Throat cancer describes cancer that begins in the pharynx (throat) or larynx (voice box). The throat is divided into larynx and pharynx, which can be subdivided into nasopharynx, oropharynx, and hypopharynx.
Cancer of the nasopharynx was ranked at the fifth among all new cancer cases in Malaysia, with an incidence of 4.6% in 2020. This was followed by cancers of the larynx (1.2%), hypopharynx (0.3%) and oropharynx (0.29%).
There are 2 main types of throat cancers: pharyngeal and laryngeal cancer.
- Nasopharyngeal cancer: Upper part of the pharynx
- Oropharyngeal cancer: Middle of the pharynx
- Hypopharyngeal cancer: Lower part of the pharynx
- Supraglottic cancer: Upper portion of the larynx, including the epiglottis (a piece of cartilage that prevents food from entering your throat)
- Glottic cancer: Region of the larynx with vocal cords
- Subglottic cancer: Lower region of the larynx, below the vocal cords
The following risk factors put you at a higher risk of developing throat cancer.
- Age beyond 65
- Excessive consumption of alcohol
- A diet that lacks vegetables and fruits
- Human papillomavirus (HPV) infection
- Epstein-Barr virus (EBV)
- Close family members with throat cancer
- Occupational exposure: pesticide, asbestos, plastic, and sulfuric acid mist
Most symptoms are not noticeable in the early stages of throat cancer, and they depend on the type of throat cancer. Some general symptoms of throat cancer include:
- Hoarseness of voice
- Pain or difficulty swallowing food
- Lump in the throat region
- Chronic sore throat or cough
- Ear pain
- Throat/neck pain
- Coughing up blood
- Unexplained weight loss
If you persistently experience the above symptoms, please seek medical consultation immediately.
Diagnosis is made based on various investigations, including a thorough physical examination of the mouth, throat and neck, and a blood test may be requested.
Other tests carried out for diagnosis are:
- Laryngoscopy with an endoscope inserted deep inside the throat to have a clearer picture of the throat’s inner region.
- Nasendoscopy to examine the larynx by inserting a small, flexible tube with a light and video camera (endoscope) into one of the nostrils and then into the back of the throat.
- Biopsy removes a small tissue sample for laboratory examination.
- Imaging studies to determine the extent of cancer spread, including magnetic resonance imaging (MRI), positron emission tomography (PET), computed tomography (CT) scan and a combination of PET-CT scan.
Learn more about the different types of screening and diagnostic procedures performed to diagnose throat cancer.
The treatment of choice for throat cancer depends on the type of cancer, the tumour's position and size, and the stage of cancer.
The key treatments used are surgery, chemotherapy, radiotherapy, and targeted therapy.
- Different types of surgeries performed to remove the affected area:
- Endoscopic resection inserts a hollow tube with a camera and light known as the endoscope into the throat to remove the tumorous growth.
- Pharyngectomy removes a part of or the entire pharynx.
- Partial laryngectomy removes the affected larynx. It is still possible to talk as parts of the larynx is retained, but hoarseness post-surgery is expected.
- Total laryngectomy removes the entire larynx is removed when the cancer has spread. A stoma (permanent hole) would be created in the neck to in breathing post-surgery. It may be difficult to speak normally as the vocal cords will be removed, However, there are several ways to learn to speak again.
- Radiotherapy uses high-energy radiation to shrink tumours and destroy cancer cells. This treatment is used to relieve symptoms associated with advanced cancer.
- Chemotherapy employs potent cancer-killing medications. It can be given before surgery to shrink tumour size to reduce the rate of spread of cancer or used in combination with radiotherapy.
- Targeted therapy aims to inhibit the progression of advanced throat cancer. For example, cetuximab stops the action of a protein that is more prevalent in throat cancer cell.
- Immunotherapy employs specific drugs to boost the body’s natural immune system to fight cancer cells. This treatment is mostly reserved for those with advanced throat cancer that are not responsive to standard treatments.
Learn more about the different types of treatment technologies to treat throat cancer.
Tips and lifestyle changes to reduce the risk of throat cancer include:
- Quit smoking
- Limit alcohol consumption
- Protect yourself from HPV through vaccinations
- Adopt a healthy diet rich in vegetables and fruits
No routine screening test for cancers of the oropharynx, larynx and hypopharynx is available. Nevertheless, early detection of oropharyngeal cancer may be possible through routine oral exams by a doctor or dentist, while laryngeal and hypopharyngeal cancers may be found early through voice changes or other obvious symptoms.
Gleneagles Hospital works with oncologists to assist patients through cancer treatment. The caring and multidisciplinary team of healthcare professionals are available for consultation and to provide the best care.