Types of Throat Cancer

Symptoms and risk factors

What are the first signs of throat cancer?

Symptoms of throat cancer will vary based on the location of the tumor and may include:

• Lumps in the mouth or neck
• Sore throat
• Changes in your voice or breathing
• Difficulty swallowing

Depending on where your tumor is located, it's also possible to experience the following:

• Ear pain
• Bleeding sores in the mouth
• Bad breath
• Nasal obstruction

Other conditions can also cause these symptoms, so it’s important to see a doctor right away. Keep in mind that oropharyngeal cancers caused by HPV infection are often harder to detect than tobacco-related cancers because the symptoms are often subtle and painless.

Who is at risk for developing this cancer?

Tobacco use is one of the primary risk factors for developing throat cancer. In addition, smoking or chewing tobacco in combination with excessive alcohol consumption can elevate the risk even more.

Even those who don't smoke may still be at risk for developing certain throat cancers. For example, oropharyngeal cancer is closely linked to certain strains of the human papillomavirus (HPV), a sexually-transmitted infection. Not everyone infected with HPV will develop cancer, but knowing if you have an HPV-positive cancer is vital for determining treatment options. Please keep in mind that:

• There is no cure for HPV, but most people with infections from the particularly troublesome strains do not develop cancer.
• While the HPV vaccine cannot help patients already diagnosed with oral or oropharyngeal cancer, it can help lower the risk of this disease. Parents are encouraged to vaccinate their children at age 11 or 12, though men and women can get the shots as late as 26.
• Oral and oropharyngeal cancers are tested for HPV, and those that are positive often respond well to treatment, with expected cure rates significantly higher than cancers caused by smoking.
• We are particularly knowledgeable about HPV-related head and neck cancers—one of our pathologists developed the vaccine and continues to research the diseases. That helps us appreciate the nuances of these cancers and the best treatment approach.

Other factors that could increase your risk of nasopharyngeal cancer include:

• Having Asian ancestry
• Exposure to the Epstein-Barr virus (EBV), a herpes virus that normally causes mild symptoms and is transmitted through bodily fluids like saliva, sex, blood transfusions, and organ transplants

Screening and prevention

Can I prevent these cancers?

Not all instances of these cancers are preventable. However, you can lower your risk of developing head and neck cancers by:

• Quitting tobacco use
• Avoiding excessive alcohol consumption

At MedStar Health, we offer individualized smoking cessation programs and support throughout the region. Find a program nearby.

Diagnosis

How is throat cancer diagnosed?

To make a complete and accurate diagnosis, your doctor may perform the following:

• Medical history
• Physical examination
• Complete exam on your mouth, nose, head, and face to determine the type and nature of the growth
• Remove a small tissue sample for biopsy, which will help determine the kind of cancer, how aggressive it is, and the best way to treat it

Different diagnostic studies may be ordered, including imaging studies, lab tests, and detailed physical examinations. These exams and tests help the doctor determine the type of cancer and its stage, how aggressive it is, and whether it has spread. These may include:

• Nasal endoscopy is used by your doctor to view the upper airways and inside the nostrils, the throat, and vocal cords. This is normally done by inserting a scope with a light and camera down the nose and throat.
• Panendoscopy includes direct laryngoscopy (look at voice box), esophagoscopy (esophagus), and bronchoscopy (bronchial tubes and lungs) to stage the tumor and look for additional tumors within these areas.
• Other imaging tests, such as X-ray, MRI, CT, or PET scans, may be used to evaluate other suspicious areas in the body and determine the extent of disease (stage).

Treatments

What are my throat cancer treatment options?

Treatment  for throat cancer depends on when and where the cancer is found, as well as the type and grade of the tumor and your overall health. Your treatment will be discussed and planned by a team of multidisciplinary specialists with expertise in different medical fields. Working together, we can more effectively personalize a treatment plan that will offer the best possible outcome for you, considering all of the available treatment options.

Surgery

When surgery is recommended as part of your treatment, you can expect our head and neck surgeons to offer the latest surgical options using advanced technology that allows us to precisely plan and execute your surgery. We're skilled in performing all of the latest surgical techniques in both open surgery and minimally invasive procedures, balancing the goal of a cure with preservation of your appearance and throat function.

Whenever possible, our ENT and reconstructive surgeons prioritize less invasive approaches, such as Transoral Robotic Surgery (TORS). This allows us to operate through the mouth, eliminating the need for external incisions. As a result, many patients benefit from shorter hospital stays, faster recoveries, and less impact on swallowing and speech. Your surgeons will help determine whether these options are right for you.

For other patients, traditional open surgery may be the best option. Our head and neck surgeons are also experts in performing advanced procedures, including complex surgeries that may not be offered elsewhere. In addition, they work closely with reconstructive surgeons to rebuild parts of the throat and mouth affected by throat cancer. Our goal is always to preserve your quality of life, so we also work closely with speech pathologists and other rehabilitation experts to restore your natural ability to eat and speak to the best extent possible.

Chemotherapy

Chemotherapy may be used in combination with radiation therapy or surgery for certain patients with throat cancer. This type of therapy uses powerful medications to kill cancer cells throughout the body. As part of your multidisciplinary team, a medical oncologist will help determine if this treatment option is right for you.

Learn More About Chemotherapy

Immunotherapy and targeted therapy

For others with advanced cancer, targeted therapy or immunotherapy may offer innovative options for slowing cancer growth and boosting the immune system's response to the cancer. Many of these newer treatments are being studied in clinical trials, and your doctors will determine whether or not they may offer an effective option for treating your cancer.

Learn More About Immunotherapy

Learn More About Targeted Therapy

Radiation therapy

Your treatment team includes a radiation oncologist, who will determine if you would benefit from radiation therapy. This type of therapy uses high-energy waves or particles to destroy cancer cells. At MedStar Health, we offer the latest advances in radiation technology to more precisely pinpoint cancer cells while limiting the amount of radiation exposure to healthy tissue. For example, we were the first in the world to use proton beam therapy using HYPERSCAN^TM, making our doctors some of the most experienced in the region in treating patients with throat cancer using this cutting-edge therapy.

Learn More About Radiation Therapy