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Throat anatomy
Throat anatomy


Oropharynx
Oropharynx


Cancer - throat or larynx

Definition:

Cancer of the throat is cancer of the vocal cords, voice box (larynx), or other areas of the throat.



Alternative Names:

Vocal cord cancer; Throat cancer; Laryngeal cancer; Cancer of the glottis



Causes, incidence, and risk factors:

People who smoke or use tobacco are at risk of developing throat cancer. Excessive alcohol use also increases risk. Smoking and drinking alcohol combined lead to an increased risk for throat cancers.

Most cancers of the throat develop in adults older than 50. Men are 10 times more likely than women to develop throat cancers.



Symptoms:
  • Abnormal (high-pitched) breathing sounds
  • Cough
  • Coughing up blood
  • Difficulty swallowing
  • Hoarseness that does not get better in 1 - 2 weeks
  • Neck pain
  • Sore throat that does not get better in 1 - 2 weeks, even with antibiotics
  • Swelling or lumps in the neck
  • Unintentional weight loss


Signs and tests:

The doctor will perform a physical exam. This may show a lump on the outside of the neck.

The doctor may look in your throat or nose using a flexible tube with a small camera at the end.

Other may include:

  • Biopsy of suspected tumor
  • Chest x-ray
  • CT scan of chest
  • CT scan of head and neck
  • MRI of the head or neck


Treatment:

The goal of treatment is to completely remove the cancer and prevent it from spreading to other parts of the body.

When the tumor is small, either surgery or radiation therapy alone can be used to remove the tumor.

When the tumor is larger or has spread to lymph nodes in the neck, a combination of radiation and chemotherapy is often used to preserve the voice box.

Some patients need surgery to remove the tumor, including all or part of the vocal cords (laryngectomy). If you have a laryngectomy, speech therapy can help you learn other ways to talk.

Many patients also need swallowing therapy after treatment to help them adjust to the changes in the structure of the throat.



Support Groups:

You can ease the stress of illness by joining a support group of people who share common experiences and problems. See cancer - support group .



Expectations (prognosis):

Throat cancers can be cured in 90% of patients if detected early. If the cancer has spread to surrounding tissues or lymph nodes in the neck, 50 - 60% of patients can be cured. If the cancer has spread (metastasized) to parts of the body outside the head and neck, the cancer is not curable and treatment is aimed at prolonging and improving quality of life.

After treatment, patients generally need therapy to help with speech and swallowing. A small percentage of patients (5%) will not be able to swallow and will need to be fed through a feeding tube.



Complications:

Calling your health care provider:

Call your health care provider if:

  • You have symptoms of throat cancer, especially hoarseness or a change in voice with no obvious cause that lasts longer than 3 weeks
  • You find a lump in your neck that does not go away in 3 weeks


Prevention:

Avoid smoking and other tobacco exposure. Limit or avoid alcohol use.



References:

Armstrong WB, Vokes DE, Maisel RH. Malignant tumors of thelarynx. In: Flint PW, Haughey BH, Lund VJ, et al, eds. Cummings Otolaryngology Head and Neck Surgery. 5th ed. St. Louis, Mo: Mosby Elsevier; 2010:chap 107.

National Comprehensive Cancer Network. National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology: Head and Neck Cancers. 2011. Version 2.2011.

Posner M. Head and neck cancer. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap196.




Review Date: 3/14/2012
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Seth Schwartz, MD, MPH, Otolaryngologist, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

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