Throat Cancers – Causes, Signs and symptoms

Throat Cancers

Reviewed By:
Mark Oren, M.D., FACP

Summary

Throat cancers appear in the pharynx (the area behind the mouth) and the esophagus, the tube that connects the pharynx to the stomach. There are four major areas of the throat that may be affected, including:

  • Oropharynx. Area of the throat directly behind the mouth.
  • Nasopharynx. Area at the back of the nose near the base of the skull and located just above the soft palate (the flap of tissue that makes up the rear portion of the roof of the mouth).
  • Larynx. The “voice box,” located in the front of the neck and visible as the “Adam’s apple” especially in males.
  • Hypopharynx. The entrance to the esophagus, or food pipe.

Lifestyle decisions play a crucial role in the development of many throat cancers. Smoking and excessive use of alcohol are almost always factors in the development of the disease. Thus, patients can substantially reduce their risk of throat cancer by making several healthy lifestyle choices.

Throat cancers may be caught in their early stages, which can substantially improve the odds of a favorable prognosis. Regular dental checkups can often reveal early signs of oropharyngeal cancers. A primary care physician should also examine the throat as part of any routine cancer-related checkup. In addition, suspicious changes in the mouth and throat may be detected in routine dental visits.

Of the various throat cancers, oropharyngeal is the most common, followed by laryngeal, hypopharyngeal and nasopharyngeal. There are various forms of treatment for throat cancers, including surgery, chemotherapy and radiation therapy. 

About throat cancers

Throat cancers are malignant tumors that develop between the rear of the mouth and the esophagus. There are several types, including:

  • Oropharyngeal cancer. Cancer of the oropharynx, which is the area just behind the mouth. This is the most common form of throat cancer. The American Cancer Society (ACS) estimates that about 34,000 news cases of oral cavity and oropharyngeal cancer will be diagnosed in the United States in 2007. The ACS predicts that nearly 7,600 individuals will die from this disease the same year.

  • Laryngeal cancer. Cancer of the larynx, or “voice box.” It is the second most common form of throat cancer. There will be more than 11,000 new cases of laryngeal cancer in 2007 and the disease will cause about 3,600 deaths, according to the ACS. These rates are dropping by 2 to 3 percent a year, primarily due to fewer people smoking.

  • Hypopharyngeal cancer. Cancer of the hypopharynx, the entrance to the esophagus, or food pipe. It is the third most common form of throat cancer with an estimated 2,500 new cases in 2007.

  • Nasopharyngeal cancer. Cancer of the nasopharynx, an area at the back of the nose located just above the soft palate. The soft palate, also known as the velum, is a muscular piece of tissue that makes up the rear portion of the roof of the mouth. It separates the mouth from the pharynx and can open and close for swallowing and speaking. This type of cancer is very rare in the United States. In North America, it occurs in only 7 out of every one million patients accounting for about 2,000 cases per year in the United States.

Throat cancers begin when cells in the throat tissue grow and divide abnormally. Groups of abnormal cells in the throat are often classified as one of two types:

  • Leukoplakia. A white area of abnormal tissue that is usually noncancerous (benign). However, 25 percent of these abnormalities are cancerous (malignant) or precancerous (dysplasia), according to the American Cancer Society (ACS).

  • Erythroplakia. A slightly raised, red area that bleeds easily when scraped. These abnormalities are usually more serious than leukoplakia, with 70 percent diagnosed as either precancerous or cancerous.

A biopsy of the suspected tissue is needed for laboratory analysis by a pathologist. Biopsies can reveal the exact nature of these abnormalities. Precancerous cells often do not progress to actual cancer and can disappear without any treatment. This is especially true when factors that trigger precancerous conditions – such as tobacco use and heavy drinking – are stopped.

However, some precancerous cells do become cancerous, developing into carcinoma in situ (CIS), the earliest form of cancer. This occurs when cancer cells develop in the lining layer without invading deeper areas of the tissue or spreading to other parts of the body. Most early cancers can be cured, often by stripping or destroying the lining layer with laser surgery. Left untreated, most cancers will spread.

