Throat or larynx cancer
Definition
Throat cancer is cancer of the vocal cords, larynx (voice box), pharynx, or other areas of the throat.
Alternative Names
Vocal cord cancer; Throat cancer; Laryngeal cancer; Cancer of the glottis; Cancer of oropharynx or hypopharynx; Cancer of the tonsils; Cancer of the base of the tongue
Causes
People who smoke or use tobacco are at risk of developing throat cancer. Drinking too much alcohol over a long time also increases risk. People who both smoke and drink alcohol have the highest risk for throat cancer.
Most throat cancers develop in adults older than 50. Men are more likely than women to develop throat cancer.
Human papillomavirus (HPV) infection (the same virus that causes genital warts) account for a larger number of oral and throat cancers than in the past. One type of HPV, type 16 or HPV-16, is much more commonly associated with almost all throat cancers.
Symptoms
Symptoms of throat cancer include any of the following:
- Abnormal (high-pitched) breathing sounds
- Cough
- Coughing up blood
- Difficulty swallowing
- Hoarseness that does not get better in 3 to 4 weeks
- Neck or ear pain
- Sore throat that does not get better in 2 to 3 weeks, even with antibiotics
- Swelling or lumps in the neck
- Weight loss not due to dieting
Exams and Tests
The health care provider will perform a physical exam. This may show a lump on the outside of the neck.
The provider may look in your throat or nose using a flexible tube with a small camera at the end.
Other tests that may be ordered include:
- Biopsy of suspected tumor. This tissue will also be tested for HPV.
- Chest x-ray.
- CT scan of chest.
- CT scan of head and neck.
- MRI of the head or neck.
- PET scan.
Treatment
The goal of treatment is to completely remove the cancer and prevent it from spreading to other parts of the body.
When the tumor is small, either surgery or radiation therapy alone can be used to remove the tumor.
When the tumor is larger or has spread to lymph nodes in the neck, a combination of radiation and chemotherapy is often used to save the voice box (vocal cords). If this is not possible, the voice box is removed. This surgery is called a laryngectomy.
Depending on what type of treatment you require, supportive treatments that may be needed include:
- Speech therapy.
- Therapy to help with chewing and swallowing.
- Learning to eat enough protein and calories to keep your weight up. Ask your provider about liquid food supplements that can help.
- Help with dry mouth.
Support Groups
You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone.
Outlook (Prognosis)
Throat cancers may be cured when detected early. If the cancer has not spread (metastasized) to surrounding tissues or lymph nodes in the neck, about one half of patients can be cured. If the cancer has spread to the lymph nodes and parts of the body outside the head and neck, the cancer is not curable. Treatment is aimed at prolonging and improving quality of life.
It is possible but not fully proven that cancers which test positive for HPV may have better outlooks. Also, people who smoked for less than 10 years may do better.
After treatment, therapy is needed to help with speech and swallowing. If the person is not able to swallow, a feeding tube will be needed.
The recurrence risk in people with throat cancer is highest during the first 2 to 3 years of diagnosis.
Regular follow-up after the diagnosis and treatment is very important to increase the chances of survival.
Possible Complications
Complications of this type of cancer may include:
- 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
Contact your provider if:
- You have symptoms of throat cancer, especially hoarseness or a change in voice with no obvious cause that lasts longer than 3 weeks
- You find a lump in your neck that does not go away in 3 weeks
Prevention
Do not smoke or use other tobacco products. Limit or avoid alcohol use.
HPV vaccines recommended for children and young adults target HPV subtypes most likely to cause some head and neck cancers. They have been shown to prevent most oral HPV infections. It is not clear yet whether they also are able to prevent throat or larynx cancers.
References
Armstrong WB, Vokes DE, Tjoa T, Verma SP. Malignant tumors of the larynx. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 105.
Garden AS, Morrison WH. Larynx and hypopharynx cancer. In: Tepper JE, Foote RL, Michalski JM, eds. Gunderson & Tepper's Clinical Radiation Oncology. 5th ed. Philadelphia, PA: Elsevier; 2021:chap 41.
National Cancer Institute website. Nasopharyngeal cancer treatment (adult) (PDQ) - health professional version. www.cancer.gov/types/head-and-neck/hp/adult/nasopharyngeal-treatment-pdq. Updated July 13, 2022. Accessed April 14, 2023.
Rettig E, Gourin CG, Fakhry C. Human papillomavirus and the epidemiology of head and neck cancer. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 74.
Yarbrough WG, Zanation A, Patel S, Mehra S. Head and neck. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 34.
Reviewed By: Josef Shargorodsky, MD, MPH, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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