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Throat cancer or pharyngeal-laryngeal carcinoma Symptoms and Treatment

Throat cancers are cancers of the upper aerodigestive tract (VADS) or ENT cancers. This “family” of cancers includes cancers of the upper respiratory tract of the nose to the pharyngo-larynx, cancers of the upper digestive tract of the mouth at the beginning of the esophagus and cancers of the pharyngolaryngeal junction that we are considering here.

These throat cancers involve such vital functions as swallowingvoice and breathing.

Location of throat cancers

Location of throat
cancers all cancers of the throat are not located at the same level. They can develop from:

  •  The hypopharynx is the part of the throat located just above the esophagus and trachea.
  •  The glottis corresponding to the vocal cords.
  •  The epiglottis, which is the area of ​​the larynx above the vocal cords. It has the shape of a movable tongue to prevent food from entering the airways.
  •  The subglottis, part of the larynx located under the vocal cords.

Types of tumors

In the first stage of cancer, the tumor remains localized to the cells in which it was formed, it is then a carcinoma in situ, which means that it has not spread, it has not infiltrated the layers deep mucous membranes, or other parts of the body. If carcinoma in situ is not treated, cancer cells can spread to deeper layers. It may then become invasive squamous cell carcinoma.

When to consult?
In the presence of abnormal signs, it is important to consult a doctor so that he can make the appropriate examinations and determine the cause of these symptoms. Smokers and those at risk should be particularly attentive and consult a doctor if symptoms last more than 2 weeks.

Symptoms of Throat cancer

 

  • Unexplained changes in voice, hoarseness, hoarse voice.
  • Increased volume of glands, painful or not.
  • Persistent sore throat, painful or difficulty swallowing.
  • Pain in the area of ​​the ear.
  • Difficult breathing.
  • Cough, sometimes accompanied by bleeding.
  • Unexplained weight loss.
These symptoms do not necessarily indicate that there is a cancerous tumor. Indeed, they may be the signs of other more common problems.

     Diagnostic of Throat cancer

The doctor examines the throat and neck directly with a headlamp and completes the examination by an endoscopy, flexible tube introduced through the nose and to see the entire pharyngo-larynx.

In the event of an abnormality, he or she can perform a more thorough examination under general anesthesia and make biopsies to determine whether or not there is a tumor and whether or not it is cancer. In this case other radiological examinations may be necessary to look for the extension of the tumor and the involvement of other organs (metastases).

People at risk

Heredity plays no role; the vast majority of throat cancers occur in men, but women who smoke or abuse alcohol are also affected.

Risk factors

The factors that increase the risk of cancer in the throat area are mostly external. Heredity, sex and age have almost no influence.

Main factors

  • The smoking is by far the leading risk factor, especially when combined with alcohol abuse.
  • The abuse of alcohol.
  • The human papillomavirus (HPV): it seems that a strain of HPV, transmitted during unprotected oral sex can cause some pharyngolaryngeal cancers particularly in non-smoking young people.
  • Prolonged exposure to asbestos and some other chemicals is also implicated in the occurrence of cancer.

Secondary factors

An unbalanced diet, poor dental hygiene or gastroesophageal reflux could favor the appearance of cancerous tumors by altering the mucous membranes

Prevention of Throat cancer

Basic preventative measures of throat cancer
  • Stop smoking or never start. See our page Smoking.
  • Avoid alcohol abuse.

 Medical treatments of Throat cancer

Treatments vary depending on the size and location of the tumor. Depending on the cancer stage, the health care team may have surgery, radiotherapy or chemotherapy. These treatments are usually combined to destroy cancer cells, limit their expansion to other parts of the body and reduce the risk of recurrence.

For each person with throat cancer, the choice of treatment is discussed during a multidisciplinary consultation involving ENT surgeon, anesthesiologist, radiotherapist, oncologist, and the decision taken after information and discussion with the patient.

Surgical interventions

  • Removal of cancer cells by endoscopic surgery. If the cancer is still beginner, the doctor can destroy cancer cells with or without laser. This intervention leaves little or no impact.
  • The partial laryngectomy involves removing part of the larynx affected by the tumor. This procedure can affect the speech and the respiratory faculties, but there are techniques of reconstruction of the larynx which make it possible to limit the sequels.
  • The cordectomy is to remove only a portion of the vocal cord affected.
  • The pharyngectomy involves removing part of the pharynx. The organ can then be reconstructed to limit sequelae and ensure normal swallowing.
  • The total laryngectomy. If the cancer is advanced, sometimes the entire larynx has to be removed and an opening in the neck connected to the trachea to allow air to enter the lungs (a tracheostomy). After such an intervention, the operated person must relearn to speak with the help of a speech therapist.
  • The recess (cleaning) node. If the lymph nodes are affected or in some forms of cancer, it is necessary to remove the affected lymph nodes during the same operation as the removal of the pharyngolaryngeal tumor. Radiotherapy to destroy the remaining cancer cells is usually indicated.

Radiotherapy

High intensity x-rays are usually used to irradiate cancer cells. Radiotherapy is used extensively in throat cancers because they are particularly sensitive to the effects of irradiation. Some advanced cancers can be treated only with radiotherapy, but sometimes it is necessary to associate radiotherapy with surgery to eliminate all cancer cells that could not be destroyed during surgery or to reduce the tumor before the surgery. Surgical removal.

Radiation therapy may have some side effects: a severe cutaneous dryness such as “sunburn”, lesions of the pharyngolaryngeal mucosa making it difficult to swallow and speech, a loss of taste, hoarseness of voice which usually disappears after end of radiotherapy.

Before radiotherapy, a dental assessment is essential to avoid complications, because this radiotherapy is aggressive for teeth and gums. The dental check-up can lead to care to keep the teeth where possible, or to extractions of too damaged teeth, or on fluorine-based treatments.

 Chemotherapy

Some cancers require a combination of surgery, radiation and chemotherapy. Chemotherapy is a combination of drugs that can be administered intravenously or orally. This treatment makes it possible to treat at the same time the cancerous cells of the starting tumor and the possible metastases in the rest of the body.

It can cause side effects such as vomiting, loss of appetite, hair loss, sores in the mouth, decreased levels of red and white blood cells, and fatigue.

Targeted therapy

Some drugs target particular aspects of cancer cells to prevent them from growing. Cetuximab (Erbitux) is one of the approved drugs for the treatment of throat cancer. This type of medicine can be used in addition to radiotherapy and chemotherapy.

Rehabilitation and follow-up

In case of surgery, a period of rehabilitation by a speech therapist is often necessary to find the best abilities to eat drink and talk.

In any case, a diet rich in quantity and quality is essential for healing and recovery

It is strongly advised to pay special attention to daily dental hygiene and to consult a dentist regularly.

Complementary approaches

Notice. Check out our Cancer fact sheet for all of the complementary approaches that have been studied in people with cancer, such as acupuncture, visualization, massage therapy and yoga. These approaches may be appropriate when used in addition to, but not substituting for, medical treatments.

 

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