Throat Cancer

Head and neck cancer occurs when tumor cells develop in the area that extends from the back of the nose to the bottom of the larynx. Depending on the location, it is classified into different types:

Pharyngeal Cancer: Affects the tube connecting the nasal passages to the larynx and the upper part of the esophagus. It is further subdivided into:

Nasopharyngeal Cancer: Develops in the upper part of the throat, in the retro-nasal area, behind the nose. These tumors are difficult to diagnose due to their location and are generally associated with infection by certain viruses.

Oropharyngeal Cancer: Appears in the back of the mouth, in the initial part of the pharynx.

Laryngeal Cancer: Also known as hypopharyngeal or laryngopharyngeal cancer. It affects the lower part of the throat that borders the esophagus and trachea, with the following subtypes:

Glottic Cancer: Tumor affects one or both vocal cords.

Supraglottic Cancer: Originates in the upper part of the larynx, above the vocal cords.

Subglottic Cancer: Develops in the lower part of the larynx, below the vocal cords.

In most cases, head and neck cancer arises from the proliferation of cells from the epithelium of the mouth, pharynx, or larynx. It is a flattened, thinned epithelium, and the cells are called "squamous cells." Sarcomas and melanomas of the mucosa in these locations are very rare.

When detected at early stages and with no distant spread, the prognosis is better. According to data from the Spanish Association Against Cancer, the five-year survival rate after diagnosis can reach 76% for laryngeal cancer, 59% for supraglottic cancer, and 90% for glottic cancer.

Head and neck cancer predominantly affects men and is closely related to smoking.

Symptoms

Symptoms can vary depending on the type of tumor and the location where it originates. Some of the most common symptoms include:

• Odynophagia (pain when swallowing).
• Dysphonia (loss of voice tone): Common in vocal cord cancer.
• Difficulty breathing.
• Referred otalgia (pain radiating to the ear).
• Cough.
• Persistent sore throat.

Causes

Smoking is the primary cause of head and neck cancer, as the cells of the pharynx and larynx epithelium are highly exposed to the carcinogenic agents in tobacco. This effect is intensified by alcohol consumption, which is also common in these patients.

Risk Factors

Factors that increase the risk of developing throat cancer include:

• Smoking: Regardless of the type (cigarettes, pipes, cigars, or chewing tobacco), smoking is the main cause of tumors in the mouth, larynx, and pharynx. The risk increases with the amount consumed and the duration of the habit.
• Excessive alcohol consumption (mainly affects the larynx).
• Unbalanced diet, especially one low in fruits and vegetables.
• Gastroesophageal reflux.
• Human papillomavirus (HPV) infection.

Complications

Some of the most common complications of throat cancer are:

• Malnutrition caused by difficulty swallowing.
• Airway obstruction.
• Partial or complete loss of voice.
• Complications from surgery, which is often aggressive and may involve partial or total laryngectomy and the need for a tracheostomy (an opening in the trachea for breathing).
• Complications from radiotherapy treatment. Patients often require the placement of a feeding tube directly into the stomach due to difficulty swallowing caused by inflammation from the radiotherapy.

Prevention

• Avoid alcohol and tobacco consumption, even passively.
• Use personal protective equipment (PPE) in workplaces exposed to chemical agents.
• Follow a balanced diet rich in fruits and vegetables, limiting red meats and processed foods.
• Protect yourself against HPV through safe sexual practices or even vaccination.

Which Doctor Treats Throat Cancer?

The management of head and neck carcinoma requires a multidisciplinary approach, involving many specialists, particularly otolaryngologists and maxillofacial surgeons. The role of the radiotherapy oncologist is essential, and together with the medical oncologist, they usually plan the treatment for these patients.