Throat cancer occurs when cells in the organs used for breathing, speaking and swallowing begin to divide abnormally and out of control. Most throat cancer begins on the vocal cords, and later spreads to the voice box (larynx), to the back portion of the throat that includes part of the tongue and the tonsils (this area is collectively called the pharynx), or below the voice box to the subglottis and trachea. An early symptom of throat cancer is unexplained hoarseness in the voice.

Smokers are at high risk of throat cancer. Other people at risk include those who drink a lot of alcohol, especially if they also smoke. People with a vitamin A deficiency and certain types of human papillomavirus (HPV) infection also may be more likely to develop throat cancer.

Throat cancer is associated with other cancers. Fifteen percent of throat cancer patients also are diagnosed at the same time with cancer of the mouth, esophagus or lung. Another 10 percent to 20 percent of people with throat cancer develop these other cancers later on.

Throat cancer is more common among men, probably because smoking is more common among men. This type of cancer is less common among people under age 55. Many throat cancers can be treated successfully, but the treatment may affect the person's ability to speak.

When throat cancer affects your vocal cords, the first symptom is a change in the sound of your voice, especially a persistent rasp or hoarseness. Other symptoms of throat cancer include:

• Painful or difficult swallowing
• Persistent sore throat
• A sense of a "lump in the throat" or a need to swallow
• Swelling or pain in the neck
• Enlarged glands (lymph nodes) in the neck
• A persistent cough
• Wheezing or raspy breathing
• Unexplained weight loss
• Coughing up blood

If your doctor suspects you have throat cancer, he or she will examine your throat. This can be done with a long-handled mirror or with a lighted tube called a laryngoscope. A local anesthetic might be used to ease discomfort. If abnormalities are found, your doctor will do a biopsy, which involves removing tissue for examination in a laboratory under a microscope. Throat cancer can only be confirmed through a biopsy. Your doctor might send you for a test called a computed tomography (CT) scan. This special type of X-ray provides images of the body from different angles, producing a cross-sectional view. A CT scan can help to find the location of a tumor, help to judge whether a tumor can be removed surgically and help to determine the cancer's stage of development.

Doctors describe cancer using numerical stages. For example, a stage 0 or stage I tumor has not invaded very far into surrounding tissues, while a stage III or IV tumor may be penetrating throughout and beyond surrounding tissues.

Without treatment, throat cancer will continue to grow.

Because most risk factors are environmental rather than genetic, throat cancer can be prevented. Two keys to preventing throat cancer are:

• Stop smoking or using smokeless tobacco products.
• Use alcohol only in moderation. Most experts recommend that women avoid more than one drink a day and that men avoid more than two drinks a day.

The type of treatment recommended depends largely on how far the cancer has spread at the time treatment begins. The preferred treatments for the early stages of throat cancer are radiation therapy and surgery. In more advanced cases, chemotherapy may be given in combination with surgery and/or radiation. When throat cancer already has spread widely throughout the body, chemotherapy may be given alone. Under these circumstances, surgery or radiation is unlikely to provide additional benefit, and it's unlikely the cancer can be cured.

Here is treatment information broken down by cancer stage:

• Stage 0 throat cancers usually can be treated by surgically stripping off the affected layer of tissue.



• Stage I or II throat cancers require surgery, radiation therapy or both. Radiation therapy can be highly successful with these cancers, but throat cancers rarely are found this early.



• Stage III or IV throat cancers likely will require some combination of surgery, radiation therapy and chemotherapy.

Most cancers at later stages require the surgical removal of part or all of the larynx or pharynx. Surgical removal of the larynx is called laryngectomy. Surgical removal of part or all of the pharynx is called pharyngectomy. A laryngectomy is the most common surgery for throat cancer. Even if only part of the larynx is removed, the patient will lose some speaking ability and will require special techniques or reconstructive procedures to regain the use of his or her voice.

If cancer cells have spread beyond the larynx or pharynx and into the lymph nodes, a surgery called neck dissection is required. In this surgery, lymph nodes known or suspected to contain cancer cells are removed to try to contain the cancer before it spreads throughout the body. After surgery, radiation therapy may be done to destroy remaining cancer cells.

After treatment for throat cancer, some people will learn new ways to speak with voice aids, breathing techniques and surgical restructuring. Because the pharynx is a passage to the digestive tract, patients undergoing pharyngectomy also might need surgery to reconstruct the pharynx to allow food to pass through.

See a doctor if any of the symptoms of throat cancer, such as hoarseness, continue for more than two weeks. You may be referred to a specialist, called an ear, nose and throat doctor (otolaryngologist), who deals primarily with disorders of the larynx and pharynx.

As with all cancers, the outlook is much better if throat cancer is discovered before it spreads to nearby tissues or throughout the body. Although many patients with earlier stages of throat cancer are cured through surgery or radiation therapy, many have to learn new ways to speak. Also, throat cancer patients are at risk of developing other cancers in the mouth, throat or esophagus. For this reason, follow-up examinations are crucial.

American Cancer Society (ACS)
1599 Clifton Rd., NE
Atlanta, GA 30329-4251
Toll-Free: (800) 227-2345
http://www.cancer.org/

Cancer Research Institute
681 Fifth Ave.
New York, NY 10022-4209
Toll-Free: (800) 992-2623
Fax: (212) 832-9376
E-Mail: info@cancerresearch.org
http://www.cancerresearch.org/

National Cancer Institute (NCI)
Building 31
Room 10A03
31 Center Dr., MSC 2580
Bethesda, MD 20892-2580
Phone: (301) 435-3848
Toll-Free: (800) 422-6237
http://www.nci.nih.gov/

American Academy of Otolaryngology (Head and Neck Surgery)
One Prince St.
Alexandria, VA 22314-3357
Phone: (703) 836-4444
http://www.entnet.org/