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Understanding Recurrent Throat Cancer

Recurrent throat cancer can arise when the initial throat cancer fails to respond completely to treatment or when it returns after the cancer has gone into remission and the patient has been symptom free for a period of time.

Unfortunately, secondary primary tumors are a significant risk for any type of head and neck cancers, including throat cancer. Approximately 10 percent to 15 percent of throat cancer patients also have a second primary cancer somewhere. This second tumor may appear later as the recurrent cancer.

The other problem is that for 70 percent of patients diagnosed with throat cancer, the cancer has already reached an advanced stage before it is discovered, increasing the likelihood of the cancer metastasizing (spreading to distant sites in the body).

Types of Recurrent Throat Cancer

Those with recurrent throat cancer fall into one of two broad categories:

the cancer metastasizes and returns elsewhere in the body
the cancer returns locally or regionally (still within the throat).

Those in the second category have a far better prognosis than those in the first.

Risk Factors for Recurrent Throat Cancer

If the initial throat cancer was caused by environmental factors, as is the case about 75 percent of the time, then a recurrent case can be caused by a patient continuing to engage in risky behavior. This risky behavior mainly includes smoking and drinking excessive amounts of alcohol.

After being treated for cancer once, a patient is still susceptible to the cancer returning if he continues to smoke or drink heavily. However, throat cancer can recur on its own even if the patient no longer smokes or drinks.

Checks for Recurrence

It is advisable to have your doctor check for any recurrence of cancer with a careful head and neck exam at least once a month for the first year after treatment, then every two months in the second year, every three months in the third year and every six months thereafter. This may seem excessive, but because the initial symptoms of throat cancer can be so mild, it's extremely necessary.

Symptoms of Throat Cancer

Symptoms of recurrent throat cancer may be mild and can include:

bad breath
chronic sore throat
coughing blood
difficulty breathing or swallowing
ear aches
excessive swallowing
hoarse voice or change in the voice's pitch (especially common in cancer of the larynx)
lump in the neck or enlarged lymph nodes
pain in the neck or throat
weight loss.

Treatment Options for Recurrent Throat Cancer

For anyone with locally or regionally recurring throat cancer, the treatment remains similar to the initial course of treatment for the first onset of throat cancer.

Those with metastatic recurrence often need chemotherapy, since this type of patient usually failed to respond to radiation therapy initially. However, they may be treated with a combination of radiation and chemotherapy, especially if surgery without radiation therapy was used the first time.

New treatment options arise continuously in clinical trials, and patients typically have the option to participate with an experimental drug or procedure if they choose. However, you should carefully discuss this with your doctor first.

Some of the experimental treatment options include:

Epidermal Growth Factor Receptor Inhibitors: Epidermal growth factor receptors (EGFRs) are proteins on the surface of all cells that promote controlled growth of the cell. But in many cancer cells, EGFRs have ceased to function properly, causing excessive growth. Inhibiting them may therefore decrease cancer growth.
Monoclonal Antibodies: These proteins can locate cancer cells and either activate the immune system to help kill them or deliver a radioactive isotope to kill them. When used in combination with radiation therapy in a study on 15 patients, this achieved a complete response rate of 87 percent in patients with advanced cancers of the tongue, tonsils, throat or larynx.
New Forms of Chemotherapy: New forms of chemotherapy, such as selective intra-arterial infusion of chemotherapy that delivers the chemicals directly to the cancer, and new chemotherapy drugs are becoming more popular.

Any course of treatment should be carefully discussed with your physician to ensure you understand the risks and potential benefits. Treatments will vary widely depending on the stage the cancer has reached, your own health and even your age.

Never be afraid to ask questions of your doctor, especially when considering newer treatments. It's important to understand as much as possible about your own medical condition and treatment as you proceed.

Resources

National Cancer Institute (2005). Hypopharyngeal Cancer (PDQ®): Treatment; Patient Version. Retrieved June 19, 2007, from the National Cancer Institute Web site: http://www.cancer.gov/cancertopics/pdq/treatment/
hypopharyngeal/patient/allpages/print.

NCH Regional Cancer Institute (n.d.). Throat Cancer. Retrieved June 20, 2007, from the NCH Regional Cancer Institute Web site: http://cancer.nchmd.org/treatment.aspx?id=741.

Oncology Resource Center (n.d.). Cancer Treatment and Prevention: Treatment of Recurrent Cancer of the Throat. Retrieved June 20, 2007, from the Oncology Resource Center Web site: http://cancer.nchmd.org/treatment.aspx?id=745.

Throat Cancer Symptoms (2006). Throat Cancer Symptoms. Retrieved June 20, 2007, from the Throat Cancer Symptoms Web site: http://www.throat-cancer-symptoms.com/html/symptoms-of-throat-cancer.php3.

Weaver, Charles H., M.D. (2006). Treatment of Recurrent Cancer of the Throat. Retrieved June 20, 2007, from the Caring 4 Health Web site: http://cancer.caring4health.com/745.aspx.

Other Topics in this Section

Stages of Throat Cancer: Symptoms and Treatment

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