Throat cancer: Causes, symptoms and treatment

Lower pharyngeal cancer is cancer that starts in the lower pharynx (usually in the pear sinus area), when cancer spreads into the larynx, it is called hypopharynx-laryngeal cancer. This is the second leading cancer (after arch cancer) in ENT cancers. Common age is 45-65 with male/female ratio = 5/1.

Learn about throat cancer

Causes of throat cancer

The cause of throat cancer is not clear. Some of the risk factors associated with throat cancer include:

• Smoking: The level of smoking is directly proportional to the incidence of cancer of the lower throat.
• Alcoholism: Prolonged drinking causes local irritation of the throat mucosa. Smoking and alcoholism are two major risk factors for throat cancer.
• Poor oral hygiene: Poor oral hygiene makes commensal bacteria thrive, causing chronic inflammation in the throat, protracted inflammation is a favorable factor of throat cancer.
• HPV virus: HPV infection is a risk factor for nasopharyngeal cancer, including throat cancer.
• Chronic irritation of the pharynx due to gastroesophageal reflux is also a risk factor for the disease.
• Plummer-Vinson syndrome: characterized by dysphagia, iron deficiency anemia, and esophageal reticulum. The disease is associated with an increased incidence of throat cancer in Nordic non-smoking women.
• Environment: environmental pollution or workers' exposure to asbestos, wood dust increases the risk of throat cancer.

Throat cancer is often silent for a long time.

Symptoms of throat cancer

Throat cancer is often silent for a long time. Symptoms of throat cancer appear gradually, including:

• Swallowing disorders: difficulty swallowing, swallowing problems gradually increase, first on one side, then spread to both sides of the throat.
• Sore throat pain, persistent, increasing, may be accompanied by ear pain.
• Swollen lymph nodes in the neck: solid, firm, limited mobility, no pain.
• In the late stage, the patient has weight loss, shortness of breath and hoarseness due to the tumor invading the larynx and nerves.

What are the stages of throat cancer? Throat cancer has 4 stages:

• Stage 1: Tumor is smaller than 2cm, growing in a lower pharynx area, has not invaded around and has not developed cervical lymph nodes.
• Stage 2: The tumor is larger than 2cm but smaller than 4cm, or invades other sites of the lower pharynx or spreads around but has not invaded the vocal cords, the larynx has not been fixed. The patient has not developed cervical lymphadenopathy and has not metastasized to distant organs.
• Stage 3: The tumor is larger than 4cm or has affected the vocal cords or has invaded the esophagus. The patient may have lymphadenopathy with lymph node size less than 3cm on one side of the neck.
• Stage 4: The tumor has invaded cartilage, bone, and soft tissue. Patients may have bilateral cervical lymphadenopathy and distant metastases.

Subjects at risk of throat cancer

• The male patient has a history of alcoholism and smoking for many years
• People infected with HPV types 16, 18
• People with a history of exposure to toxic chemicals asbestos
• People with Plummer-Vinson syndrome
• People with a history of prolonged gastroesophageal reflux

Is throat cancer contagious ? This is a non-communicable disease. To prevent the disease, there are a number of non-specific measures as follows:

• The most important measure is to quit drinking and smoking as these are the two main risk factors.
• Labor protection in hazardous chemical environments
• Complete treatment of gastroesophageal reflux disease.
• Balanced nutrition, avoiding malnutrition and vitamin deficiency. The American Cancer Society emphasizes healthy eating: lots of vegetables, fruits, and whole grains, while limiting red meat and processed foods.
• Prevent HPV infection with vaccines, safe sex.
• Clean teeth, treat diseases of the nose and throat area thoroughly.
• When symptoms appear hoarse, difficulty breathing, difficulty swallowing (especially in patients over 40 years old), it is necessary to go to an otolaryngologist for early detection of the disease.

Throat cancer treatment

Tests to help diagnose the disease:

• Laryngoscopy-laryngoscopy: laryngoscopy with a rigid or flexible tube helps to directly evaluate the lesion: location, number, and nature of the tumor and helps in diagnostic biopsy.
• Pathology: Click biopsy of the lesion for the surest result. May be combined with lymphadenectomy to determine nodal invasion of the tumor.
• Computed tomography of the neck: assessment of tumor spread to cervical lymph nodes or surrounding tissues

Is throat cancer curable? Throat cancer is a disease that has not been completely cured so far. The main treatment measures include: surgery, radiation, chemotherapy and immunotherapy.

• Surgery: depending on the stage of the disease, appropriate surgery is indicated (partial or total pharyngo-laryngectomy with or without cervical lymphadenectomy)
• Radiation: can be radiotherapy alone or adjuvant radiotherapy after surgery
• Chemotherapy and immunotherapy: systemic treatment in end stage nasopharyngeal cancer.

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