top of page

Throat Cancer

The larynx, which protects the windpipe during swallowing, allows air to reach the lungs, and produces sound through the vocal cords, is the region where the respiratory and digestive systems separate. Laryngeal cancer, where tobacco and alcohol use are the biggest risk factors, manifests with symptoms such as weight loss, shortness of breath, ear pain, and bad breath.

What is throat cancer?


Laryngeal cancer, also known as throat cancer, occurs in the region between the base of the tongue and the trachea, where the vocal cords are located, in the head and neck area. Throat cancer, also referred to as larynx or laryngeal cancer, is one of the most common types of cancer among head and neck cancers.


What are the symptoms of throat cancer?


Persistent hoarseness lasting more than 3 weeks: Persistent hoarseness is one of the most common symptoms of laryngeal cancer. However, hoarseness is not the sole cause of laryngeal cancer. Various factors such as acute laryngitis, excessive yelling, smoking, reflux, nasal congestion, allergies, thyroid issues, and aging can lead to hoarseness. Sudden changes in voice tone should also be noted alongside hoarseness.


Difficulty swallowing: Difficulty swallowing can be described in various ways. Feeling like there's something stuck in the throat, inability to swallow food completely, pain or burning sensation while swallowing, and the sensation that food is sticking in the throat are all indicative of swallowing problems.


Not every difficulty in swallowing signifies throat cancer. A harmless narrowing of the esophagus known as a stricture can also lead to swallowing difficulties. However, it's important to remember that advanced laryngeal tumors can also cause difficulty in swallowing.


Unintended weight loss: Uncontrolled weight loss can be a symptom not only of throat cancer but also of many other cancers. It's more commonly observed in advanced stages of throat cancer. In cases where 4-5 kg is lost in a short period without intentional effort, seeking routine check-ups can be life-saving.


Shortness of breath: Shortness of breath or wheezing during breathing is also among the symptoms of throat cancer. Particularly if there's a progressively worsening wheezing and shortness of breath, throat cancer should be considered.


Feeling of lump or swelling in the throat

Fatigue

Bad breath

Earache

Unintended weight loss


Many of these symptoms can stem from non-cancerous health issues. Especially in individuals who have smoked and consumed alcohol for many years, similar symptoms may arise.


These symptoms, indicative of throat cancer, can also arise from non-cancerous causes.


Chronic laryngitis, smoking, reflux, vocal strain, non-malignant benign tumors, growths of tissue known as laryngeal nodules on the vocal cords, and wart-like growths caused by HPV in the larynx can be mistaken for throat cancer symptoms. However, getting the necessary check-ups based on the symptoms can be life-saving.


What are the causes of throat cancer?


There are risk factors that may contribute to the development of throat cancer.


Tobacco and alcohol use: Alcohol and tobacco use are the most significant risk factors that increase the risk of throat cancer. The amount and duration of tobacco and alcohol use directly correlate with the level of risk. Individuals who smoke more than 25 cigarettes a day or have been smoking for more than 30 years are about 40 times more likely to develop throat cancer compared to non-smokers. Similarly, those who have been consistently and regularly using alcohol for a long time are 3 times more at risk compared to non-drinkers. The majority of head and neck cancers, including throat cancer, are caused by smoking. Additionally, individuals who are constantly exposed to secondhand smoke are also at an increased risk of throat cancer.

Gender: The risk of throat cancer in males is 4-5 times higher compared to females. However, the increasing prevalence of smoking among women in recent years has led to a higher incidence of throat cancer in females as well.

Genetic factors: Individuals with a family history of head and neck cancer or throat cancer have a higher risk of developing throat cancer compared to those without such a history.

Age: As with many other cancer types, advancing age is a significant risk factor for throat cancer. Throat cancer is rare in individuals under the age of 40.