The majority of throat cancers are squamous cell cancers.. Squamous cells are flat, scale-like cells lining the throat.  As cancers spread from the throat, they often destroy nearby tissues and spread to other parts of the body (metastases).

Some areas of the throat have minor salivary glands that can develop cancers as well, including adenocarcinomas, adenoid cystic carcinomas and mucoepidermoid carcinomas. The tonsils and base of the tongue also contain lymphoid tissue that can develop into lymphomas.

Types and differences of throat cancers

There are four major types of throat cancers. The most common type is called oropharyngeal cancer, which develops just behind the mouth, in the area of the throat known as the oropharynx. This includes the back one-third of the tongue, the soft palate, the tonsils and tonsillar pillars and the back wall of the throat, known as the posterior pharyngeal wall.

More than 90 percent of cancers in the oropharynx are squamous cell carcinomas. Invasive oropharyngeal cancer that spreads into the deep tissue layers of the oropharynx is more common in African Americans than in white people. The rate of incidence has been declining for more than two decades, which may be due to a decline in smoking.

The tonsils and base of the tongue contain immune system (lymphoid) tissue that can develop into a cancer. But these cancers are not as common as squamous cell carcinomas.

Patients diagnosed with oropharyngeal cancer often have other associated cancers. Upon initial diagnosis, about 15 percent are found to have another cancer in a nearby area such as the voice box (larynx), the esophagus or the lung, according to the American Cancer Society (ACS). Another 10 percent to 40 percent will develop such cancers at a later time.

Laryngeal cancer (cancer of the larynx, or “voice box”) is the second most common type of throat cancer. The larynx contains the vocal cords and is located in the front of the neck in the area commonly known as the “Adam’s apple,” which is more prominent in men. The larynx is divided into three sections, with the cancer treated differently depending on where it starts:

  • Glottis. The area between the vocal cords. Vocal cords open when a person breathes to let air into and out of the lungs. They are largely responsible for voice production, including pitch and sound of a person’s voice. About 60 percent of laryngeal cancers begin in the vocal cords, according to the ACS.

  • Supraglottis. Area above the vocal cords. It includes the epiglottis, which closes off the larynx during swallowing and helps prevent food from entering the windpipe (trachea). About 35 percent of laryngeal cancers begin in the supraglottis, according to the ACS. 

  • Subglottis. Area below the vocal cords. About 5 percent of laryngeal cancers begin in the subglottis, according to the ACS.

As with oropharyngeal cancer, almost all laryngeal cancers develop from squamous cells in the lining layer of the larynx. Cancers such as chondrosarcomas or synovial sarcomas very rarely develop from connective tissues of the larynx.

Hypopharyngeal cancer is the third most common form of throat cancer. Cancer cells grow in the hypopharynx, which is the entrance to the esophagus, or food pipe, that lies beside and behind the larynx. Food travels through the hypopharynx into the esophagus before reaching the stomach. The structure of the hypopharynx ensures that food goes around the larynx and into the esophagus.

Like oropharyngeal and laryngeal cancers, almost all hypopharyngeal cancers develop from squamous cells in the lining layer of the hypopharynx. Cancers such as chondrosarcomas or synovial sarcomas very rarely develop from connective tissues of the hypopharynx.

The rarest form of throat cancer is nasopharyngeal cancer, which develops in the nasopharynx, an area at the back of the nose near the base of the skull and located just above the soft palate. It differs from the other throat cancers in that it tends to spread widely and is not often treated with surgery. This type of cancer also has different risk factors than the other throat cancers. 

Nasopharyngeal carcinoma (NPC) is the most common malignant tumor of the nasopharynx. There are three types of NPC:

  • Keratinizing squamous cell carcinoma (type 1)
  • Nonkeratinizing carcinoma (type 2)
  • Undifferentiated carcinoma (type 3)

Treatment is usually the same for all three types of NPC. When determining the prognosis for these cancers, the extent that the disease has spread is more important than the type of NPC. 

