Throat cancer refers to cancerous tumors that develop in the throat (pharynx) and voice box (larynx). The throat consists of three parts – the nasopharynx, oropharynx, and laryngopharynx. Throat cancer usually begins in the flat cells that line the inside of the throat. There are two main types of throat cancer:
Squamous cell carcinoma
This is the most common type of throat cancer, accounting for more than 90% of throat cancer cases. It develops from the flat, squamous cells that line the throat. Risk factors include smoking, alcohol use, and infection with human papillomavirus (HPV).
Adenocarcinoma
This type starts in the glandular cells of the throat. It is much less common than squamous cell carcinoma. Potential risk factors include smoking and alcohol use.
Some key facts about throat cancer:
– It accounts for about 3% of all cancers in the United States.
– An estimated 20,000 people are diagnosed with throat cancer each year.
– It is more common in men than women. The male-to-female ratio is about 2:1.
– It rarely affects people under age 40. The average age at diagnosis is 62.
– Smoking and alcohol use are major risk factors. HPV infection is another important risk factor.
– The main treatment options are surgery, radiation therapy, chemotherapy, targeted therapy, or a combination of these.
The stage of throat cancer refers to how far it has spread at the time of diagnosis. Early detection leads to better outcomes. Some symptoms to watch out for include:
– Persistent sore throat
– Difficulty swallowing
– Voice changes or hoarseness
– Ear pain
– A lump in the neck
– Unexplained weight loss
What Does Throat Cancer Look Like?
The appearance of throat cancer depends on the location and extent of the tumors. Here are some common signs:
Visible Tumors or Lesions
Cancerous growths may be visible as abnormal lumps, masses, or lesions in the mouth, throat, tongue, or larynx. They are usually painless. The texture varies – they may have an ulcerated, raised, flat, or cauliflower-like appearance.
Difficulty Swallowing
As tumors grow, they can obstruct the passageways, making swallowing difficult or painful. You may feel like food is getting stuck.
Hoarse Voice
Laryngeal cancer often causes hoarseness by affecting the vocal cords. It may sound raspy, strained, or weaker than normal.
Enlarged Lymph Nodes
Lymph nodes in the neck may become enlarged as cancer spreads. You may notice lump(s) in the neck.
Ear Pain
Some laryngeal and oropharyngeal cancers can cause ear pain as a warning sign.
Bleeding
Tumors in the throat or voice box may bleed, causing blood in the saliva or phlegm.
What Color is Throat Cancer?
The color of throat cancer lesions can vary depending on factors like location, stage, and type of cancer. Common colors include:
Red or Pink
Red or pink lesions are common. Increased vascularity (blood vessels) in the abnormal tissue leads to red discoloration.
| Location | Appearance |
|---|---|
| Tongue | Red lesion on the tongue, may be ulcerated |
| Tonsils | Enlarged, reddened tonsil with an irregular surface |
| Pharynx | Rose-pink mass in the pharynx |
| Vocal cords | Pink, swollen, irregular growths on the vocal cords |
White
White lesions and patches may develop. The abnormal tissue often has a thick, whitish appearance.
| Location | Appearance |
|---|---|
| Larynx | White, thickened lesions on the vocal cords |
| Tongue | White patch or plaque on the tongue |
| Cheeks/gums | White lines or patches inside the mouth |
Mixed Red and White
Some lesions may be a mix of red and white. This can occur with red, ulcerated tumors that develop white regions as they thicken.
Normal Flesh Tones
Early stage cancers don’t always look abnormal. They may blend in with normal oral tissue. Throat cancer can appear flesh-colored, normal pink, or resemble a mouth sore.
Why Does Throat Cancer Have Different Colors?
There are a few reasons throat cancer lesions can have varied coloring:
Increased Blood Vessels
Cancer cells multiply rapidly, forming new blood vessels to supply nutrients and oxygen. This increased vascularity leads to red coloring.
Cellular Changes
The molecular changes in cancer cells lead to differences in pigmentation. This alters light absorption and reflection, causing color variations.
Thickness
Thick, abnormal cell growth turns white. A thick, keratinized layer on the surface of lesions appears white.
Ulceration
Ulcers expose underlying tissue with small blood vessels. This lends a red, ulcerated appearance.
Location
Cells and blood supply differ between areas. A tumor on the tongue may look different than one on the tonsil or larynx.
What are the Stages of Throat Cancer?
Throat cancer has five main stages, ranging from early to advanced disease:
Stage 0
Abnormal cells are only present in the inner lining of the throat. This stage is called carcinoma in situ.
Stage I
The tumor is 2 cm or smaller and has not spread to lymph nodes or distant sites.
Stage II
The tumor is larger than 2 cm but smaller than 4 cm and has not spread.
Stage III
The cancer is larger than 4 cm or has spread to a single lymph node on the same side as the primary tumor.
