Throat cancer can be a complex condition to manage and treat. If you or a loved one has been diagnosed with throat cancer, we know you may have questions about it. Experts at the OSUCCC – James are here to help you learn more about throat cancer and make informed decisions about your care. The OSUCCC – James is home to central Ohio’s only dedicated Head and Neck Oncology Clinic that specializes in treating throat cancer. Our team will be with you every step of the way, from diagnosis to survivorship.
What is throat cancer?
Throat cancer refers to cancer affecting any area within the throat. It’s a general term used to describe several subtypes of cancer.
Many complex structures are in the throat that perform or help with specific functions from swallowing to breathing. Over time, abnormal cancer cells grow out of control and can form a tumor. This tumor may impact one or more of those functions.
The location of the tumor will also determine the type of throat cancer and its treatment options.
Types of throat cancer
There are several subtypes of throat cancer. The type of cancer can determine different treatment options.
The main subtypes include:
- Laryngeal cancer: These cancers affect the larynx. This is the area around the voice box (larynx) and vocal cords near the throat's front.
- Pharyngeal cancer: This cancer forms in the pharynx. The pharynx is a channel behind the nasal passages, leading into the larynx and esophagus.
- Tonsil cancer: Tonsil cancer occurs in the back of the throat. Each person has two tonsils on either side of the throat. Tonsils are made up primarily of lymphoid tissue and are designed to help ward off infections and bacteria.
- Base-of-tongue cancer: This cancer forms on the back part of tongue, the part that sits closest to the throat.
What causes throat cancer?
Cells are the foundation of our body’s tissues; your throat, as well as the rest of your body, is made up of them. Our cells also have “instructions” called DNA. These “instructions” tell cells how to grow and replicate. Healthy cells grow and reproduce at a normal rate.
However, in some people, these instructions can change over time, causing cells to grow out of control and replicate abnormally. When this occurs, a cancerous tumor (mass) can form in the throat.
Researchers aren’t sure what causes this in some people and not others. However, some risk factors may increase the likelihood that it could happen in certain cases. Risk factors are anything that increases your chances of developing a condition.
It’s important to remember that just because you may have a risk factor, it doesn’t mean you’ll develop the condition. If you’re at risk for throat cancer, talk to your doctor and your dentist to understand your potential risk of developing cancer and what to monitor.
Throat cancer risk factors
There are different risk factors associated with throat cancer.
Some of the major risk factors for throat cancer include:
- Tobacco use: Smoking cigarettes or using other types of tobacco, including chewing tobacco or smokeless tobacco, is associated with increased risks of throat cancer when compared to non-tobacco users. Nearly 90% of all head and neck cancers, including throat cancer, occur in people who use tobacco. If you currently use any form of tobacco, you should quit. There are many tools available to help you stop using tobacco, from medications to nicotine replacement therapies.
- Excessive alcohol use: Drinking any type of alcohol in excess can increase your risk of throat cancer. Those who are moderate to heavy drinkers are more likely to develop throat cancer. If you drink alcohol in excess and use tobacco, your risk of developing throat cancer increases exponentially.
- HPV infection status: Those who have had human papillomavirus (HPV) infections are at risk of developing throat cancer. HPV is a common sexually transmitted infection with no cure. But most cases of HPV tend to resolve on their own. However, some strains of HPV (like HPV 16) can cause changes in your throat’s cells that can lead to cancer over time. The Gardasil 9 vaccine can help prevent HPV infections for both men and women. Talk to your doctor about getting vaccinated if you’re eligible.
- Sex: Throat cancer is more likely to occur in males assigned at birth when compared to females assigned at birth. Biological males tend to report higher rates of smoking, excessive alcohol consumption and higher rates of sexual partners leading to increased exposure to HPV, which all can increase the likelihood of developing throat cancer. Biological females can still develop throat cancer but are less likely to when compared to males.
- Age: Adults over 50 are most likely to be diagnosed with throat cancer. Throat cancer can grow slowly and may take longer to be diagnosed.
Throat cancer symptoms
Throat cancer can have different symptoms depending on its location. Please note that just because you may have one or two symptoms, doesn’t mean you have throat cancer. These symptoms may overlap with other treatable conditions like strep throat or an ear infection. It’s important to schedule an appointment with your doctor to determine the exact cause of your symptoms. Early detection of throat cancer can be key to positive treatment outcomes for this complex condition. If you’re aware of early signs of throat cancer, pay attention to your body and contact your doctor if something seems unusual.
