPV is a sexually transmitted disease that can increase the risk of head and neck cancer, especially throat cancer. People with HPV-positive throat cancer have a poorer prognosis than those with HPV-negative ones.
• Occupational exposure: Workers in certain industries such as wood, metal, leather, textiles, and oil and gas workers who are exposed to certain chemicals, dust or fumes in the workplace may be at increased risk of illness. throat cancer.
• Diet: Several studies have shown that a poor diet low in fruits and vegetables can increase the risk of developing throat cancer.
• Epstein-Barr virus (EBV): EBV is a chronic infectious mononucleosis. Viral infections can stay in the pharynx and immune system without causing symptoms. The Epstein-Barr virus is associated with an increased risk of throat cancer.
• Plummer-Vinson syndrome: A rare syndrome that can occur in people with chronic iron deficiency, which may increase the risk of oropharyngeal cancer.

3.2 Internal factors

• Gender: Men are more likely to develop throat cancer than women.
• Age: The risk of throat cancer increases with age. Most patients were over 55 years of age at diagnosis.
• Ethnicity: People of Chinese or Southeast Asian ancestry may have an increased risk of oropharyngeal cancer. Southeast Asia is the most common region for throat cancer in the world.

4. Types of throat cancer

Throat cancer is a general term that applies to cancer that develops in the pharynx or larynx (voice box). Because the pharynx and larynx are closely connected. Laryngeal cancers are also classified as throat cancers

Although most pharyngeal cancers involve the same cell type (nonkeratinizing stratified squamous epithelium accounting for 95% of cases), the specific terms used to distinguish the site of origin of the cancer are letters:

• Begins in the oropharynx – the part of the pharynx just behind the nose is nasopharyngeal cancer (nasopharynx cancer)
• Origins behind the oral cavity include cancers of the tonsils called oropharyngeal cancers.
• Throat cancer (laryngeal cancer) is cancer in the pharynx - larynx
• Laryngeal cancer is cancer of the two vocal cords.
• Originating in the superior region of the glottis, including cancer of the epiglottis is epiglottitis
• Beginning in the lower part of the vocal cords is subglottic cancer. This is one of the sites with the worst prognosis of throat cancer.

5. Epidemiology of throat cancer

Nasopharyngeal cancer: is the most common of the head and neck cancers. However, there is still no complete and exact statistics. But according to the statistics of K-Hanoi Hospital (1998):

• Nasopharyngeal cancer ranks 4th and 5th after lung cancer, uterine cancer, ovarian cancer, breast cancer, liver cancer, and is the leading disease in head and neck cancer with the rate: 9-10 patients/100,000 population/ five.
• Sex is common in men, male/female ratio: 2-3/1.
• Age: the disease usually appears from 20 to 65 years old, after 65 years of age, the disease rate decreases.

Throat cancer: is the third cancer after nasopharyngeal cancer and nasopharyngeal cancer. It is most common from the age of 50-65 (accounting for about 75%) and before 50 and after the age of 65 accounts for about 25%. More men than women.

Oropharyngeal cancer: less common than the above two types, there are still no complete statistics in Vietnam.

6. Symptoms of throat cancer

Depending on the location of the tumor, there will be related symptoms.

Symptoms of throat cancer

6.1 Symptoms of nasopharyngeal cancer

Nasopharyngeal cancer (nasopharynx cancer) has the following symptoms:

• Pain or numbness in the facial skin.
• Prolonged stuffy nose .
• Recurrent nosebleed.
• Symptoms of chronic nasopharyngitis
• Ear pain, persistent otitis media, or a feeling of fullness in the ear
• Headache
• Vision is affected (blurred vision, blindness, etc.)
• Hearing loss, tinnitus

6.2 Symptoms of oropharyngeal cancer

Symptoms of oropharyngeal cancer (oropharyngeal cancer):

• Chronic pharyngitis
• Difficulty chewing, swallowing, swallowing pain, difficulty swallowing
• Persistent ear pain (Jacobson's neuralgia)
• Painless neck mass (neck lymphadenopathy)
• Hoarseness, voice change
• Chewing arthritis

6.3 Symptoms of throat cancer

Symptoms of cancer in the lower pharynx (larynx):

• Chronic pharyngitis
• Persistent ear pain (Jacobson's neuralgia)
• Painless neck mass (neck lymphadenopathy)
• Difficulty swallowing, painful swallowing, trouble swallowing
• Hoarseness, voice change
• Increasing difficulty breathing

7. How to Diagnose Throat Cancer

Patients who come to the clinic will be asked by the doctor about a complete medical history including symptoms, family history, living habits and previous treatments. Your doctor will evaluate and detect suspicious signs (eg, enlarged cervical lymph nodes) to diagnose the disease early. Tools to support the assessment of throat cancer include:

Endoscopic

The doctor uses an endoscope (a long small camera tube) to examine the structures inside the nose, throat, and larynx. It is a simple and quick method to evaluate the pharynx and related areas before proceeding with more specialized tests.