Nasopharyngeal cancer is rare in North America, where it accounts for less than 1 percent of all cancers and about 2 percent of all head and neck cancers, according to the ACS. However, the cancer is much more common in areas of Asia and North Africa. The prevalence of the Epstein-Barr virus (the virus that causes infectious mononucleosis) along with cultural dietary preferences, such as salt-preserved foods, are associated with the incidence of this cancer. It also occurs more often in immigrant groups in the United States, such as recent Chinese immigrants and people from Southeast Asia. NPC most often affects people between ages 30 and 50, but is occasionally seen in children.

Risk factors and causes of throat cancers

Scientists do not completely understand what causes throat cancers, although the role of some risk factors has been established. For example, use of tobacco and excessive drinking damage cells. Tobacco use damages cell DNA, while alcohol increases the sensitivity of cells to DNA-damaging chemicals. The damage to DNA creates abnormalities that can produce tumors.  For this reason, the combination of alcohol use and tobacco use is especially dangerous and increases the risk of developing throat cancers.

The risk factors associated with throat cancer can be divided into two groups: those that affect oropharyngeal, laryngeal and hypopharyngeal cancers and those that affect nasopharyngeal cancer.

Risk factors associated with oropharyngeal, laryngeal and hypopharyngeal cancers include:

  • Human papillomavirus (HPV) infection. Papillomaviruses are a group of more than 100 related viruses, many of which may cause warts on various parts of the body. HPV may contribute to oropharyngeal cancers in about 20 percent of people, and may also be a factor in laryngeal and hypopharyngeal cancers.

  • Suppressed immune system. Patients who are taking immunosuppressive drugs to either treat various immune-system diseases or prevent rejection of transplanted organs may be at greater risk for these cancers.

  • Dietary factors. Malnutrition and vitamin deficiencies may be related to an increased risk of throat cancers. Eating smoked or salt-preserved foods, which contain nitrates, has also been associated with increased risk.

  • Occupational exposure. Long and intense exposures to industrial chemicals such as metalworking chemicals or asbestos may increase the risk.

  • Recreational drugs. The use of drugs such as marijuana has been linked to a higher incidence of throat cancers.

  • Age. Throat cancers are very rare in children. The risk of being diagnosed with these cancers increases with age. For example, half of all patients are older than age 65.

  • Gender. Oropharyngeal cancer is twice as common in men as in women. Meanwhile, laryngeal and hypopharyngeal cancers are four to five times as common in men as women. This may be related to increased use of alcohol and tobacco among men.

  • Race. African Americans are much more likely to be diagnosed with these cancers than whites.

Nasopharyngeal cancer risks include:

  • Diet. NPC has been associated with diets high in salt-cured fish and meat, such as those of people in areas of Asia, northern Africa and the Arctic region.

  • Epstein-Barr virus infection. Almost all nasopharyngeal cancer cells contain the Epstein-Barr virus (EBV), an infection that causes infectious mononucleosis, commonly known as “mono.” The link between EBV infection and NPC is not well-understood.

  • Gender. Males are twice as likely to be diagnosed as females.

Signs and symptoms of throat cancers

The signs and symptoms of oropharyngeal, laryngeal and hypopharyngeal cancer vary depending on the location of the cancer. Some of the most common symptoms are a sore in the throat that does not heal or pain in the throat that does not go away. Individuals also may notice an unusual lump or thickening in the neck.

