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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

People who smoke or otherwise 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 the development of 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.

Watch this video about: Cancer of the throat or larynx

Symptoms

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

Exams and Tests

An examination of the neck and throat may show cancer of the throat. The sputum (what is coughed up) may appear bloody. A lump may appear on the outside of the neck. A laryngoscopy, which is examination by use of a tube with a small lighted camera (laryngoscope), allows the physician to look into the mouth and down the throat to see the tumor.

A neck or cranial CT scan or cranial MRI may show throat cancer. These tests will also help determine if the cancer has spread to lymph nodes in the neck.

Biopsy and analysis of tissues that appear abnormal may confirm the presence of a cancerous tumor.

Treatment

Treatment is aimed at completely removing the cancer and preventing the spread of the cancer to other parts of the body.

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

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

Surgical removal of the tumor, including all or part of the vocal cords (laryngectomy) may be necessary in some cases. If a laryngectomy is required, a surgical prosthesis (artificial vocal cords) may be implanted, voice aids may be used, or speech therapy may be recommended to teach alternative methods of speaking.

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

Support Groups

The stress of illness can often be eased by joining a support group of people who share common experiences and problems. See cancer - support group.

Outlook (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.

Possible Complications

• Airway obstruction
• Difficulty swallowing
• Disfigurement of the neck or face
• Hardening of the skin of the neck
• Loss of voice and speaking ability
• Spread of the cancer to other body areas (metastasis)

When to Contact a Medical Professional

Call your health care provider if you have symptoms of throat cancer, especially hoarseness or change in voice with no obvious cause that lasts longer than 1 week. Also call your health care provider if you find a lump in your neck that does not go away in 2 - 3 weeks.

Prevention

Minimize or avoid smoking and excess alcohol use.

References

National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology: Head and Neck Cancers. National Comprehensive Cancer Network; 2008. Version 2.2008.

Posner M. Head and neck cancer. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 200.

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