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Throat cancer is a common way of referring to some head and neck cancers, usually squamous cell carcinomas. Its precise usage varies, as different researchers and practitioners define the area of the throat in different ways.

As with other squamous cell carcinomas, the tumor begins to develop in the tissue lining the hollow organs of the body. These cancer cells tend to rapidly multiply, killing the healthy cells, and causing death unless they are stopped or slowed down in time.

Contents 1 Definitions 2 What could be wrong 3 Risk factors 4 Types of throat cancer 4.1 Squamous Cell Carcinoma 4.2 Epidimoid Cancer 4.3 Adenocarcinoma 4.4 Hypo-Pharangeal cancer 4.5 Oro-Pharangeal cancer 4.6 Esophogeal cancer 4.7 Cancer of the Larynx 5 Treatment 5.1 Surgery 5.2 Radiation therapy 5.3 Chemotherapy 6 Effects on body systems 6.1 Digestive system 6.2 Respiratory system 6.3 Others 7 Prevention/prophylaxis 8 Statistics for throat cancer 9 References

Some define throat cancer as the cancer of the pharynx and so refer to it as pharyngeal cancer. This includes cancer of:

• The nasopharynx, the area behind the throat
• The oropharynx, the area at the base of the tongue, including the soft palate and tonsils
• The hypopharynx, which is the bottom of the throat.

Others restrict their definition of throat cancer to include the vocal cords and larynx (voice box).

Throat Cancer usually begins with symptoms that seem harmless enough, like an enlarged lymph node on the outside of the neck, a sore throat or a hoarse sounding voice. However, in the case of throat cancer, these conditions may persist and become chronic. There may be a lump or a sore in the throat or neck that does not heal or go away. There may be difficult or painful swallowing. Speaking may become difficult. There may be a persistent earache. Other possible but less common symptoms include some numbness or paralysis of the face muscles.

There are a wide variety of factors which can put someone at a heightened risk for throat cancer. Such factors include smoking or chewing tobacco or other things, such as betel, gutkha, marijuana or pan, heavy alcohol consumption, poor diet resulting in vitamin deficiencies (worse if this is caused by heavy alcohol intake), weakened immune system, asbestos exposure, prolonged exposure to wood dust or paint fumes, exposure to petroleum industry chemicals, and being over the age of 55 years. Another risk factor includes the appearance of white patches or spots in the mouth, known as leukoplakia; in about ⅓ of the cases this develops into cancer.

The presence of acid reflux disease (GERD - gastroesphogeal reflux disease) or larynx reflux disease can also be a major factor. In the case of acid reflux disease, stomach acids flow up into the esophagus and damage its lining, making it more prone to throat cancer.

Ethnicity may also play a part, with African American men in the U.S. being found to be at a 50% higher risk of throat cancer than caucasian men.

Throat cancers are classified according to their histology or cell structure, and are commonly referred to by their location in the oral cavity and neck. This is because where the cancer appears in the throat affects the prognosis - some throat cancers are more aggressive than others depending upon their location. The stage at which the cancer is diagnosed is also a critical factor in the prognosis of throat cancer.

Squamous cells are the epithelium (tissue layer) that is the surface cells of much of the body. Skin and mucous membranes are squamous cells. This is the most common form of larynx cancer, accounting for over 90% of throat cancer.^{[reference please]} Squamous Cell Carcinoma is most likely to appear in males over 40 years of age with a history of heavy alcohol use coupled with smoking.

(See Squamous Cell Carcinoma)

Adenocarcinoma is a cancer of the columnar epithelium typical of the lower esophagus. It is typical of Barrett's Esophagus but may be at another location. Adenocarcinoma is thought of as a product of Barrett's Esophagus.

Examples of locational nomenclature are:

Often a dark white spot appears on the throat where it is visible.

Some would describe esophageal cancer as a throat cancer.^{[citation needed]}

Cancerous tumors can occur anywhere in the larynx, like on the vocal cords (most common) or above them or below the glottis which is the opening at the top of the larynx. Less prevalent are tumors above (supraglottic) or below the glottis (subglottic) but these are also the throat cancers with the worst prognosis because they tend to spread or metastasize more rapidly than other types of throat cancer.

Many different treatments and therapies are used in the treatment of throat cancer. The type of treatment and therapies used are largely determined by the location of the cancer in the throat area and also the extent to which the cancer has spread at time of diagnosis. Patients’ also have the right to decide whether or not they wish to consent to a particular treatment. For example, some may decide to not undergo radiation therapy which has serious side effects if it means they will be extending their lives by only a few months or so. Others may feel that the extra time is worth it and wish to pursue the treatments.

Surgery as a treatment is sometimes used in cases of throat cancer. In such cases an attempt is made to remove the cancerous cells. This can be particularly tricky if the cancer is near the larynx and can result in the patient being unable to speak. Surgery is more commonly used to resection (remove) some of the lymph nodes to prevent further spread of the disease.

Radiation therapy is the most common form of treatment. There are different forms of radiation therapy. One of newer treatments is Intensity-modulated radiotherapy or IMRT which is able to focus more precisely so that fewer healthy cells are destroyed than was the case with some of the older radiation therapies. IMRT reduces incidental damage to the many important structures of the throat and mouth that may not be involved. However if the cancer has metastisized or is widespread, the older form of treatment may be the most effective at slowing the progression of the disease. Radiation will generally cause the patient to feel sicker and weaker for several weeks following the treatment, but is a very effective treatment in stopping the disease.