Dietary habits: Those who consume red meat, processed foods, or fried foods excessively are at a higher risk of developing throat cancer. Moreover, studies have shown that inadequate intake of vitamins A and E through diet can contribute to throat cancer. Adhering to a Mediterranean diet rich in fresh fruits and vegetables, which provides adequate amounts of vitamins A and E, can help reduce the risk of throat cancer.

HPV virus: Scientific studies suggest that the Human papillomavirus (HPV) infection, which is primarily transmitted sexually and causes genital warts, cervical, and vaginal cancers in women, may also contribute to throat cancer. HPV is a common infection that often resolves on its own without causing any issues in most individuals.

Exposure to harmful substances: Prolonged exposure to certain harmful or chemical substances due to occupational reasons can lead to throat cancer.

  • Wood dust

  • Coal or charcoal dust

  • Paint fumes

  • Formaldehyde, commonly used in industries such as paint production and cosmetics

  • Nickel Isopropyl alcohol, used as a cleaning solvent

  • Sulfuric acid mist

  • Asbestos

  • Poor oral hygiene and acid reflux disease can also contribute to throat cancer.


How is throat cancer diagnosed?


Early diagnosis of throat cancer provides significant advantages in treatment. Individuals with one or more symptoms should promptly seek the expertise of an otolaryngologist (ear, nose, and throat specialist), as timely diagnosis is crucial.


Doctor's examination: A doctor's examination can provide insights into the presence of throat cancer. The doctor evaluates lifestyle and occupational risk factors such as smoking and alcohol use. Since throat cancer may manifest as a lump-like swelling in the throat, a physical examination is performed. During the examination, the doctor inspects the inside of the mouth, including cheeks and lips, as well as the base of the mouth, back of the throat, nose, and ears. Various tests and imaging methods can be used to clarify the diagnosis of throat cancer.

Nasendoscopy: Nasendoscopy is a type of endoscopy used by the doctor to better visualize the throat. An elongated, flexible tube with a light and a small camera at its end is inserted through the patient's nostrils to examine the presence of any abnormal structures in the throat. There is no need for any special preparation before a nasendoscopy procedure.

Laryngoscopy: Laryngoscopy is performed when the throat cannot be adequately examined using nasendoscopy or when a suspicious formation is detected. The endoscope used in laryngoscopy is longer, and the procedure is conducted through the mouth. In preparation for laryngoscopy, the use of blood-thinning medications can be stopped. The procedure is usually carried out under general anesthesia.

Video Laryngostroboscopy: This procedure can be employed in cases where general anesthesia is not suitable or for diagnosing tumors affecting the vocal cords. The endoscope used has a camera and a fiber-optic strobe light. It can be performed before, during, and after treatment to assess the condition of the vocal cords. The procedure lasts around 30 minutes and can be conducted under local anesthesia.

Biopsy: If a suspicious structure is observed during nasendoscopy or laryngoscopy, a tissue sample can be taken and sent to a laboratory for examination. In cases of suspected cancer, a portion or the entire suspicious tissue can be surgically removed for biopsy. Fine-needle aspiration biopsy can also be performed when a palpable lump is felt in the neck.


Imaging methods can also be utilized for diagnosing throat cancer. Imaging techniques such as X-rays, ultrasound, Computed Tomography (CT), Magnetic Resonance Imaging (MRI), and Positron Emission Tomography (PET) provide insights into the precise location and size of the cancer.


What are the treatment methods of throat cancer?


The treatment of throat cancer can vary depending on factors such as the location, stage, grade of the tumor, and the patient's overall health. Generally, surgical procedures, radiation therapy, and chemotherapy are used in the treatment of throat cancer. Sometimes, a combination of these options is employed.


Surgical Treatment of Throat Cancer


Endoscopic Resection (Endoscopic Laser Surgery) for Partial Throat Removal

This method is suitable for early-stage and locally advanced throat cancer patients.

Known colloquially as endoscopic laser surgery, it is performed through the mouth without any incisions.

