Throat Cancer

Throat cancer can begin in the pharynx (throat) or the larynx (voice box). The pharynx is a muscular tube that runs behind the nose and mouth and connects to the esophagus, the tube that carries food to your stomach. The larynx sits just below it and holds the vocal cords.

Like other cancers, throat cancer can grow into nearby tissue and, in some cases, spread to other parts of the body.

Types & Stages

Most throat cancers begin in the thin, flat cells that line the inside of the throat. Doctors use different names depending on where the cancer starts:

• Nasopharyngeal cancer. Starts in the upper part of the throat, just behind the nose.
   
• Oropharyngeal cancer. Starts in the middle part of the throat behind the mouth, including the tonsils. This is the most common form in the United States.
   
• Hypopharyngeal cancer. Starts in the lower part of the throat, just above the esophagus and windpipe.
   
• Laryngeal cancer. Affects the voice box. It can start in three areas:
  • Glottic: the vocal cords
  • Supraglottic: the area above the vocal cords
  • Subglottic: the area below the vocal cords

Throat cancer is not described with a single simple number. Instead, doctors look at:

• Where in the throat the cancer started
• The size and depth of the tumor
• Whether it has reached nearby lymph nodes
• Whether it has spread to other parts of the body

This helps your care team plan the best treatment.

Signs & Symptoms

Many throat cancer symptoms can look like a cold or allergies at first. The difference is that throat cancer symptoms tend to stick around instead of getting better.

Visit a doctor if you are experiencing any of these symptoms:

• A sore throat
• Ear pain, which may feel like an earache
• Trouble or pain when swallowing
• A lump in the neck, throat or back of the mouth
• Voice changes, such as hoarseness
• An ongoing cough or coughing up blood
• Weight loss, often because eating and swallowing hurt

Many of these symptoms can be caused by conditions that are not cancer. Still, if a symptom lasts 2 weeks or more, talk with a healthcare provider so the cause can be found.

Diagnosis

Tests and procedures used to diagnose throat cancer may include:

• Physical exam. Your doctor reviews your symptoms and health history and checks your neck for lumps or other changes.
   
• Endoscopy or laryngoscopy. Your doctor uses a thin, lighted tube to look closely at the throat and voice box.
   
• Biopsy. A small sample of tissue is removed and examined under a microscope by a pathologist. This is the only way to confirm throat cancer.
   
• Imaging tests. A CT scan, MRI or PET scan may be used to show the location of the tumor and whether it has spread.

Treatment

Treatment depends on where the cancer started, the size of the tumor, whether it has spread, and your overall health. Surgery is a main treatment for many throat cancers. Your care team can help explain the benefits and risks of each option.

Treatment may include:

• Surgery. Some smaller tumors can be removed with minimally invasive surgery through the mouth or with endoscopic approaches, which use small tools and a lighted scope. These methods can help reduce recovery time and often leave no visible scar. Larger or more complex tumors may need open surgery. Depending on the cancer, surgery may remove part of the throat or voice box. Lymph nodes in the neck may also be removed if cancer has spread there or is likely to.
   
• Radiation therapy. Radiation uses high-energy beams to kill cancer cells. External beam radiation may be the only treatment needed for some small tumors that have not spread, or it may be combined with surgery and chemotherapy.
   
• Other treatments. Chemotherapy or other medicines may be used in select cases, especially for more advanced cancer.

Clinical trials may also be an option. These studies test new treatments or new ways to use current ones. Ask your care team whether a clinical trial may be right for you.

Causes & Risk Factors

The exact cause of throat cancer is not always known. Some factors may raise the risk, including:

• Tobacco use. Smoking or using other tobacco products is the single largest risk factor.
   
• HPV. Human papillomavirus (HPV) is a common virus passed through sexual contact and is now a leading cause of new throat cancer cases.
   
• Alcohol use. Drinking alcohol raises the risk, especially when combined with tobacco.
   
• Epstein-Barr virus. The virus that causes mononucleosis (mono) is linked to some nasopharyngeal cancers.
   
• Workplace exposures. Long-term contact with certain substances may raise risk, such as asbestos, wood dust and formaldehyde.
   
• Diet. A diet high in preserved meats and low in fruits and vegetables may increase risk.

Having a risk factor does not mean you will develop throat cancer, and some people with the disease have no clear risk factors. Talk with your healthcare provider about your personal risk.

Screening

There is no routine screening test recommended for throat cancer.

Because there is no screening test, it is important to pay attention to your body and report symptoms that do not go away, such as a lasting sore throat, hoarseness, trouble swallowing, or a lump in the neck.

If you have symptoms that are new, lasting, or unusual for you, talk with a healthcare provider about whether further evaluation is needed.

This information is for general education only and is not a substitute for medical advice. Please consult a qualified healthcare provider for diagnosis, treatment recommendations, and guidance based on your personal health history.