Throat cancer is a type of head and neck cancer that occurs in the throat or surrounding area. It is usually a squamous cell carcinoma because it typically starts in the squamous cells lining the throat.
Throat cancer: learn more
Throat cancer refers to cancerous tumors that develop in the throat or pharynx, the voice box or larynx, or the tonsils. Your throat is a muscular tube that begins behind your nose and ends in your neck. The throat and the voice box are closely connected—your voice box is located just below your throat.
Throat cancer can also affect the piece of cartilage called the epiglottis that acts as a lid for your windpipe. Tonsil cancer, another type of throat cancer, affects the tonsils, which are located on the back of the throat.
We still don’t know the exact cause, but throat cancer develops when cells from the parts of the throat develop mutations in their DNA and grow out of control. These abnormal cancer cells can form a tumor and may spread to other areas of the head and neck, or other parts of the body.
Types of throat cancers
Though most throat cancers involve squamous cells, specific terms are used to differentiate the part of the throat where cancer originated:
Nasopharyngeal cancer. The nasopharynx is the part of your throat just behind your nose.
Oropharyngeal cancer. The oropharynx is the part of your throat right behind your mouth that includes your tonsils.
Hypopharyngeal cancer or laryngopharyngeal cancer. The hypopharynx or laryngopharynx is the lower part of your throat, just above your esophagus and windpipe.
Glottic cancer. The vocal cords.
Supraglottic cancer. The upper portion of the larynx. This includes cancer that affects the epiglottis.
Subglottic cancer. The lower portion of your voice box, below your vocal cords.
Throat cancer symptoms, risk factors, and FAQs
Signs and symptoms
You should see your provider right away if you experience any of these common symptoms of throat cancer:
- Changes in your voice, such as hoarseness or not speaking clearly
- Difficulty swallowing
- Ear pain
- A lump or sore that doesn’t heal
- Sore throat
- Weight loss
- Research has identified factors that may increase the risk of throat cancer:
- Tobacco use, including smoking and chewing tobacco
- Heavy alcohol use
- Human papillomavirus (HPV)
- A diet lacking in fruits and vegetables
- Gastroesophageal reflux disease (GERD)
Questions and answers (FAQs)
If you have a type of throat cancer that affects your vocal cords, your voice will be affected, but most likely you will not lose your voice entirely. Part of your treatment plan and recovery will focus on keeping your voice and learning how to talk if you’ve had part of your larynx removed.
You can’t. If you have signs and symptoms of throat cancer, you need to be checked out by a specialist for a proper diagnosis of throat cancer or some other condition.
No. Polyps, throat nodules and granulomas are benign and typically do not turn into cancer.
Throat cancer diagnosis
Because no two people develop head and neck cancer in the same way, we offer a wide array of resources for proper evaluation of your case.
Your provider will start by taking your medical history and performing a physical exam to feel for swollen lymph nodes in the neck, look down your throat with a small, long-handled mirror, and check your lips and oral cavity for abnormal areas. Then, we may use any combination of these tests and procedures to find and stage throat cancer:
- Barium swallow (upper GI series). A liquid containing barium coats the lining of the esophagus and stomach for diagnostic X-rays.
- Biopsy. The only definitive way to diagnose cancer cells. We remove cells or tissues for viewing under a microscope.
- Bronchoscopy. We insert a thin, lighted tube called a bronchoscope into the trachea and lungs through the nose or mouth to check for abnormal areas or to take tissue samples for biopsy.
- Computed tomography scan (CT). A type of X-ray creates detailed, highly accurate, cross-sectional images of the body.
- Endoscopy. We insert a thin, lighted tube called an endoscope through a body opening or a small incision in the skin to examine internal organs and tissues for abnormalities; may also be used to take tissue samples or lymph nodes for biopsy.
- Esophagoscopy. We insert a thin, lighted tube called an esophagoscope into the esophagus through the nose or mouth to check for abnormal areas or take tissue samples for biopsy.
- Exfoliative cytology. We use a piece of cotton, a brush or a small wooden stick to gently scrape cells from the lips, tongue, mouth, or throat to check for abnormalities by viewing under a microscope.
- Laryngoscopy. We use a thin, lighted tube called a laryngoscope or a hand-held mirror to examine the voice box, or larynx.
- Magnetic resonance imaging (MRI). A magnetic field instead of X-rays provides detailed images of body structures.
- Positron emission tomography (PET scan). An injection of a short-lived radioactive substance creates detailed images of body structures that help identify cancer and areas of inflammation in different parts of the body.
- Serum tumor marker test. We check a blood sample for amounts of certain substances called tumor markers released by organs, tissues, or tumor cells in the body that indicate specific types of cancer when found at increased levels.
- Ultrasound. High-energy sound waves bounce off internal tissues or organs and make images of body tissues, called a sonogram.
Throat cancer staging
UCHealth follows the American Joint Committee on Cancer (AJCC) TNM system to stage oral and throat cancer, which is based on three key pieces of information:
- The extent of the tumor (T): How large is the main (primary) tumor and which, if any, tissues of the oral cavity or oropharynx it has spread to?
- The spread to nearby lymph nodes (N): Has the cancer spread to nearby lymph nodes?
- The spread (metastasis) to distant sites (M): Has the cancer spread to distant organs such as the lungs?
Cancer staging can be complex, so ask your doctor to explain it to you in a way you understand.
|AJCC stage||Stage grouping||Lip, oral cavity and p16 negative oropharynx stage description*|
|The cancer is still within the epithelium (the top layer of cells lining the oral cavity and oropharynx) and has not yet grown into deeper layers.
