Throat cancer, known in medicine as “cancer of the upper aerodigestive tract”, generally affects the larynx and pharynx. This cancer affects swallowing, speech and breathing.
THE throat cancer can reach all of the upper aero-digestive tracts, i.e. the nasal cavitythe oral cavity (language, palace, gum, lips), THE tonsils, the vocal cords (otherwise called the larynx or glottis) and the epiglottis. This cancer causes symptoms at the level of voice or the swallowing. He affects men more than women and is most often diagnosed from 50 years old. How diagnose throat cancer? What symptoms spot? Can we heal throat cancer? What are the treatments ?
Definition: what is throat cancer?
Throat cancer is more commonly referred to in medicine as “upper aerodigestive tract cancer“. It usually affects the larynx and pharynx. Its frequency of occurrence is closely correlated with the duration of exposure and the amount of tobacco and alcohol consumed.
What are the symptoms of throat cancer?
Most throat cancers develop from precancerous lesions that have not been detected. Leukoplakia, oral submucosal fibrosis, erythroplakia or erythroleukoplakia represent the most common precancerous conditions of the mouth. The difficulty in early detection of cancerization of these lesions lies in the fact that the process remains long asymptomatic. However, this cancer has consequences on swallowing, speech and breathing. “It’s here unusual persistence over time (more than 3 weeks) of these classic symptoms which should, in patients at risk, raise the suspicion of cancer”, explains Dr. Antoine Moya-Plana, ENT surgeon at Gustave Roussy. Among the symptoms which may suggest throat cancer:
- voice pitch change,
- cough,
- difficult breathing,
- painful swallowing,
- ear pain,
- sore throat,
- adenopathy
► Nodule in the throat. A nodule is a small rounded mass that usually forms just under the skin. In particular, they can be located in the thyroid or on the vocal cords. In this case, we often speak of “singer’s nodules“, because they frequently affect professional interpreters. This is also the case in other professions where the voice is very much in demand, such as teachers, lawyers, market gardeners, etc. In the vast majority of cases, the nodule is completely benign.
Can throat cancer be cured?
THE Survival chances in case of throat cancer depend mainly on the stage cancer. If the cancer is stage I, the 5-year survival rate is greater than 80%. If throat cancer is regional (stage II or III), survival rate drops to 42%. It is only 32% when throat cancer is stage IV and that there are metastases. If diagnosed early, cancer limited to the vocal cords has a prognosis of 90% survival at 5 years.
What are the risk factors for throat cancer?
THE smoking is the main risk factor for throat cancer. In association with excessive consumption alcohol, tobacco is particularly dangerous for the upper airways. However, other external factors may be responsible for the proliferation of cancer cells. This is particularly the case of thepapillomavirus infection (HPV). “This virus, sexually transmitted, can induce oropharyngeal cancers (amygdala, soft palate, base of tongue)”, says the doctor. We can also cite theprolonged exposure to toxic substancesTHE gastroesophageal reflux and nutritional deficiency. These cancers affect men more than women and are most often diagnosed from 50 years old.
If cancer of the upper aero-digestive tract is suspected, a endoscopy of this area of the body is performed under general anesthesia. We introduces a rigid tube into the throat to explore the air and digestive tracts and to remove suspicious tissue to analyze them (biopsy). “The diagnosis of cancer is established if cancer cells are found in the samples, continues the specialist. In the event of proven cancer, other examinations are necessary to assess the extent of the disease: cervico-facial scanner, CT scan of the chest, MRI, PET-scan.”
What are the different stages of throat cancer?
The staging of throat and laryngeal cancers is based on the TNM classification. Like any cancer, throat cancer can be diagnosed at a more or less advanced stage. The more the cancer spreads, the higher the stage and the lower the chances of survival.
► Stage I is a localized and small cancer. Whether it is a subglottic or supraglottic throat tumor, it does not affect the lymph nodes in the neck or other areas of the body.
► In stage II, the tumor involves more than one area.
► In stage III, the vocal cords have lost some of their mobility or the tumor has spread to surrounding tissues.
► At stage IVthe lymph nodes are affected, the cancer has spread and metastases have appeared.
If the cancer is stage I, the 5-year survival rate is over 80%.
What are the treatments for throat cancer?
The management of throat cancer will be decided by a multidisciplinary medical team (ENT surgeon, anesthetist, radiotherapist, radiologist, oncologist) depending on the nature of the pathology and its stage of development. Several possible surgeries:
► Removal of the tumor by endoscopic surgery. (only for the vocal cords). If the cancer is still in its infancy, the doctor can destroy the cancer cells with or without a laser.
► There partial laryngectomy involves removing the part of the larynx affected by the tumour. This intervention can affect speech and respiratory faculties, but there are techniques for reconstructing the larynx which make it possible to limit the sequelae.
► There cordectomy involves removing only part of the affected vocal cord.
► There pharyngectomy involves removing part of the pharynx. The organ can then be reconstructed in order to limit the sequelae and ensure normal swallowing.
► There total laryngectomy. If the cancer is advanced, it is sometimes necessary to remove the entire larynx and make an opening in the neck connected to the trachea to ensure the entry of air to the lungs (a tracheostomy). After such an intervention, the operated person must learn to speak again with the help of a speech therapist.
► THE lymph node dissection. If the lymph nodes are affected or in certain forms of cancer at risk, it is necessary to remove the lymph nodes during the same operation as the removal of the pharyngo-laryngeal tumor.
A complementary radiotherapy to destroy any residual cancer cells may be indicated. If surgery is contraindicated, radiotherapy is generally used. “Some medications target specific aspects of cancer cells to prevent them from growing. Cetuximab (Erbitux®) is one of the drugs approved for the treatment of throat cancer. This type of drug can be used in addition to radiotherapy and chemotherapy. details the specialist. In case of surgerya period of rehabilitation by a speech therapist is often necessary to regain the ability to eat, drink and speak as well as possible. In the case of radiotherapy, it is necessary to pay particular attention to daily dental hygiene and to consult a dentist regularly.
Produced in collaboration with Dr Antoine Moya-Plana, ENT surgeon at Gustave Roussy.