Neck & Throat Cancer
Neck and throat cancers usually form in the squamous cells lining the inside of the mouth, nose, and throat. They are highly curable if detected early, and often respond well to surgery or radiation treatment.
Cancers in this region are classified according to where they are located in the body. They include:
- Oral cavity. This region includes the lips, tongue, hard palate, gums, and mouth.
- Larynx. Comprised of the vocal cords and epiglottis.
- Pharynx. There are three sections of the throat: the nasopharynx (the upper portion, located behind the nose), oropharynx (the middle section, which includes the soft palate and tonsils), and hypopharynx (the lower portion).
- Paranasal sinuses. The nasal cavity.
- Salivary glands. Located at the bottom of the mouth near the jawbone.
Other types of cancers in close proximity, like brain tumors and thyroid cancer, behave very differently and are not considered cancers of the neck and throat.
Causes of Throat Cancer
The majority of neck and throat cancers are caused by tobacco use; smoking cigarettes and chewing tobacco both substantially increase your risk of cancer. Alcohol use, especially in people who also smoke, is another contributing factor. Exposure to industrial toxins, a diet high in red meats and processed foods, human papillomavirus (HPV), Epstein-Barr virus, and acid reflux can all add to your risk.
Symptoms of Throat Cancer
Many symptoms of throat cancer are associated with other, less serious conditions, so don’t worry needlessly if you experience some of these signs. Make an appointment with a doctor for a thorough exam and diagnosis if any of the following symptoms are persistent:
- Chronic cough (especially if you are coughing up blood)
- Hoarseness or other changes in your voice
- Difficulty swallowing
- Lumps or sores on the neck
- Ear or neck pain
- Sore throat
- Weight loss
Your doctor will attempt to rule out other, more common causes first. They will examine your throat with a lighted scope and likely order a biopsy if an abnormality is spotted. Imaging tests, including X-rays, CT scans, MRIs and PET scans, can help your doctor see how far your cancer has spread. Once diagnosed, the cancer will be assigned a stage (I-IV) that indicates its extent and helps determine which course of treatment to pursue.
Treatment for throat cancer depends on the tumor’s size, location and whether it has spread to other areas of the body. Radiation therapy, surgery and chemotherapy – or a combination of the three – may be employed.
Radiation therapy delivers radiation to the cancerous cells through X-rays or other high-energy beams, causing them to die. It is most effective in early-stage cancers, where it may be the only treatment necessary.
Surgery can be effective for cancers of various stages. Procedures to remove all or portions of your voice box (laryngectomy) or throat (pharymgectomy) may be necessary. If cancer has spread to the lymph nodes, a neck dissection to remove those cancerous cells may be recommended.
Chemotherapy relies on chemicals to kill cancer cells. It is often used in combination with radiation therapy for better results.
Following treatment, you may need speech therapy or swallowing therapy, depending on the procedure(s) performed.
Transoral Robotic-Assisted Surgery (TORS)
When a patient has been diagnosed with an oral cancer, transoral robotic-assisted surgery (TORS) may be an option if the tumor needs to be removed. TORS is a minimally invasive surgery that can be done through the mouth. It uses a sophisticated, computer enhanced system to guide surgical tools. This system gives the surgeon an enhanced view of the cancer and surrounding tissue.
TORS was developed in 2004 by Dr. Gregory Weinstein and Dr. Bert O’Malley Jr. at the University of Pennsylvania. TORS uses the da Vinci Robot System, which was already in use at the time in urologic, thoracic and abdominal procedures. The doctors realized this system could also be useful in otolaryngological procedures. The FDA approved da Vinci for TORS in 2009 after data proved it would cure cancer with less operating time, blood loss and complications.
TORS may be used to treat cancers of the:
During the surgery, the surgeon will sit at a control console a short distance from the patient and operating table. They will precisely control the motion of the surgical instruments using two hand-and-finger control devices. The console display will show a magnified, 3-D view of the intended surgical area, which enables the surgeon to visualize the procedure in greater detail than laparoscopic surgery.
This surgery typically has fewer complications and shorter hospital stays compared to traditional surgery; however, there are certain risks as there are with any procedure. The exact risk will depend on the extent and type of surgery but they include bleeding, infection, difficulty speaking, difficulty swallowing and salivating.
If detected early, throat cancers have a cure rate of 90 percent. If cancer has spread to surrounding tissues or lymph nodes, it is curable in 50 to 60 percent of patients.