Other signs and symptoms can include:

  • Persistent white (leukoplakia) or red patch on the lining of the throat or tonsils
  • Continual sore throat or feeling that something is caught in the throat
  • Difficulty moving the jaw or tongue or swallowing problems
  • Voice changes or hoarseness
  • Weight loss
  • Persistent bad breath
  • Ear pain
  • Breathing difficulties

Signs and symptoms of nasopharyngeal cancer include the following:

  • Hearing loss (especially on one side only)
  • Nasal blockage or stuffiness
  • Pain
  • Nosebleeds
  • Difficulty opening the mouth
  • Blurred or double vision

Some throat cancers often do not present many symptoms. For example, a neck mass indicating metastasis to the nearby lymph nodes is the only apparent sign of cancer in about one-third of patients with nasopharyngeal cancer.

Diagnosis methods for throat cancers

Throat cancers can sometimes be caught in their early stages. This is important, because detecting cancer early usually leads to a more favorable prognosis. Regular dental checkups can often reveal early signs of oropharyngeal cancers. A primary care physician should also examine the throat as part of any routine cancer-related checkup.

A physician will compile a thorough medical history and perform a complete physical examination. If throat cancer is suspected, the patient may be referred to a specialist such as an oral and maxillofacial surgeon or an otolaryngologist (head and neck surgeon) for a complete evaluation.

Tests that may be performed include:

  • Head and neck exam. This may include a nasopharyngoscopy, pharyngoscopy and laryngoscopy. Special fiberoptic endoscopes (flexible, lighted, narrow tubes inserted through the mouth or nose) and mirrors are used to examine the throat area. There are two primary types of head and neck exams:

    • Indirect pharyngoscopy, nasopharyngoscopy or laryngoscopy. Use of small mirrors to look at the pharynx, nasopharynx, base of the tongue or larynx.

    • Direct pharyngoscopy, nasopharyngoscopy or laryngoscopy. Endoscope is used to examine the area as patients with oral or oropharyngeal cancer have a higher risk for more cancers in other parts of the head and neck region. The region behind the nose, the larynx, and the lymph nodes of the neck are examined carefully for any signs of cancer

  • Panendoscopy. This is an examination of the throat that is performed while the patient is under general anesthesia. The procedure is performed if the risk of a head or neck cancer are high and can include laryngoscopy, esophagoscopy, and possible bronchoscopy. It is performed if the odds of a head and neck cancer are high. The oral cavity, oropharynx, larynx, esophagus, and the trachea and bronchi (breathing passageways that lead to the lungs) are all examined by endoscope. 

Samples of suspected tissue (biopsy) may be obtained during these procedures. The samples are sent to a pathologist for analysis for indications of the presence of cancer and if present, the type and stage of the cancer.

Other tests that may be performed to look for cancer of the throat – or cancer that has spread to other regions – include:

  • X-ray. Chest and head x-rays as well as dental x-rays.

  • CAT scan (Computed axial tomography).  Uses multiple x-ray images and computerized technology to produce cross-sectional images of the body.

  • MRI (Magnetic resonance imaging). Test that produces clear cross-sectional or three-dimensional images of the body’s tissues, even through bone and other obstructions.
  • PET scan (Positron emission tomography). A small amount of radioactive tracer is combined with a sugar substance and injected into the body. Cancerous tumors absorb greater amounts of the tracer, which appear as hot spots on the images. This test is often used to detect signs of metastasis.

  • Barium swallow. A barium compound is swallowed, coating various internal structures, such as the throat, esophagus and the inner lining of gastrointestinal (GI) tract. This test can detect physical abnormalities such as tumors or esophageal constrictions and may be used to diagnose swallowing problems (dysphagia). 

Not all throat cancers can be detected early. For example, cancers of the nasopharynx usually spread quickly to the lymph nodes before symptoms occur. Over 80 percent of patients diagnosed with NPC have advanced cancer at the time of diagnosis, according to the American Cancer Society (ACS).

Treatment options for throat cancers

There are many different treatments for throat cancers. The treatment used will vary depending on the location of the cancer, the type and its stage of development (extent of spread). The patient’s general health and additional factors will also be considered in treatment planning. Treatment often will combine a number of approaches, including:

  • Surgery. Some throat cancers can be cured by resecting (removing) the tumor. This may involve inserting instruments into the mouth to remove the throat cancer, or using an incision in the neck.