Early signs of throat cancer
One of the earliest symptoms of throat cancer or other mouth cancers is a change to your voice. If your voice becomes hoarse or muffled and the change lasts longer than two weeks with no apparent cause, it could be a sign of concern.
Sometimes this voice change is referred to as “hot potato voice,” because it resembles the sound you might make with a mouth full of hot food.
Other common symptoms of throat cancer
Other symptoms of throat cancer may include:
- Sore throat that won’t go away
- Difficulty swallowing, chewing or eating
- Ear pain or pressure
- Lump or bump around the neck or throat
- Vocal changes (hoarseness, raspiness)
- Unintended weight loss
What does throat cancer feel like?
Depending on where your throat cancer starts and the stage at which it’s diagnosed, you may feel like there’s a lump in your throat or that it’s difficult to swallow. Throat cancer can feel like there’s something stuck in your throat, but you can’t clear it.
What does throat cancer look like?
Depending on where your throat cancer starts and the stage at which it’s diagnosed, you may see redness, swelling or sores in the back of your throat or mouth. You may also see a mass in your neck if the cancer has spread to your lymph nodes.
When to see a doctor
While the cause of these symptoms is much more likely to be a common and less severe condition, consult a health care provider about any changes you experience in your throat and mouth. This is especially true if the symptoms are:
- Persistent
- Out of the norm
- Causing pain or limiting your ability to accomplish daily living
- Lasting longer than two weeks
Diagnosing throat cancer
Throat cancer can be diagnosed using a variety of imaging tests or procedures. Your doctor will first perform a physical exam. From there, they may order one or more tests to help form an accurate diagnosis.
Imaging
Imaging tests allow your doctors to gain better understanding of any suspected tumors and to diagnose your condition. Some of the imaging tests your doctor may order include:
- X-ray
- Ultrasound
- Computed tomography (CT) scan
- Magnetic resonance imaging (MRI) scan
- Positron emission tomography (PET) scan
- Laryngoscopy
- Endoscopy
- Panendoscopy
A panendoscopy is done under general anesthesia, so you won’t feel anything; the exam will look into your mouth, nose, throat and windpipe. Endoscopies and laryngoscopies use thin, flexible tubes (endoscopes) inserted down the throat into the upper gastrointestinal (GI) tract.
Biopsies
Your doctor may order a biopsy of any areas that are of concern in the throat. A doctor will remove a tissue sample from the area in question, often using a local numbing agent. Once the sample has been obtained, a specially trained OSUCCC – James pathologist will look at it under a microscope. The results will be communicated to your doctor shortly after the analysis is completed. Afterwards, your doctor will follow up with you about the results and next steps. If it’s throat cancer, treatment will largely depend on the location, stage and subtype.
Treatment options for throat cancer
When it comes to treating throat cancer, the head and neck oncologists at the OSUCCC – James will work with you, your family and other health care providers on your team to develop a personalized treatment plan.
Treatments available at the OSUCCC – James can be very effective at treating throat cancer, but we’re also continuously working to improve these therapies, so they have less side effects.
Your throat is important to enjoying your favorite foods, communicating with others and even breathing — and our throat cancer experts will do everything possible to minimize damage to it during treatment. The James Voice and Swallowing Clinic, which is one of the largest in the Midwest, will help you regain functions you might lose or that might be impacted from treatment. When you or a loved one is diagnosed with throat cancer, where you go for care matters.
Recommended therapies will be based on a variety of factors, including the type of throat cancer, whether it has spread and your overall health. Also, treatment options might depend on whether the cancer was caused by the human papillomavirus (HPV).
We’ll always opt for the least invasive treatment possible with the best chance of giving you a positive outcome. Some treatments doctors might recommend include:
Nonsurgical treatments
There are various treatment methods for throat cancer that don’t involve surgery. Sometimes doctors use these alone, or sometimes before or after surgery. Nonsurgical options for throat cancer treatment include:
- Radiation therapy – This mode of treatment involves administering high-energy beams to kill cancer cells and slow the growth of new ones. We’re increasingly using proton therapy, a form of radiation that allows us to better target cancer cells with fewer side effects. The OSUCCC – James is currently the only hospital in central Ohio offering proton therapy.
- Chemotherapy – Chemotherapy contains medications that kill cancer cells. For throat cancer, this can sometimes be added to radiation therapy regimens or before or after surgery. It can be administered intravenously (IV) or via a pill/capsule form.