The use of a laser during the procedure reduces bleeding.

The surgery takes place in an operating room under general anesthesia.

Surgical tools and lasers are passed through a tube inserted from the mouth to the vocal cords. The surgeon, aided by a microscope, can clearly see the cancerous tumor.

Depending on the tumor's condition, the surgeon can use the laser to remove a portion or completely eliminate it with high energy.

Patients must be evaluated for suitability before undergoing endoscopic laser surgery. Suitable oral and throat structures are necessary due to the oral approach.

Hospitalization duration after oral laser surgery varies based on the tumor's location and size. Swelling after major tumor removal through endoscopic laser surgery can cause breathing and feeding problems.

Generally, oral laser surgery does not lead to permanent speech or swallowing problems. There might be speech restrictions for a few days after the surgery. Working with a speech therapist can yield positive results for prolonged speech issues.


Throat Laryngectomy Surgery for Throat Cancer


Depending on the tumor's size and location, either the affected part or the entire larynx can be surgically removed.

Partial laryngectomy, involving the removal of only a portion of the larynx, can be performed with a small neck incision or through the mouth without incisions.

For partial laryngectomy, a small hole is created in the neck to ensure breathing. This hole usually closes after surgery.

Temporary speech issues might arise after partial laryngectomy, but usually, speech and breathing are not affected after the recovery period.

In total laryngectomy, where the entire larynx is removed, the trachea is connected to an opening in the throat for breathing.

The opening in the throat is permanent after total laryngectomy.

Patients lose their voice after total laryngectomy. Speech prostheses or voice devices can help with communication.

Total laryngectomy can lead to swallowing, taste, and smell issues, in addition to voice problems.


Neck Dissection Surgery


Throat cancer can spread to lymph nodes in the neck. Often, cancer cells first spread to the lymph nodes. In some cases of throat cancer treatment, removal of a part or all of the lymph nodes might be necessary, depending on the affected area and tumor size.

Neck dissection surgery involves removing muscles, nerves, and adjacent tissues.

Due to its side effects, not every patient is a candidate for neck dissection surgery.

Although lymph node removal is an essential measure to prevent cancer spread, it can lead to side effects such as numbness in the ear, loss of movement in the lower lip, movement and sensation loss in the tongue, shoulder movement impairment, and arm movement impairment, depending on the removed lymph nodes.

After neck dissection surgery, radiation therapy can be applied.

Consult a doctor if you experience any swelling, fullness, pressure, difficulty swallowing, or changes in voice.


Radiation Therapy for Throat Cancer


In early-stage throat cancer, radiation therapy is often the first choice. Radiation therapy, which uses high energy to destroy cancer cells, can be used alone or combined with surgery and chemotherapy, depending on the tumor's location and size.

Radiation therapy can also be applied after throat cancer surgeries. It can be used after surgery to prevent the recurrence of throat cancer, when the entire tumor cannot be removed, or when tumors grow along the throat wall.

For advanced-stage throat cancer patients, radiation therapy combined with chemotherapy might yield better results.

Advanced-stage throat cancer treated with radiation therapy can alleviate problems like swallowing and breathing difficulties.

During radiation therapy, side effects such as fatigue, skin redness or darkening, sore throat, difficulty swallowing, or swelling might occur.


Chemotherapy Treatment for Throat Cancer


Chemotherapy for throat cancer can be administered before or after surgery and is often used in conjunction with radiation therapy.

Preoperative chemotherapy can reduce tumor size, making it easier for surgery to be performed.

Chemotherapy can also be used to prevent throat cancer recurrence.

Targeted therapies, smart drugs that focus on specific targets, have gained prominence in recent years for chemotherapy treatment. Targeted therapies reduce chemotherapy's side effects while increasing its effectiveness.


FREQUENTLY ASKED QUESTIONS ABOUT THROAT CANCER

Which doctor should you consult for Throat Cancer?