    In other cases, surgery may include removal of the larynx. This procedure, known as a laryngectomy, may be necessary when cancer has affected tissue in the laryngeal area. In a laryngectomy procedure, the larynx or voice box is removed. The windpipe is then attached to the skin of the neck as a hole (stoma). The patient breathes through the hole and will have to undergo speech therapy to learn to communicate. Some patients may be able to communicate with esophageal speech, which uses the walls of the throat instead of the vocal cords, to produce voice.  In other patients, a device may be placed in the stoma to produce a synthetic voice. Some patients may use an external device known as an electrolarynx to produce a voice. The small vibrating instrument is held against the throat while the patient mouths words. Swallowing skills  may be affected with a laryngectomy and patients may need to receive therapy for dysphagia (difficulty swallowing). A  speech-language pathologist can provide therapy for swallowing and communication problems.

Other forms of surgery that may be used to treat patients with throat cancer include:

  • Lymph node dissection.. Removal of lymph nodes affected by cancer spread.

    • Pedicle or free-flap reconstruction. Throat defects caused by removal of large tumors may require reconstruction using tissue from another part of the body.

    • Pharyngectomy. Removal of a portion or all of the hypopharynx. Several reconstructive procedures can be used to rebuild the pharynx and improve the patient’s ability to swallow after the operation. Usually the larynx must also be removed.

    • Tracheostomy. Cancers that block the throat and are too large to remove may require a tracheostomy. This is a hole in the neck that bypasses the tumor and allows the patient to breathe more easily through the neck.

    • Vocal cord stripping (removing superficial layers of vocal cord tissue) or cordectomy (removing part or all of the vocal cords).

  • Radiation therapy. Uses specialized high-energy beams or particles to destroy cancer cells or slow their rate of growth. This therapy may be more effective for those patients who have quit smoking. It may be used before or after surgery and in combination with chemotherapy. In addition to external radiation therapy, patients may receive internal radiation, also known as brachytherapy. This type of treatment uses radioactive “seeds” or capsules that are implanted directly into or near the tumor. 

  • Chemotherapy. Use of powerful drugs that destroy cancer cells and help prevent them from spreading. Chemotherapy may be given intravenously or taken by mouth. Chemotherapy typically uses a combination of drugs and is given when the cancer is suspected to have spread in the body.

Other types of treatments are being researched in clinical trials.

Prevention methods for throat cancers

Throat cancers cannot always be prevented. In some cases, patients will develop throat cancer despite having none of the major risk factors associated with the disease. However, lifestyle factors play a crucial role in the development of many throat cancers. Thus, patients can substantially reduce their risk of throat cancer by making several lifestyle choices, including:

  • Avoiding tobacco use. Tobacco use is a major contributor to most forms of throat cancer. For example, about 90 percent of patients with oropharyngeal cancer use tobacco, according to the American Cancer Society (ACS). The longer a person uses tobacco – and the more frequently they use it – the higher the risk of developing cancer.

  • Not drinking excessive amounts of alcohol. Alcohol use increases the risk of throat cancer. The combination of drinking and smoking particularly increases a person’s risk of getting this cancer.
  • Eating a healthy diet. Diets low in fruits and vegetables have been associated with an increased risk of developing throat cancers. The ACS recommends eating at least five servings of fruits and vegetables every day, as well as servings of whole grain foods from plant sources such as breads, cereals, grain products, rice, pasta or beans. People should also eat fewer red meats, especially those processed (like deli meat) or high in salt and/or fat.

Ongoing research in throat cancers

There is considerable research being conducted on cancers of the throat. Scientists are studying the causes and prevention of the disease, as well as more effective treatment methods. Areas of research include:

  • DNA. Scientists are studying DNA changes that may contribute to the development of oral, oropharyngeal and laryngeal cancers. Studies have found that mutations of the p53 gene may be linked to the growth of cancer cells in the mouth and throat. Researchers continue to work on developing tests that may detect the p53 gene mutation to help identify early oral and laryngeal tumors. These tests also may help physicians define the margins of a tumor, which is used to determine if all the cancer cells have been removed. Such tests also have potential to determine which tumors will respond better to surgery or radiation therapy.