A typical radiation course could be 37 consecutive daily sessions of 11 one-minute exposures at positions encircling the neck. The patient is immobilized by a plastic mask that snaps into holes on the treatment table. The table is adjusted so that lasers mounted on the ceiling hit dots on the mask. The computer then adjusts the gantry arm and head, table, and shutters, makes the exposure and adjusts again for the next exposure.

Chemotherapy in throat cancer is not generally used to cure the cancer as such. Instead, it is used to provide an inhospitable environment for metastases so that they will not establish in other parts of the body. Typical chemotherapy agents are a combination of Taxol and Carboplatin. Erbitux is also used in the treatment of throat cancer. While not specifically a chemotherapy, Amifostine is often administered intravenously by a chemotherapy clinic prior to a patient's radiotherapy sessions. Amifostine protects the patient's gums and salivary glands from the effects of radiation.

Throat cancer has numerous negative effects on the body systems.

As it can impair a person’s ability to swallow and eat, throat cancer affects the digestive system. The difficulty in swallowing can lead to a person to choke on their food in the early stages of digestion and interfere with the food’s smooth travels down into the esophagus and beyond.

The treatments for throat cancer can also be harmful to the digestive system as well as other body systems. Radiation therapy can lead to nausea and vomiting, which can deprive a body of vital fluids (although these may be obtained through intravenous fluids if necessary). Frequent vomiting can lead to an electrolyte imbalance which has serious consequences for the proper functioning of the heart. Frequent vomiting can also upset the balance of stomach acids which has a negative impact on the digestive system, especially the lining of the stomach and esophagus.

In the cases of some throat cancers, the air passages in the mouth and behind the nose may become blocked from lumps or the swelling from the open sores. If the throat cancer is near the bottom of the throat it has a high likelihood of spreading to the lungs and interfering with the person’s ability to breathe; this is even more likely if the patient is a smoker, because they are highly susceptible to lung cancer. If the respiratory system is unable to bring oxygen into the body, the oxygen deprivation will cause the body's cells to wither and die, causing one to become weaker and sicker.

Like any cancer, metastasization affects many areas of the body, as the cancer spreads from cell to cell and organ to organ. For example, if it spreads to the bone marrow, it will prevent the body from producing enough red blood cells and affects the proper functioning of the white blood cells and the body's immune system; spreading to the circulatory system will prevent oxygen from being transported to all the cells of the body; and throat cancer can throw the nervous system into chaos, making it unable to properly regulate and control the body.

In considering the previously listed risk factors and symptoms it makes sense that you should contact your doctor if you have a sore throat, difficulty in swallowing, or an earache that just does not seem to go away. This is also the case if your voice seems to be hoarse for a prolonged time. Family doctors have guidelines to follow from The Department of Health which indicate that a doctor should make an urgent appointment with a specialist in Ear Nose and Throat (ENT) if a patient presents with difficulty in swallowing or a lump in the neck area for over three weeks or a hoarse voice which has lasted over six weeks. These symptoms may not be the result of throat cancer but just to be on the safe side they should be examined.

Not smoking and not chewing tobacco (betel, gutka or pan included) will decrease your chances of developing this disease. Other preventive measures include eating a sensible, well-balanced diet(one that is low in saturated fat and rich in whole grains, fruits, and vegetables). Such diet can include alcohol, but only in moderation(Moderate alcohol intake is two drinks per day for men and one drink per day for women). If you suspect you might have Gastroesophageal Reflux Disease, it is best to contact your doctor. This is also good advice to follow if you have white spots in your mouth or have developed sore which do not seem to go away. Regular visits to a dentist are also recommended because part of the dental exam includes looking at the interior of your mouth so the dentist may notice spots or sores that a patient may have been unaware of before the exam. In this case the dentist can advise a patient to check it out further by contacting their family doctor. Early detection and treatment of this disease is crucial in a patient’s fight against this disease.

Many people may still be alive today had they taken such preventative measures. These also include some famous individuals who succumbed to this devastating disease. For example, Graham Chapman of Monty Python fame died relatively young of throat cancer. In most of his skits he is shown smoking and this was most likely what put him at heightened risk for the disease. He mentioned that the primary site of his cancer was the spot where the jet of smoke from his pipe hit the back of his throat. Likewise, Sammy Davis Junior, a heavy smoker, also died of throat cancer. The world of entertainment seems to put its stars at increased risk because smoking, heavy alcohol consumption, and poor diets are commonly found in this environment. Dr. Seuss, also a smoker, died of related jaw cancer.

• In the U.S. there were 28,900 people diagnosed with cancers of the throat and oral cavity in 2002. ^[1]
• Seventy-four hundred Americans are projected to die of these cancers. ^[1]
• More than 70% of throat cancers are at an advanced stage when discovered. ^[2]
• Men are 89% more likely than women to be diagnosed with, and are almost twice as likely to die of, these cancers. ^[1]
• African-American men are at a 50% higher risk of throat cancer than Caucasian males.^{[reference please]}
• Smoking and tobacco use are directly related to Oro-pharangeal (throat) cancer deaths. ^[3]

1. ^ ^{a b c} Cancer Facts and Figures, http://www.cancer.org/downloads/STT/CancerFacts&Figures2002TM.pdf,, American Cancer Society 2002.
2. ^ Throat Cancer patient information web page, http://cancer.nchmd.org/treatment.aspx?id=741, NCH Healthcare Systems, 1999
3. ^ Reducing the Health Consequences of Smoking: 25 Years of Progress. A Report of the Surgeon General, U. S. Department of Health and Human Services, Public Health Service,Centers for Disease Control and Prevention, 1989.sad