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Throat cancer is an oncological disease that involves the throat partly or as a whole – base of the tongue, tonsil, pharynx or tube. Cancer that extends from the nasal passages to the mouth to the oesophagus and sinus are called oropharyngeal and hypo pharyngeal cancers.
Usually men between 40 and 70 years and people who live in the cities suffer from throat cancer.
Risk factors for developing throat cancer may include:
- Smoking tobacco – smokers are more affected than non-smokers
- Heavy alcohol use especially in combination with smoking
- A diet low in fruits and vegetables
- Drinking maté, a stimulant drink common in South America
- Chewing betel quid, a stimulant commonly used in parts of Asia
- Being infected with human papillomavirus (HPV)
- Influence of nickel, sulphuric and asbestos
Symptoms of throat cancer may include:
- A sore throat that does not go away
- Permanent cough
- Painful or difficulty swallowing
- Weight loss for no known reason
- Ear pain
- A lump in the back of the mouth, throat or neck
- Advanced tumours may invade the voice box, causing hoarseness or breathing difficulty
- Bleeding from the throat or blood-tinged sputum
- Toothache and spontaneous loss of teeth.
Diagnosis of throat cancer in Germany
In making a diagnosis of throat cancer, your doctor will start by recording your medical history, asking about any symptoms you may be experiencing and conducting a thorough physical examination. Your doctor may also may recommend one or more of the following diagnostic tests:
A laryngoscopy is often used to examine the back of the throat. The two types of laryngoscopy are used – indirect laryngoscopy and direct laryngoscopy.
During an indirect laryngoscopy, small mirrors are placed at the back of your mouth to examine your throat, the base of your tongue and part of your larynx.
During a direct laryngoscopy, your doctor may use a fibre-optic laryngoscope, which is a thin, flexible, lighted tube that is inserted through the mouth or nose, to examine the larynx and surrounding areas.
The doctor may use a numbing medicine to avoid pain, which he sprays on the back of your throat during both procedures. Because people diagnosed with laryngeal cancer are also at increased risk for other head and neck cancers, your doctor will also cautiously examine the nasopharynx (the top portion of the throat, behind the nose), mouth, tongue and neck.
- Imaging tests – Your doctor may also recommend imaging tests, such as a computed tomography (CT) scan, positron emission tomography (PET) scan, or magnetic resonance imaging (MRI). This tests provide more exact information concerning the stage of the tumour and whether the cancer has spread to surrounding lymph nodes in the neck or elsewhere in the body.
- Biopsy – during a biopsy, a doctor removes a small sample of tissue or fluid from the body. A pathologist inspects the cells of removed body sample under a microscope to see if they are cancerous. If the cells are found to be cancerous, a biopsy can help determine if the cancer began somewhere in the body and spread to the biopsy site or it started at the biopsy site.
Throat cancer therapy
Surgery is the preferred treatment for early-stage throat cancers.
For advanced stage or recurrent throat cancer other forms of treatment, such as radiation therapy and chemotherapy can be combined. These treatments may be used to minimize the tumour before surgery.
The following are surgical procedures for throat cancer:
- Vocal cord stripping: The outer layers of tissue on the vocal cords will be removed by a long surgical instrument. This procedure may be used for a biopsy, or to treat some stage 0 cancers connected to the vocal cords. Vocal cord stripping rarely impacts speech after the surgery.
- Laser surgery: During this procedure the tumour can be vaporized or cut out using the endoscope with a high-intensity laser on the tip which is inserted down the throat.
- Cordectomy: In a cordectomy, the surgeon removes part or all of the vocal cords. This approach may be used to treat glottis cancer that is very small or located only on the surface tissues. Patients who get a cordectomy may experience changes in speech. (Hoarse voice). If both vocal cords are taken, speech would no longer be possible.
- Laryngectomy: An operation in which part or all of the larynx is taken.
- Partial laryngectomy: For small laryngeal cancers, it may be possible to remove only the portion of the voice box where the cancer exists, leaving the rest of the larynx intact. During the partial laryngectomy the part of the larynx above the vocal cords can be removed, or only one of the two vocal cords (hemilaryngectomy).
- Total laryngectomy: For larger laryngeal cancers, sometimes a total laryngectomy may be the recommended treatment option. With this surgery the entire voice box is removed. Then, in a process known as a tracheostomy, the windpipe shall be surgically moved toward a hole in the neck for normal breathing. For patients who receive this treatment option, normal speech is no longer possible, but other forms of speech can be learned. Foods and liquids can be swallowed normally, just as they were before the treatment. .
If necessary feeding tube can also be placed in the stomach through the mouth. With this process, called as a percutaneous endoscopic gastrostomy (PEG), a camera is fixed to the end of a long, thin tube, allowing your doctor to see directly into the stomach. The nutrition can be realized by special liquid nutrients through the tube.
The tube keeps you healthy and fed during treatment, and can stay in after treatment if necessary. The tube can be also easily removed as soon as normal eating is possible.