Throat cancer- causes, symptoms, treatment- side effects

What is throat cancer?

Surprisingly, doctors don't use the term "throat cancer." Several different kinds of cancer can involve different parts of the throat and mouth.

Oropharyngeal cancer may involve the base of the tongue, the tonsils and surrounding tissues, the soft palate, or the front and back walls of the throat.

Doctors use the term "insidious" to describe base-of-tongue tumors. That's because there is no pain sensation at the base of the tongue, so the tumors can become quite advanced before symptoms appear.

What causes throat cancer?

The cancer probably was caused by smoking and drinking.

Smoking is a major cause of oropharyngeal cancer. Drinking alcohol, as far as the statistics can tells us, is not as bad by itself. But the combination of drinking and smoking is the worst combination.

This is a disease that is increasing really at a dramatic rate, particularly in the male population. Not that long ago, this only made up about 18% of head and neck cancers. Now it makes up a full third and is increasing at a very rapid rate.

What's causing the rise in cases,  is a surge in the number of cases caused not by smoking and drinking but by human papillomavirus -- HPV, the sexually transmitted virus best known as a cause of cervical cancer and genitalwarts.

 A study recently found that people with more than six lifetime oral sex partners have the greatest oropharyngeal cancer risk. It's not yet clear why some people with HPV get this throat cancer while others do not. But it does appear that decades can elapse between HPV infection and the appearance of cancer.

The infection may happen in a person's 20s and only manifest as cancer in the 40s.

Can throat cancer be cured?

If caught in its early stages, this "throat cancer" can be cured 85% of the time by surgery or radiation.

Later stages are more problematic. 

For the advanced stage IV cancers, it depends on the situation with the lymph nodes in the neck. There is over a 60% chance of remission if it has not spread to the lymph nodes. But if it already has spread to the lymph nodes in the neck, the odds of remission are more like 40% or 30%."

Interestingly, oropharyngeal cancer caused by HPV is much more easily cured -- even at late stages -- than cancer caused by smoking and drinking.

What are the symptoms of throat cancer?

The most common symptoms of oropharyngeal cancer include:

• Throat pain
• Difficulty swallowing
• Ear pain (which is actually pain from the base of the tongue referred to the ear)
• Bleeding in the mouth or throat
• Hoarseness
• A lump in the throat, or the feeling that something is stuck in the throat
• Any of these symptoms may signal throat cancer.
  All of us have hoarseness at end of the day, but if it persists over three weeks, see the doctor.
  If you go to your doctor with ear pain and he says your ear is fine and unrelated to any other problem, go see an ear, nose, and throat doctor.

  What is the treatment for throat cancer? What are the side effects?

  Treatment for early stage oropharyngeal cancer has traditionally been radiation, usually along with chemotherapy. But  surgery is becoming more and more popular, because small throat tumors can be removed with minimally invasive surgery or even with robotic surgery.
  This spares the patient radiation therapy, which is quite taxing to the patient.
  Advanced tumors present more of a challenge.
  One is to do very, very big surgery. This removes the base of the tongue but sometimes also the voice box, because the base of the tongue prevents food from going through the voice box into the windpipe.
  However,  that reconstructive surgery can use tissues from other parts of the body to repair the base of the tongue. This technique makes it unnecessary for the surgeon to remove the voice box.

  What is the treatment for throat cancer? What are the side effects? 

  The other option for late stage oropharyngeal cancer is radiation and chemotherapy. Surgery would be necessary only if this treatment fails.
  While avoiding surgery, the side effects of radiation and chemotherapy are severe.
  The first few weeks are no big problem, but then patients often have significant difficulty with swallowing. In most cancer centers -- and we certainly do it with advanced base-of-the-tongue tumors -- they insert a feeding tube right into the stomach through the belly. Mostly we try to do it ahead of time, before problems start, because if you do it later you have to interrupt treatment.
  Another serious problem is that the radiation can burn the mouth and throat, sometimes raising blisters. And patients usually suffer severe fatigue during treatment.
  Although the burns, fatigue, and swallowing problem usually go away after therapy, patients may have another problem for the rest of their lives: dryness of the mouth and throat.
  Radiation kills the tumor, but it also kills the salivary glands in the throat. That is why, if you go into a  waiting room, everybody is carrying a bottle of water all the time.