It has not spread to nearby lymph nodes (N0) or distant sites (M0). This stage is also known as carcinoma in situ (Tis).
|The cancer is 2 cm (about ¾ inch) or smaller. It’s not growing into nearby tissues (T1). It has not spread to nearby lymph nodes (N0) or to distant sites (M0).|
|The cancer is larger than 2 cm but no larger than 4 cm (about 1½ inch). It’s not growing into nearby tissues (T2). It has not spread to nearby lymph nodes (N0) or to distant sites (M0).|
|The cancer is larger than 4 cm (T3). For cancers of the oropharynx, T3 also includes tumors that are growing into the epiglottis (the base of the tongue). It has not spread to nearby lymph nodes (N0) or to distant sites (M0).|
|T1, T2, T3
|The cancer is any size and may have grown into nearby structures if oropharynx cancer(T1-T3) AND has spread to 1 lymph node on the same side as the primary tumor. The cancer has not grown outside of the lymph node and the lymph node is no larger than 3 cm (about 1¼ inch) (N1). It has not spread to distant sites (M0).|
N0 or N1
|The cancer is any size and is growing into nearby structures such as:
For lip cancers: nearby bone, the inferior alveolar nerve (the nerve to the jawbone), the floor of the mouth, or the skin of the chin or nose (T4a)
For oral cavity cancers: the bones of the jaw or face, deep muscle of the tongue, skin of the face, or the maxillary sinus (T4a)
For oropharyngeal cancers: the larynx (voice box), the tongue muscle, or bones such as the medial pterygoid, the hard palate, or the jaw (T4a).
This is known as moderately advanced local disease (T4a).
AND either of the following:
It has not spread to nearby lymph nodes (N0)
It has spread to 1 lymph node on the same side as the primary tumor, but has not grown outside of the lymph node and the lymph node is no larger than 3 cm (about 1¼ inch) (N1).
It has not spread to distant sites (M0).
|T1, T2, T3 or T4a
|The cancer is any size and may have grown into nearby structures (T0-T4a). It has not spread to distant organs (M0). It has spread to one of the following:
1 lymph node on the same side as the primary tumor, but it has not grown outside of the lymph node and the lymph node is larger than 3 cm but not larger than 6 cm (about 2½ inches) (N2a) OR
It has spread to more than 1 lymph node on the same side as the primary tumor, but it has not grown outside of any of the lymph nodes and none are larger than 6 cm (N2b) OR
It has spread to 1 or more lymph nodes either on the opposite side of the primary tumor or on both sides of the neck, but has not grown outside any of the lymph nodes and none are larger than 6 cm (N2c).
|The cancer is any size and may have grown into nearby soft tissues or structures (Any T) AND any of the following:
It has spread to 1 lymph node that’s larger than 6 cm but has not grown outside of the lymph node (N3a) OR
It has spread to 1 lymph node that’s larger than 3 cm and has clearly grown outside the lymph node (N3b) OR
It has spread to more than 1 lymph node on the same side, the opposite side, or both sides of the primary cancer with growth outside of the lymph node(s) (N3b) OR
It has spread to 1 lymph node on the opposite side of the primary cancer that’s 3 cm or smaller and has grown outside of the lymph node (N3b).
It has not spread to distant organs (M0).
|The cancer is any size and is growing into nearby structures such as the base of the skull or other bones nearby, or it surrounds the carotid artery. This is known as very advanced local disease (T4b). It might or might not have spread to nearby lymph nodes (Any N). It has not spread to distant organs (M0).|
|The cancer is any size and may have grown into nearby soft tissues or structures (Any T) AND it might or might not have spread to nearby lymph nodes (Any N). It has spread to distant sites such as the lungs (M1).|
Source: American Cancer Society
Throat cancer treatment and recovery
Treatment for head and neck cancer varies greatly from person to person. Your multidisciplinary team may use any combination of surgery, chemotherapy, radiation, targeted therapy, or new immunotherapies to treat or control your throat cancer:
Surgery. Surgery may be part of an overall plan for treating a recurrence or new tumors. Specially trained head and neck surgical oncologists remove a tumor and some surrounding tissue, as well as some nearby lymph nodes. Your surgery may involve lasers for precise removal of cancer or precancerous growths or to relieve symptoms of cancer. Laser surgery is used most often to treat cancers on the surface of the body or in the lining of internal organs.
Radiation therapy (radiotherapy). We use X-rays and other types of medical radiation aimed at specific parts of the body. The radiation kills cancer cells, prevents cancer cells from developing or recurring, and improves many of cancer’s symptoms. For certain cancers, radiation therapy is combined with chemotherapy and called chemo-radiotherapy.
Chemotherapy. Drugs that slow down, damage, or kill cancer cells. It may involve single drugs or combinations of drugs taken intravenously or by mouth. Chemotherapy is often taken in cycles lasting three or four weeks each. Your team may also prescribe drugs to reduce or eliminate chemotherapy’s side effects.
Anti-cancer drug therapy. Single drugs or combinations of drugs taken through intravenous injections or as prescribed tablets/capsules help fight the cancer itself or side effects from chemotherapy. Drugs may be taken in repeating patterns that usually last three to four weeks.
Targeted therapy. Anti-cancer drugs or other substances that directly interfere with cancer growth and progression at the molecular level may be taken—with few side effects—on their own or combined with standard chemotherapy. Many new targeted therapies, including vaccines and gene therapies, are currently in development.
MedlinePlus: National Library of Medicine. Throat Cancer (https://medlineplus.gov/throatcancer.html)
Center for Disease Control and Prevention (CDC). HPV and Oropharyngeal Cancer (https://www.cdc.gov/cancer/hpv/basic_info/hpv_oropharyngeal.htm)
National Center for Biotechnology Information (NCBI): National Library of Medicine. Laryngeal Cancer (https://www.ncbi.nlm.nih.gov/books/NBK526076/)