DIAGNOSIS
Your doctor will examine you and ask about your general health, smoking and drinking habits, and sexual history. He might use devices to get a closer look at your throat.
If the doctor thinks you may have cancer, he’ll order tests and procedures depending on what kind he suspects. Common ones include:
A biopsy collects a tissue sample that gets examined under a microscope to look for cancer cells. It’s the only way to know for sure if a tumor is cancer and what kind it is. The procedure may be done with surgery, fine needles, or an endoscope—a flexible tube with a camera that’s lowered into the throat through your nose or mouth. A tool on the end will take the biopsy.
Imaging tests can help doctors find a tumor. They can also show how big it is and if it has spread. These include:
- MRI or CT scan
- PET scan
- X-rays
If cancer of the oropharynx is found, the sample may be tested for HPV. Usually, someone’s health outlook is better if their disease tests positive for this virus rather than being smoking-related cancer.
Throat cancer has four stages. Each type of this cancer has its own rules for staging, which describes how severe the disease is. But generally, stages I and II are smaller cancers and remain in one area of the organ. Stage III diseases may have spread to lymph nodes or other parts of the throat. And stage IV cancers may have spread to lymph nodes and different parts of the head, neck, or chest. The most serious stage IV cancers have traveled to distant parts of the body like the lungs or liver.
TREATMENTS
Doctors will try to get rid of the tumor, keep the cancer from spreading, and protect your ability to swallow and speak as much as possible. Your treatment will depend on:
- The stage of your cancer
- Where it is
- Your general health
- Your preferences
There are several treatments available.
Radiation uses high-energy rays to kill cancer cells. It’s given outside your body by a machine, or inside by radioactive seeds planted near the cancer. Sometimes radiation is the only treatment needed for early-stage cancers. But it can be used with chemotherapy or surgery to treat later-stage disease.
Surgery may be done through incisions with a scalpel. It may also be less invasive—going in through the mouth with a tube called an endoscope, or with lasers or robotic techniques.
Very early cancers can usually be taken out with endoscopes or lasers.
If your cancer is more advanced, parts or all of your larynx or pharynx may need to be removed. This may affect your ability to swallow, breathe, or speak normally.
Doctors may use tissue from another spot in your body to rebuild parts of your throat to help you swallow.
If your voice box is removed, the surgeon will attach your windpipe to an opening in your neck, called a stoma, so you can breathe.
If cancer has spread deep in your neck, your surgeon may do an operation to remove lymph nodes.
Chemotherapy drugs can kill cancer and stop it from spreading. It may be used before surgery to shrink tumors, or after to keep the disease from coming back. Some chemo drugs can make radiation work better.
Targeted therapy drugs can starve cancer cells by blocking substances they need to grow.
Your doctor can prescribe medication to help you manage pain.
You may have problems during or after your treatment. Specialists can:
- Show you how to care for your stoma
- Teach you to speak if you have no voice box
- Come up with ways to make swallowing or eating easier
