Throat cancer includes cancer that forms in tissues of pharynx (the hollow tube inside the neck that starts behind the nose and ends at the top of windpipe) and larynx (voice box). Larynx and pharynx cancers are the third most common cancers diagnosed in Indian male after lung and oral cavity cancer. More than 60,000 cases are diagnosed every year with the throat cancer.
Risk Factors – Tobacco is by far the most common cause of throat cancer. Both smoking and ‘smokeless’ tobacco (tobacco chewing) increases the risk of throat cancer. Heavy alcohol use, diet low in fruits or vegetables is the other factors associated with the development of throat cancer.
When to see a doctor – A sore throat that doesn’t go away, pain or difficulty in swallowing, hoarseness or change in voice quality, ear pain, a lump in neck are the common symptoms of throat cancers. These symptoms may be caused by other less serious conditions. It is important to check with your doctor for any of these.
Diagnostic Tests – In making a diagnosis of throat cancer, your doctor will start by recording your medical history, asking about any symptoms you may be experiencing and conducting a thorough physical examination. Your doctor may also recommend some tests like endoscopy (to visualise the throat), CT scan or PET scan (additional information regarding the spread to adjacent areas, staging of disease), cytology or biopsy (removal of tissue to confirm the diagnosis).
How are throat cancers treated?
Throat cancer patients are best treated by a multi-disciplinary team of specialists that includes surgical oncologist, radiation oncologist, medical oncologist, dieticians, speech and physical therapists. The treatment plan for an individual patient depends on number of factors including the site of disease, stage of the disease, person’s age and general health. The patient and doctor should consider and discuss each treatment option carefully.
1. Surgery – It may involve removal of a part of throat, voice box. In these cases the ability to speak, swallow or breathe may be affected. Surgery is usually reserved for advanced cases now-a-days.
2. Radiation Therapy – This treatment involves the use of high energy X-rays to kill cancer cells. Traditionally it was used as an adjunct after the surgery in throat cancers. With the better understanding of tumor biology and behaviour, technological advancement in radiation planning and delivery, radiation alone (in early cases) or combined with chemotherapy has become the new standard of care since past decade. Radiation therapy not only provides good tumor control rates but also helps in preservation of organ form and function i.e.is speech and swallowing.
3. Chemotherapy – This treatment uses drugs to kill cancer cells. The co-administration of chemo-radiotherapy has provided a credible alternative of organ preservation to throat cancer of patients. Chemotherapy not only kills cancer cells throughout the body, but also enhances the action of radiation.
4. Targeted Therapy – This treatment includes drugs that act at molecular level to destroy or inhibit cancer cell growth. Unlike chemotherapy they have fewer side-effects.
Regular follow-up care is very essential after treatment of throat cancer to make sure the cancer has not returned. The medical check-up could include neck or throat examination. From time to time doctor may perform blood tests, CT or PET scans.
Quitting smoking and alcohol not only lowers the risk of throat cancer, but also reduces the chance of developing new second cancers in already treated patients.
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