The throat is a component of the upper respiratory tract and also serves as a vocal organ. Ear, Nose, and Throat (ENT) doctors are responsible for the initial diagnosis and treatment of throat cancer, also known as laryngeal cancer or larynx cancer. When selecting an ENT doctor for throat cancer treatment, it's crucial to choose a physician specialized in head and neck surgery and a hospital with a strong foundation in this area.


What are the types of throat cancer?


Throat cancer is categorized into different types based on the type of cells from which it originates.

Squamous cell type throat cancer: This type accounts for nearly 95% of all throat cancers. It starts in flat, thin squamous cells found in the upper part of the throat known as the epiglottis or in similar cells throughout other parts of the throat.


Squamous cell type throat cancer is further classified based on the area it spreads to:


Glottic cancer: Starts in the vocal cords.

Supraglottic cancer: Begins in the upper part of the vocal cords.

Subglottic cancer: Originates below the vocal cords.

Oropharyngeal cancer: Begins in the back of the mouth.

Nasopharyngeal cancer: Initiates in the back of the throat.


Adenocarcinoma laryngeal cancer: Despite being rarer compared to squamous cell type throat cancer, its occurrence has increased in recent years. It starts in adenomatous cells that produce mucus, though its prevalence remains lower compared to squamous cell type cancer.


There are also extremely rare variations of throat cancer, including tumors of the minor salivary glands, sarcomas, melanomas, non-Hodgkin lymphoma, or extramedullary plasmacytoma.


What are the grades of throat cancer?


The grade of throat cancer is related to the appearance of cancerous cells. Generally, throat cancer is classified into two categories: low-grade and high-grade.


Low-grade throat cancer: The cancer cells in this type resemble the cells from which they originated. Low-grade throat cancer cells typically grow slowly and have a lower likelihood of spreading.

High-grade throat cancer: There is a higher degree of differentiation among cancer cells in this type. High-grade throat cancer cells tend to proliferate faster and have a higher likelihood of spreading compared to low-grade cancer cells.


What are the stages of throat cancer?


After the diagnosis of laryngeal cancer, determining its stage is important for shaping the treatment plan. The stage of laryngeal cancer is determined by assessing how much the cancer has spread. It is categorized based on the exact location of the tumor, its involvement in nearby lymph nodes, and the presence of metastasis to distant organs.


There are five stages of throat cancer:


Stage 0: Abnormal cancer cells are limited to the inner lining of the throat and have not spread to surrounding tissues.

Stage 1 and 2: These are early stages of laryngeal cancer. The tumor is small and has not extended beyond the larynx.

Stage 3: The tumor is larger and may affect one of the vocal cords. In Stage 3 laryngeal cancer, the tumor might have grown into the upper part of the larynx, including the thin, leaf-like structure called the epiglottis, or the inner part of the thyroid gland.

Stage 4: This is the advanced stage of laryngeal cancer. The tumor has spread beyond the larynx to involve the thyroid gland, the trachea (windpipe), or the esophagus.


The staging helps guide treatment decisions and provides information about the extent of the cancer's spread, aiding in determining the most appropriate approach for managing the condition.


Is Throat Cancer Fatal?


Throat cancer is a potentially fatal disease. The prognosis varies depending on factors such as the type, location, size of the throat tumor, its extent of spread, and the patient's response to treatment.

In general, based on studies, the 5-year survival rates after appropriate treatment are as follows:

  • Stage 1 throat cancer: Approximately 90% survival rate

  • Stage 2 throat cancer: Approximately 70% survival rate

  • Stage 3 throat cancer: Approximately 60% survival rate

  • Stage 4 throat cancer: Approximately 40% survival rate

It's important to note that individual patient outcomes can vary based on a variety of factors, and it's not possible to definitively predict a patient's lifespan based solely on statistics.