    Other studies are focusing on DNA changes and the human papillomavirus (HPV). Scientists are working tests that may detect HPV DNA, which may lead to earlier diagnosis of throat cancers. HPV vaccines that prevent cervical cancer are being evaluated in terms of oral cancer prevention.
  • Chemoprevention and chemotherapy. Scientists are evaluating several drugs that may be used in chemoprevention of certain throat cancers. These drugs may help prevent precancerous lesions from becoming cancerous or prevent cancerous growths from returning. Other chemopreventive agents are being tested to help prevent a second primary tumor from developing in head and neck cancer patients.

    Researches continue to work on new chemotherapy drugs or combinations that may be more effective against throat cancers. Scientists are studying the use of intralesional chemotherapy, which involves injecting drugs directly into a tumor. Initial use of this approach was limited because the drug appeared to quickly spread to nearby tissues. However, improvements with the drug solution have renewed an interest in this therapy. Researchers are also studying the injection of chemotherapy drugs into arteries feeding the cancer in advanced laryngeal cancer patients.

Growth factors. Oral, oropharyngeal and laryngeal cancers have been associated with certain growth factors. These hormone-like substances attach to receptors that signal cells to grow and divide. Too much growth factor can cause cancer cells to grow especially fast and spread in the body. One particular growth factor that has been linked to throat cancers is called epidermal growth factor (EGF).

Scientists have developed several new drugs to block EGF receptors. Three of these drugs, known as EGFR inhibitors, are being used in clinical trials for head and neck cancers. The drugs have shown limited effectiveness on their own but may help make chemotherapy and radiation more effective.

Another drug, cetuximab is a monoclonal antibody and has been shown to be successful in shrinking and eliminating oral cancers when given along with radiation therapy. It has been recently approved by the Food and Drug Administration (FDA) to use with radiation in patients with advanced oral cancer. Further studies on growth hormone inhibitors are being continued.

Staging throat cancers

The prognosis (predicted outlook or chance of survival) of throat cancers depends on the cancer’s stage and grade. The stage indicates the extent of the cancer, or how widespread it is in the body. The grade measures how abnormal the cells look under a microscope. The grading and staging systems are combined into another system that allows the physician to discuss the pathology in plain terms.

Sometimes, additional letters will follow the initial pathology such as “Tm,” which indicates the presence of multiple cancers or “Tis,” which indicates that the cancer is superficial (carcinoma in situ) and has not invaded surrounding tissues. For more information, please see Stages of Cancer.

Stages vary depending on the type of throat cancer:

  • Oropharyngeal cancer 

    • Stage 0: No evidence of tumor.

    • Stage I: Tumor 2 cm (about ¾ inch) or smaller.

    • Stage II: Tumor larger than 2 cm, but smaller than 4 cm (about 1.5 inches).

    • Stage III: Tumor larger than 4 cm.

    • Stage IV: Tumor of any size that invades adjacent structures (such as bone, connective or muscle tissue of the neck, deep muscle of the tongue, skin, sinuses, or the larynx).

  • Nasopharyngeal cancer

    • Stage 0: No evidence of tumor.

    • Stage I: Tumor is limited to the nasopharynx.

    • Stage II: Tumor has spread to tissues (but not bone) outside the nasopharynx. Cancer has spread to the oropharynx (the back of the mouth, below the soft palate, where the throat begins) and/or nasal cavity but no further; or, cancer has also spread to the left or right sides of the upper part of the throat.

    • Stage III: Tumor has spread to the sinuses or the bones near the nasopharynx.

    • Stage IV: Tumor has spread into the skull and/or cranial nerves (nerves in the head that lie near the nasopharynx and have special functions such as vision, smell, and eye movement), the hypopharynx (lower part of the throat), the eye or its nearby tissues.