Stage IVA
The tumor has invaded surrounding structures like the larynx, bones, or muscles. Or it has spread to single or multiple lymph nodes on one side of the neck.
Stage IVB
The cancer has spread to lymph nodes on both sides of the neck, or distant organs like the lungs.
What Are the Survival Rates by Stage?
Survival rates give an estimate of the percentage of people who live for a designated time after being diagnosed with cancer. Here are 5-year survival rates by stage for laryngeal cancer:
| Stage | 5-Year Survival Rate |
|---|---|
| Stage 0 | 90% |
| Stage I | 75-90% |
| Stage II | 55-75% |
| Stage III | 35-50% |
| Stage IVA | 20-35% |
| Stage IVB | 10-15% |
As shown, early stage throat cancers have better prognosis. The survival rates decrease as the cancer advances.
What Are the Treatment Options?
Common treatments for throat cancer include:
Surgery
Removing part or all of the tumor and affected throat tissue. May involve laser surgery or robotic surgery.
Radiation Therapy
Using radiation to destroy cancer cells and shrink tumors. External beam radiation or internal radiation may be used.
Chemotherapy
Using chemical drugs to kill cancer cells. May be combined with radiation as chemoradiation.
Targeted Therapy
Drugs that target specific proteins or genes in cancer cells. Cetuximab is an example.
Immunotherapy
Medications boost the immune system to better detect and destroy cancer cells.
Treatment plans are tailored to the individual based on the cancer site, stage, and overall health. The goals are to remove or destroy the cancer, prevent recurrence, and preserve throat function.
What Are the Risk Factors?
Factors that increase the risk of developing throat cancer include:
Tobacco Use
Smoking cigarettes, cigars, or pipes accounts for 75% of laryngeal cancers and 25-60% of oral cavity/pharyngeal cancers.
Alcohol Consumption
Frequent, heavy alcohol use combined with smoking significantly increases risk.
HPV Infection
The human papillomavirus (HPV) causes a majority of oropharyngeal cancers.
Gastroesophageal Reflux Disease (GERD)
Acid reflux can cause cellular changes and irritate the lining of the larynx, increasing throat cancer risk.
Poor Diet and Nutrition
Low fruit and vegetable intake and vitamin deficiencies may contribute.
Gender
Men are two to three times more likely to develop throat cancer.
Age
Most cases occur in those aged 50-80 years old.
Environmental Exposures
Breathing in asbestos fibers, paint fumes, or certain chemicals can increase risk.
The more risk factors present, the higher the likelihood of developing throat cancer. Some people are genetically predisposed.
Who Is Most at Risk?
Those at highest risk for throat cancer include:
– Middle-aged and older men
– Heavy smokers and drinkers
– People with HPV infection
– Individuals with long-standing GERD
– Workers exposed to carcinogens
– Those with a family history of throat or other head and neck cancers
Routine screening for throat cancer is not recommended for people at average risk. But certain high-risk groups should have regular head, neck, and throat exams by a doctor.
Can Throat Cancer Spread?
Unfortunately, yes – throat cancer often spreads from its primary site to lymph nodes in the neck. This is why neck lumps are a common symptom. It can also spread to distant parts of the body later in the disease course, most often the lungs.
Routes of metastasis include:
Lymphatic System
Cancer cells can break off, enter lymphatic vessels, and travel to lymph nodes in the neck. This is why checking for enlarged nodes is part of staging.
Bloodstream
Cancer may invade blood vessels and circulate to distant organs like the lungs, liver, and bones.
Direct Extension
Some throat tumors grow large enough to directly invade nearby structures like the tongue, throat muscles, voice box, or esophagus.
Catching throat cancer early and treating it aggressively is key to preventing it from metastasizing.
How Can You Reduce Your Risk?
Steps to lower your risk of throat cancer include:
– Quitting smoking and limiting alcohol intake
– Practicing safe sex and getting the HPV vaccine if eligible
– Eating a healthy, balanced diet with sufficient fruits and vegetables
– Avoiding known carcinogens and limiting environmental exposures
– Managing reflux disease if present
– Getting regular dental exams to screen for oral cancers
Protecting yourself from HPV infection through vaccination and safe sex practices is especially important.
Conclusion
Throat cancer most often appears as red, white, or mixed lesions somewhere in the oral cavity, pharynx, larynx, or neck. Its appearance varies by location and stage. Early stage throat cancer may seem benign, so be aware of subtle changes like hoarseness, trouble swallowing, or throat pain. While challenging to treat once advanced, throat cancer caught early has much better outcomes. Know the risk factors and get evaluated promptly if you observe any suspicious symptoms. With a healthy lifestyle, avoiding tobacco, and managing any reflux disease or HPV infection, you can lower your risk of throat cancer.