After treatment, patients should have regular check-ups with their doctors every three to six months during the first two years. It's worth mentioning that around 80-90% of recurrences of cancer occur within the first 3 years after treatment.


Where Does Throat Cancer Metastasize?


Cancerous cells can spread from their original location to other parts of the body. Throat cancer metastasis initially tends to affect neighboring tissues. In advanced stages, metastasis can occur in distant organs as well.


Along the throat, throat cancer can metastasize to:

  • Soft tissues of the neck

  • Thyroid gland

  • Vocal cords

  • Base of the tongue

  • Pharynx

  • Trachea (windpipe)

  • Tongue muscles and neck muscles

  • Esophagus

  • Lymph nodes

  • It can also metastasize to the lungs, liver, and bones.


Will I Be Able to Speak After Throat Cancer Surgery?


In cases of partial throat cancer surgery, it's possible to preserve the vocal cords. In surgeries where the vocal cords are spared, there might be temporary difficulty in speaking immediately after the surgery, but over time, the voice can return to its previous state. However, in surgeries where the entire larynx (voice box) is removed, the patient loses their voice.


After such surgeries, different speaking techniques or devices can be employed based on the patient's condition. One technique is esophageal speech, where air is pushed down the esophagus and then brought back up to produce speech. This approach often requires working with speech therapists.


Another option is using an electronic larynx, a small device held against the neck to produce sound. Additionally, voice prostheses, also known as "voice microphones" in colloquial terms, can be used to help patients regain their ability to speak.


How Should Nutrition Be Managed After Throat Cancer?


During throat cancer treatment, which can involve radiation therapy or surgery, difficulties in swallowing, pain, loss of taste, and weight loss can occur.


After throat cancer surgery, transitioning to a solid food diet may not be immediate. In such cases, a feeding tube can be connected through the nose, a hole in the throat, or the abdominal wall to deliver liquid nutrition. During this period, the patient receives liquid nutrients through the feeding tube.


When transitioning to a regular diet, it's important to avoid acidic and spicy foods.

Some patients may experience a loss of taste after certain surgeries. To enhance taste, strong sauces or flavor-enhancing ingredients like herbs, garlic, or lemon juice can be added to meals.


Opting for foods that are easier to chew and swallow is recommended. If weight loss continues to be a concern, consulting a doctor for additional vitamin supplementation is advisable.


Can Smoking Cause Throat Cancer?


Smoking is a primary risk factor for throat cancer. In fact, approximately one in every 100,000 individuals develops laryngeal (throat) cancer, and this is mostly observed among male smokers. As cigarette usage increases, there has also been a recent rise in the occurrence of throat cancer among women. The most significant symptom of throat cancer is hoarseness of voice. If hoarseness persists for more than 2 weeks, it is essential to seek consultation from an ear, nose, and throat specialist.


What Should You Do to Prevent Throat Cancer?


There is no definitive proven way to completely prevent throat cancer. However, taking precautions against risk factors can help reduce the likelihood of developing throat cancer.


  1. Avoid smoking and alcohol: The most significant risk factor for throat cancer is smoking. Quitting smoking significantly reduces the risk of throat cancer. Avoid excessive alcohol consumption as well.

  2. Maintain a diet rich in fruits and vegetables: A diet that is abundant in fruits and vegetables ensures you receive necessary vitamins and antioxidants.

  3. Consider HPV vaccination: Human papillomavirus (HPV) can contribute to throat cancer. If appropriate, consider getting an HPV vaccine.


Remember, while these steps can reduce the risk, it's also important to have regular medical check-ups and screenings to catch any potential issues early.


Questions about appointments?

You'll find answers to questions about the appointments process, scheduling, referrals and more.

See Frequently Asked Questions here.

Read Uniqacare Stories

Sharing Uniqacare is a place for patients, families and Uniqacare staff to share their experiences. You might find inspiration in their triumphs and powerful stories.

Read Uniqacare stories

bottom of page