Oropharyngeal cancer, popularly known as throat cancer, develops in the part at the back of the mouth that can be seen when standing in front of the mirror with the mouth open. This region includes the base of the tongue, the soft palate, the uvula, the tonsils, the tonsillar pillars, and the lateral and posterior walls of the throat.
The throat participates in the processes of breathing, speaking, eating, and swallowing. In this context, it is made up of various types of cells and tissues, in which different types of tumors can develop.
The risk factors associated with throat cancer are smoking, excessive alcohol consumption, and chronic HPV infection (human papillomavirus, transmitted through sexual intercourse).
Symptoms of Throat Cancer
The main signs and symptoms of throat cancer are:
- Sore throat;
- Difficulty swallowing;
- Frequent choking;
- Presence of persistent whitish or reddish lesions in this area (inside the mouth and on the tonsils) for more than three weeks;
- Tongues in the neck also persistent (for more than three weeks);
- Frequent coughing;
- Voice changes, such as hoarseness or difficulty in pronouncing words clearly
- Difficulty swallowing liquids and/or food
- Ear pain
- Unintentional weight loss
- Difficulty breathing.
Diagnosing Throat Cancer
To diagnose throat cancer, the doctor may use a few approaches.
Initially, an endoscope similar to a digestive endoscopy exam is used to examine the throat – the device has a camera on the tip that transmits the images to a screen. A laryngoscope may also be used, which is inserted into the larynx to evaluate the vocal cords.
If during the exams any abnormality is detected, the next step is to take a tissue sample and send it for laboratory analysis. This test, called immunohistochemistry, tests the tumor cell for a specific protein that, when present, represents a characteristic of the tumor related to HPV.
Once the throat cancer is detected, it is necessary to stage it, that is, to find out the degree of the disease. Imaging tests, such as CT scan, MRI, or PET scan, may be ordered to determine the extent of the disease and see if it has affected the lymph nodes or other organs.
Treatment
The choice of the most appropriate treatment is based on factors such as the location of the tumor and its staging, types of cells present, whether there is HPV infection, the patient’s general health status, and personal preferences. Possible procedures are:
- Surgery – this is usually the initial approach, but it depends on the location and stage the cancer is in, as well as the patient’s health conditions, before it can be performed;
- Radiotherapy – indicated for small throat cancers or those that have not yet spread to the lymph nodes. It can be associated with chemotherapy or surgery. In advanced stages of the disease, it helps to reduce symptoms and make the patient more comfortable;
- Chemotherapy – this is usually done together with radiotherapy, with the aim of killing the cancerous cells;
- Targeted therapy – treats throat cancer by taking advantage of defects in the cancer cells that fuel its growth, preventing them from continuing to multiply;
- Immunotherapy – the patient’s own immune system is stimulated to produce proteins that help the healthy cells “hide” from the cancerous ones. This type of treatment is usually restricted to more advanced cases of cancer that do not respond to conventional treatments.
Multidisciplinary teams are needed in the treatment of throat cancer. Usually there are clinical oncologists, head and neck surgeons, radio-oncologists, speech therapists, dentists, physical therapists, and nurses. They follow the patient in a global way, actively participating in the treatment and rehabilitation.
This last stage is important because, after the treatment, it is common for the patient to have complications that require follow-up to resume normal life – it will be necessary to recover the ability to swallow, eat solid food, and even to speak.
Prevention
There is no scientifically proven way to prevent throat cancer from happening. But, some precautions can be helpful in reducing the risk. These are:
- Do not smoke;
- If you consume alcoholic beverages, do so in moderation;
- Protect yourself against HPV – use a condom in all sexual intercourse and discuss with your doctor about the HPV vaccine, which lowers the risk of infection and potentially prevents throat cancer, as well as other types of neoplasms associated with this virus, such as cervical cancer.
