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Throat Cancer on the Rise – And Not in Smokers or Tobacco Users

Throat cancer is a term that encompasses various forms of cancer within the throat area but, in general, is categorized by two primary types: oropharyngeal cancer and laryngeal/hypopharyngeal cancer.


“There are many subsites within each category, and this can influence treatment options,” explained Brian Cervenka, MD, UC Health head and neck cancer surgeon and assistant professor in the Department of Otolaryngology-Head and Neck Surgery at the University of Cincinnati College of Medicine. “The easiest way to imagine where throat cancer occurs is in the upper part of the throat (oropharynx), like your tonsils or base of your tongue – or within the lower part of your throat, in the voice box, also called the larynx.”

The pharynx, more commonly known as the throat, is a tubular muscle that runs from the back of the nose down through the neck, serving as our pathway for air, food and liquids.

The larynx, or voice box, is the organ made up of vocal cords which uses air to create vibrations and sound waves as it passes through towards the lungs. Additionally, the voice box also has a key role in swallowing and breathing functions.

Types of Cancer Cells

Within the pharynx and larynx, cancer cells most commonly originate from mucosal squamous cells.

Squamous cell carcinoma is also referred to as squamous cell cancer. Many people think of skin cancer when they hear squamous cell carcinoma, but these cells can also be found in other parts of the body, such as the outermost layer of cells that line the throat.

There are additional types of cancer such as adenocarcinoma, sarcomas and minor salivary gland tumors, but these are much less common.

“Within the squamous cell carcinoma group, there are two subtypes that is caused by HPV, similar to cervical cancer, and that is not related to HPV,” Dr. Cervenka said. “Much of the rise of oropharyngeal cancer numbers has been related to the increase in HPV related cancer – and these cases are in people that do not have a history of smoking or tobacco use.”

Symptoms of Throat Cancer

Throat cancer symptoms can vary depending on the location and type of cancer, but generally, a person may experience the following:

  • Lump or mass identified in the neck.
  • Persistent unilateral or one-sided throat pain.
  • Trouble swallowing.
  • Persistent coughing with or without blood.
  • Hoarseness that doesn’t go away.

Detecting Throat Cancers

Some of these symptoms may seem minor, but simply ignoring them could compromise an early cancer diagnosis. Early detection could mean bypassing radiation and chemotherapy and even possibly an earlier entry into remission.

There are a couple of things you can regularly do at home to help you identify abnormalities:

  • Feel along the muscles of your neck for lumps. If you notice a mass that feels larger than the others, it could be cause for concern.
  • Examine the inside of your mouth, tongue and throat for sores or lumps.

Outside of regular self-examinations, be sure to stay up to date on annual physical evaluations with your primary care provider, as well as visiting the dentist every six months.

Your primary care physician will do an exam similar to what you would do at home by checking for swollen lymph nodes in your neck, and by sometimes placing a long-handed mirror toward the back of your throat to exam the upper pharynx region.

During a dental appointment, your dentist will do screenings for mouth and throat cancer by looking at your gums, tongue, tonsils and the inside of your cheeks for lumps or discoloration.

If any abnormalities are found, your clinician will then refer you to a head and neck cancer specialist, like those at the UC Health Head and Neck Cancer Center.

Progression and Stages

Our bodies give us signs to when things are working and when they’re not. Paying attention and addressing signs and symptoms as soon as possible can impact the overall progression of the cancer cells and your future quality of life.

Throat cancer can progress quickly. Dr. Cervenka explained, “Throat cancer typically progresses in stages, which is reflected in the TNM staging system.” The TNM Staging System is used to descript the spread and amount of cancer within nearby tissue.

The cancer begins at the primary site in the throat and then sequentially travels to lymph nodes lower in the neck. Finally, it will travel to the lungs. At that point, complete cure of the disease becomes less likely.

Although most throat cancers are detected before it reaches the lungs, treatment is determined based on where the cancer is located.  

Treatments

When a patient makes an appointment or is referred to a head and neck cancer specialist, there are a couple different tests that are performed to confirm and characterize a throat cancer diagnosis: a biopsy and an imaging study. Typically, CT scans are performed of the neck, and distant disease is assessed by a PET scan or a CT chest scan.

“If the primary mass or a lymph node is accessible for direct biopsy or ultrasound-guided fine needle aspiration, this can be done in clinic,” said Dr. Cervenka. “However, if the mass is only located on the voice box or deep in the throat, we will have to perform the biopsy in the operating room.”

If cancer is detected, there is usually a combination of various treatments depending on the stage of cancer – for earlier stages, radiation and/or surgery may be single modality options, or, if more advanced, a combination of treatment options is used — sometimes all three.

In most throat cancer diagnoses, patients recover very well from treatment, but it is critical that they work with their multidisciplinary team, including a speech and swallow therapist, oncologist, nutrition specialist, physical therapist and survivorship specialist. All of these specialists are accessible at the UC Health Head and Neck Cancer Center, part of the UC Cancer Center.

Cancer Treatment Backed by Science and Delivered With Care

With several locations conveniently around the Greater Cincinnati area, the UC Health Head and Neck Cancer Center has experts in all areas pertaining to a patient’s cancer care – from surgery, radiation and facial reconstruction, to nutrition, speech therapy, social work and patient navigation.

Whether early-stage or highly complex and rare, our head and neck cancer team is equipped with the latest technology and a multidisciplinary team of experts who meet weekly to discuss each and every patient case to determine the best treatment approach.

Dr. Cervenka explained, “Because we have specialists from numerous areas looking at each case, we often have multiple good treatment paths that are not only backed by science, but ones that uniquely make the most sense for that patient and their life.”