Cancer

Throat cancer – Causes, symptoms and the importance of an early diagnosis

Throat (or neck) cancer is understood as the appearance of a malignant tumor either at the level of the larynx or at the level of the pharynx. The differentiation of the specific type of neck cancer is based on imaging investigations. In fact, under the name of “head and throat cancer,” several types of cancer are gathered that affect structures located in the head and neck, including the tonsils and salivary glands, the paranasal sinuses, and the nasal cavity or oral cavity. Approximately one-third of all neck and head cancer cases are represented by laryngeal cancer, a very complex condition that can involve different parts of the larynx, including those of the glottis.

Although the diagnosis of throat cancer is not as frequent as other forms of cancer, the condition presents an increased risk of mortality and morbidity, especially if it is diagnosed in the advanced stages. Precisely for this reason, early diagnosis is extremely important, as it has the potential to dictate the prognosis associated with the patient. Recognizing the symptoms associated with the beginning of throat cancer can also raise the person’s suspicion of a diagnosis and allow him to request the necessary investigations in a timely manner. Next, more details will be provided regarding the causes and symptoms of throat cancer and the importance of rapid diagnosis.

Throat cancer – causes and risk factors

Any type of cancer involves genetic mutations, and this is also true in the case of throat cancer. However, these genetic mutations are caused by constant exposure, over long periods of time, to certain risk factors. As a result, the causes of throat cancer can be the following:

Smoking and alcohol consumption

Smoking is the most significant risk factor for laryngeal cancer. In approximately 70% of throat cancer cases, the fact that the person smokes is attested. Passive smoking is another risk factor for throat cancer: a person who has been exposed over time for more than 20,000 hours to cigarette smoke has an enormous risk of developing throat cancer. Classic cigarettes represent the main risk, but also smoking pipes or cigars or chewing tobacco. Excessive alcohol consumption is another major risk factor, as it irritates the mucous membrane of the throat. Especially in combination with smoking, the carcinogenic effect is amplified, increasing the risk of cancer.

Genetic predisposition

Even if most cases of throat cancer are attributed to risk factors related to lifestyle, genetic predisposition plays an important role. People with a family history of cancer, especially neck and head cancer, have an increased risk of developing neck cancer. Here, hereditary (inherited) genetic mutations are involved, such as those of the TP53 gene, known for its role in regulating the cell cycle and preventing cancer. Other syndromes that increase the risk of cancer are Fanconi anemia, Plummer-Vinson syndrome or Zinsser-Engman-Cole syndrome (congenital dyskeratosis).

Human papillomavirus (HPV) and Epstein-Barrvirus (EBV) infections

HPV infection, especially HPV-16, is associated with oropharyngeal cancer, a clinical subtype of throat cancer. HPV is transmitted through sexual contact, and the infection is considered to be one of the main causes of the increase in the incidence of throat cancer among younger people, who do not present classic risk factors (smoking, alcohol consumption).Epstein-Barrvirus infection causes infectious mononucleosis, but it was found that it could increase the risk of throat cancer (nasopharyngeal subtype) among affected people. The link between infection and cancer risk is not supported by the entire medical community.

Prolonged exposure to toxic substances and radiation

Prolonged exposure to certain substances, as a result of professional activity and pollution, can increase the risk of throat cancer. Certain toxic substances, such as asbestos, formaldehyde, sulfuric acid mist, wood dust, and nickel fumes, have carcinogenic potential. For this reason, it is observed that the diagnosis of neck cancer is more frequent in people who work in industries such as woodworking, construction, or the textile industry. Irradiation of the head and neck area (radiotherapy or frequent imaging investigations) increases the risk of throat cancer.

These are the causes of throat cancer, with the mention that smoking is, of all, the biggest associated risk factor. In more than half of the diagnosed cases, the people were found to be smokers (for long periods of time) or had quit smoking relatively recently.

Throat cancer – symptoms and manifestations

The symptoms of throat cancer can be very obscure and difficult to associate with this diagnosis because initially, they are often non-specific and thus confused with the symptoms of a less severe disease. However, recognizing common signs and symptoms will facilitate rapid diagnosis and, implicitly, allow early initiation of treatment for throat cancer. The most common symptoms that people with throat cancer may experience are:

  • Pain and discomfort in the neck: people with throat cancer face persistent pain in the throat that does not improve. This can be accompanied by the constant feeling of a foreign body in the throat or difficulties in swallowing(dysphagia), which can signal tumor growth;
  • Voice changes: persistent hoarseness or change in vocal tone, which becomes relatively more serious, may indicate a tumor affecting the larynx or vocal cords. If the symptoms persist for more than two weeks, the suspicion of laryngeal cancer is all the greater;
  • Persistent cough and breathing difficulties: persistent cough, which can be accompanied by blood in the sputum (hemoptysis), can be a symptom of throat cancer. Breathing difficulties may also occur when the tumor grows and partially obstructs the airways;
  • Ear pain and swollen lymph nodes: In some cases, people with throat cancer have complained of periodic episodes of ear pain, probably as a result of pain radiating from the neck. Inflammation of the lymph nodes of the throat, without an apparent infectious cause, can already signal cancer with lymph node metastases;
  • Weight loss and persistent fatigue: are general symptoms in case of throat cancer and usually appear in the advanced stages.

It was found that men have an approximately five times higher risk of developing throat cancer. As a result, such symptoms should be taken into account especially by male persons (however, if they appear in female persons, they are the same).

Diagnosis of throat cancer and early identification

In the case of neck cancer, the prognosis associated with the diagnosis depends on the stage at which the tumor was diagnosed. The earlier the cancer is detected, the more varied and less invasive the therapeutic options are, and the improved life expectancy.

Survival and prognosis in case of throat cancer

Survival rates in the case of throat cancer vary significantly depending on the stage of the disease at the time of diagnosis: According to statistics, people diagnosed with stage I or II throat cancer have a five-year survival rate of over 70%, compared to people diagnosed in stages III or IV, where the rate drops below 50%.

Treatments available

In the early stages, throat cancer treatment can involve minimally invasive surgery and localized radiotherapy or laser therapy, which have proven effectiveness and allow a much faster recovery than other interventions. In advanced stages of throat cancer, the treatment is much more complex, often requiring a combination of major surgery (removal of the larynx, but also of other affected structures), extensive radiotherapy, and chemotherapy.

Reduction of morbidity

Rapid diagnosis in the case of neck cancer allows the initiation of less aggressive treatments, which preserve the normal functionality of the affected organs. For example, in cases where laryngeal cancer is detected early, it may be possible to keep the vocal cords intact and avoid laryngectomy (removal of the larynx), which leads to permanent loss of voice.

Screening and medical supervision

Screening for throat cancer is not (yet) standardized in the general population, but people at high risk (smokers, who consume alcohol, infected with HPV) should regularly consult the ENT doctor (especially if they have symptoms). Advanced investigations, such as endoscopy and MRI, can detect precancerous lesions or cancers in the early stages.

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