  • Laryngeal cancer – Supraglottic

    • Stage 0: No evidence of tumor.

    • Stage I: The tumor is limited to 1 subsite of the supraglottis, and the vocal cords move normally.

    • Stage II: The tumor invades more than 1 subsite of the supraglottis; the vocal cords move normally.

    • Stage III: The tumor is limited to the larynx, and the vocal cords do not move and/or invasion of the postcricoid area, paraglottic space, or pre-epiglottic (in front of the epiglottis) tissues.

    • Stage IV: The tumor invades through thyroid cartilage (firm tissue that separates the thyroid gland from the front of the larynx) and/or extends to tissues beyond the larynx. The tumor invades prevertebral (in front of the cervical spine) space, is growing around a carotid artery, or is growing down into the front of the chest cavity.

  • Laryngeal cancer – Glottic

    • Stage 0: No evidence of tumor

    • Stage I: The tumor is limited to the vocal cord(s); the vocal cords move normally. The tumor is either limited to one vocal cord or appears on both.

    • Stage II: The tumor is growing into the supraglottis and/or subglottis, and/or the vocal cords move only a little.

    • Stage III: The tumor is limited to the larynx and the vocal cords do not move and/or the tumor invades the paraglottic space, and/or there is minor erosion of thyroid cartilage (firm tissue that separates the thyroid gland from the front of the larynx).

    • Stage IV: The tumor invades through thyroid cartilage and/or extends to tissues beyond the larynx. The tumor invades prevertebral space (in front of the cervical spine), surrounds a carotid artery, or is growing down into the front of the chest cavity.

  • Laryngeal cancer – Subglottic

    • Stage 0: No evidence of tumor.

    • Stage I: The tumor is limited to the subglottis.

    • Stage II: The tumor extends to the vocal cords, with normal or reduced vocal cord movement.

    • Stage III: The tumor is limited to the larynx; the vocal cords do not move.

    • Stage IV: The tumor invades through the cricoid or thyroid cartilage and/or extends to tissues beyond the larynx. The tumor invades prevertebral space (in front of the cervical spine), surrounds a carotid artery, or is growing down into the front of the chest cavity.

  • Hypopharyngeal cancer

    • Stage 0: No evidence of tumor.

    • Stage I: The tumor is limited to 1 subsite of the hypopharynx and is smaller than 2 centimeters (about 3/4 of an inch) in diameter.

    • Stage II: The tumor involves more than 1 subsite of the hypopharynx or an adjacent site or is 2 to 4 cm in size, and does not affect the vocal cords.

    • Stage III: The tumor is larger than 4 cm in diameter or is affecting the vocal cords.

    • Stage IV: The tumor invades the cricoid or thyroid cartilage, hyoid bone, thyroid gland, esophagus, or the strap muscles in front of the larynx. The tumor invades the space in front of the cervical spine, is growing around a carotid artery, or is growing down into the front of the chest cavity.

Questions for your doctor about throat cancers

Preparing questions in advance can help patients have more meaningful discussions with their physicians regarding their conditions. Patients may wish to ask their doctor the following questions about throat cancers:

  1. Am I at risk for throat cancer?

  2. What tests will be used to diagnose my cancer?

  3. What type of cancer do I have and where is it located?

  4. What is the stage and grade of my cancer?

  5. Do I need to have surgery? If so, what is involved?

  6. Can surgery remove all of the cancer?

  7. Will I need additional treatments before or after surgery?

  8. If I have surgery, how will it affect my speech and swallowing?

  9. Who will help me with these problems?

  10. What can be done if I cannot get enough nutrition?

  11. What are the chances of my cancer returning?

  12. Does this cancer put me at higher risk for other cancers?

  13. How will my cancer be monitored following treatment?

  14. What is the prognosis based on my cancer?

  15. Can you recommend some support groups for patients with throat cancers?
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