Biopsy

With specialized equipment, the doctor will take a part of the suspect tissue for pathology. This is the only way to help confirm the diagnosis. Patients may undergo endoscopic or fine-needle biopsies (FNA).

School image

These imaging tests allow your doctor to determine if a tumor is present, as well as its size, location, and extent. These tests can also detect the spread of cancer into nearby structures. Options include:

• Chest X-ray
• CT-Scan
• MRI
• PET-CT
• Contrast barium upper gastrointestinal tract X-ray
• Panorex

8. Stages of Throat Cancer

Staging the cancer helps the doctor to assess the progress of the disease, the extent of metastasis to the lymph nodes or distant metastases. This is an important step in planning treatment and prognosis:

Oropharyngeal cancer

Nasopharyngeal (nasopharynx) cancer

Lower throat cancer

9. Treatment of throat cancer

Treatment for throat cancer depends on the location of the tumor (nasopharynx, oropharynx, or hypopharynx), the size of the tumor, and the extent/spread of the tumor to nearby tissues/structures. The following is a brief overview of treatment options for tumors in different parts of the pharynx:

Nasopharyngeal (oropharynx)

The most common treatment for nasopharyngeal cancer is radiation therapy to the tumor and lymph nodes. Radiation therapy may be used to the lymph nodes as a preventive measure, even if no cancer is found there. In advanced cases, a combination of chemotherapy and radiation therapy is considered the mainstay of treatment. Cervical lymphadenectomy to remove lymph nodes and related structures. Laparoscopic tumor resection may be an option for some patients who are poorly responsive to radiation therapy.

Oropharynx (oropharynx) and hypopharynx (larynx)

The main treatment for cancers of the oropharynx and hypopharynx is also radiation therapy to the tumor and lymph nodes. Surgery after radiation therapy is another option that may be considered in some cases. In the case of more advanced disease, the main treatment is usually combined chemotherapy and radiation therapy, targeted radiation therapy, or surgery followed by chemotherapy. For metastatic disease, your doctor may recommend chemotherapy, or palliative treatment, to relieve symptoms.

10. Precautions

There is no proven way to prevent throat cancer from occurring. But to reduce your risk of oropharyngeal cancer, you can:

Stop drinking and smoking

• Stop smoking or don't start smoking. If you smoke, quit. If you don't smoke, don't start. Stopping smoking can be very difficult, so get help. Your doctor can discuss the benefits and risks of many smoking cessation strategies, such as medications, nicotine replacement products, and counseling.
• Drink alcohol only in moderation, if at all. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink per day for women of all ages and men over 65, and up to two drinks per day for men 65 and younger. .
• A healthy diet full of fruits and vegetables. The vitamins and antioxidants in fruits and vegetables may reduce the risk of throat cancer. Eat a variety of colorful fruits and vegetables.
• Protect yourself from HPV. Some oropharyngeal cancers are thought to be caused by sexually transmitted infection with the human papillomavirus (HPV). The risk of HPV infection can be reduced by limiting the number of sexual partners and using condoms every time you have sex. Also consider the HPV vaccine, which is available for boys, girls, and young women and men.

11. Prognosis

Throat cancer tends to grow insidiously with cancer symptoms often not apparent until the cancer is quite advanced. The disease, if detected early, has a good prognosis. Prognosis is worse if nodal metastases are present.

In most cases, the 5-year survival rate is between 15% and 70%.

Furthermore, the pathological factors associated with throat cancer (mainly smoking and alcohol) reduce patient survival even with curative or controlled nasopharyngeal cancer.

Throat cancer tends to grow insidiously with cancer symptoms often not apparent until the cancer is quite advanced. The disease, if detected early, has a good prognosis. Moreover, a healthy lifestyle with preventive measures can help you limit your chances of getting the disease. Contact your doctor immediately if you are experiencing suspicious symptoms and need advice.

>> Usually there won't be much time for an examination. Therefore, the preparation before going to the doctor will save time and help the examination. Here's some information to help you prepare in advance as well as what your doctor will ask you.

Dr. Huynh Thi Nhu My