- Targeted therapy – In targeted therapy, the medication attacks certain proteins on cancer cells that help them grow and spread. For certain types of throat cancer, a pill called cetuximab (Erbitux) can be used to target these proteins. If you have a more advanced cancer, this drug can be given alongside radiation therapy.
- Immunotherapy – Treatment advancements now enable us to use our body’s immune system to identify and destroy cancer cells in a process called immunotherapy. This can be a course of treatment for later-stage throat cancer.
Surgical treatments
Surgery can be an effective way of removing, and in many cases, treating, throat cancer.
At the OSUCCC – James, our expert head and neck surgeons have helped develop some of the most advanced surgical techniques that allow people with throat cancer to not only survive but have a high quality of life following their surgery.
Possible surgical treatments for throat cancer may include:
- Transoral robotic surgery (TORS) – This type of surgery is used to remove cancer from areas of the throat that may be difficult to reach. Cameras are attached to a robot and produce three-dimensional images that specialized surgeons can see. A surgeon uses special controls with small tools at the end of the robot’s arms to remove the cancer.
- Laryngectomy – This surgery removes part of or all the voice box (larynx). If tumors are small, surgeons will remove as little of the voice box as possible, preserving your voice. If the entire voice box needs to be removed, a tracheotomy will allow you to breathe, and you’ll have several options to restore your voice. A speech therapist will work with you to learn to speak again.
- Pharyngectomy – When part of the throat (pharynx) is removed, it’s called a pharyngectomy. Sometimes a laryngectomy is performed simultaneously if the cancer spreads to the voice box. Your surgeon can reconstruct the throat to allow you to swallow food normally.
- Neck dissection – If the cancer has spread to lymph nodes in the neck, a neck dissection will remove the diseased lymph nodes.
Care after throat cancer treatment
At the OSUCCC – James, we treat the whole person. Our head and neck cancer specialists will ensure you have access to all the care and services you need following your treatment for throat cancer. We want you to thrive, not just survive cancer.
The James Voice and Swallowing Clinic is one of the largest clinics in the Midwest dedicated solely to cancers and other malignancies that can impact voice and swallowing. It’s a one-of-a-kind clinic where we’ll take a multidisciplinary approach to treat any of your voice and swallowing concerns.
Some of the care you might need after throat cancer treatment includes:
- Speech therapy
- Swallowing therapy
- Reconstructive surgery
- Dental care
- Pain management
- Physical therapy for stiff neck and other neck issues
Throat cancer clinical trials
Because we are one of only 57 National Cancer Institute-designated comprehensive cancer centers in the United States, you’ll have access to the most advanced and leading-edge throat cancer therapies, including a variety of clinical trials. Our dedicated physicians and advanced practice providers are not only on the front lines of treating people with throat cancer in doctor’s offices and operating rooms, but they’re also working diligently in laboratories to find cures, better diagnostic tools and prevention methods.
Currently, there are more than 20 active head and neck cancer clinical trials at the OSUCCC – James. Examples of our work include:
- Efficacy of adding evorpacept to a treatment plan with pembrolizumab for people with certain types of metastatic and inoperable head and neck cancers
- Comparing radiation with high-dose cisplatin every three weeks versus radiation with low-dose cisplatin weekly in advanced stage head and neck cancer
Why choose the OSUCCC – James for throat cancer treatment?
The OSUCCC – James is the third-largest cancer hospital in the United States, with dedicated experts who treat throat cancer and other types of head and neck cancers. We offer the latest in treatment options that aren’t available elsewhere. Our clinical experts provide personalized, compassionate cancer care all at one facility.
Specialized Head and Neck Oncology Clinic for treating throat cancers
We operate one of the only dedicated clinics to throat cancer in the region. At the Head and Neck Oncology Clinic, located on the fifth floor of the OSUCCC – James, our collaborative team uses a multidisciplinary approach to treat your cancer type. There are over 200 specialists on-site dedicated to understanding your cancer and addressing your specific needs, from head and neck medical oncologists to speech pathologists. The team works together to create a customized treatment plan for you.
Access to head and neck cancer clinical trials
The OSUCCC – James offers phase I, phase II and phase III clinical trials for potential new throat cancer treatments. At any time, we have over 500 clinical trials open, including several for head and neck cancers. Your doctor will determine if you’re a candidate for a throat cancer clinical trial.
If you have received a throat cancer diagnosis or want a second opinion, call 800-293-5066 or 614-293-5066 to make an appointment today.