Stages of Throat Cancer: Symptoms and Treatment

Cancer occurs when cells divide abnormally and out of control. Throat cancer specifically tends to begin in the throat before spreading to the larynx (voice box) and then the pharynx (the back portion of the throat that includes the tongue and tonsils). It can then continue to the subglottis and trachea (windpipe).

Throat Cancer Causes and Risk Factors

Smokers fall into the highest risk category for throat cancer. People who consume a lot of alcohol, those with a vitamin A deficiency and people infected with HPV (human papillomavirus) are also at greater risk of getting this disease.
 
It's also important to know that 15 percent of people with throat cancer are simultaneously diagnosed with mouth, esophagus or lung cancer. Also, 10 percent to 20 percent of throat cancer patients develop one of those other cancers later on, which is why frequent follow-up appointments with a doctor are necessary, even if treatment has been successful.
 
Men are at higher risk than women for developing throat cancer, but this statistic is affected by the fact that more men smoke than women. Also, throat cancer is more common in people over 55.
 
The good news is that these risk factors are mostly environmental and not genetic, so you can help reduce your chances of getting throat cancer considerably if you don't smoke (or quit smoking) and if you only drink alcohol in moderation.

The Five Stages of Throat Cancer

Doctors describe all types of cancer in numerical stages. Stages 0 and 1 indicate that the tumor has not invaded far into the surrounding tissues. Stages 3 and 4, by contrast, indicate that the cancer has reached a more advanced level and has spread throughout and possibly beyond the surrounding tissues.
 
The five stages of throat cancer specifically are as follows:
  • Stage 0: Stage 0 is the earliest and most benign stage, meaning generally that the cancer is only in the lining of the hypopharynx.
  • Stage I: In this stage, the cancer is less than 1 inch thick.
  • Stage II: In Stage II, cancer is between 1 inch and 2 inches in thickness.
  • Stage III: In this stage, the cancer is more than 2 inches thick and has spread to one lymph node.
  • Stage IV: In this final stage, the cancer has spread to other tissues, such as the lips and mouth. It has also spread to multiple lymph nodes on the same side of the neck or one lymph node on the opposite side of the neck, or one lymph node is greater than 3 inches in diameter.

    In the final level of Stage IV, the cancer spreads throughout the body.

Symptoms of Throat Cancer

Often, in the early stages of a cancer, a person does not experience any symptoms. But the first symptoms for throat cancer tend to include:
  • coughing up blood
  • ear pain
  • enlarged lymph nodes in the neck
  • painful or difficult swallowing or a frequent need to swallow
  • persistent cough
  • persistent sore throat
  • swelling or pain in the neck
  • unexplained hoarseness of the voice or a change in the voice
  • unexplained weight loss
  • wheezing/raspy breathing or difficulty breathing.
Anyone who has hoarseness for more than two weeks or who has a number of the above-mentioned symptoms occurring together should immediately consult a doctor. Without treatment, throat cancer will continue to grow and spread. Throat cancer can be fatal if left untreated.

Types of Treatment

There are three common types of treatment for throat cancer. Often, they are used together:
  • Chemotherapy: This treatment uses drugs to either kill cancer cells or stop them from dividing. It may be used to shrink the tumor prior to starting radiation therapy or performing surgery.
  • Radiation therapy: This treatment uses high-energy X-rays or other types of radiation to kill cancerous cells. It can be given externally, through a machine or internally with a radioactive substance placed directly into or near the cancer. The type used depends on the stage the cancer has reached.
  • Surgery: Surgically removing the tumor may involve removing part or all of the larynx or part of the pharynx as well.

Treatment Options for Different Stages

Treatment options will vary depending upon the stage of the cancer, or how far it has spread:
  • Stage 0-I: Can usually be treated by surgically removing the tumor but may need radiation therapy as well.
  • Stage II: Generally involves a combination of surgery and radiation therapy but sometimes only one of the two may be needed.
  • Stage III or IV: A combination of surgery, radiation therapy and chemotherapy will be necessary.
Removal of part or all of the larynx or pharynx is usually necessary in the later stages of throat cancer. If a laryngectomy is needed (removing part or all of the larynx), the person will lose some speaking ability and will require reconstructive procedures or speech therapy to regain the use of the voice. Swallowing therapy may also be required.
 
A type of surgery called neck dissection may be needed if the cancer has spread into the lymph nodes. This involves removing those lymph nodes suspected to contain cancer cells.
 
However, if the cancer has spread throughout the body, it is unlikely that it can be cured.

Prognosis for Throat Cancer

Early diagnosis and treatment of throat cancer can save lives. It's much harder to cure cancer in more advanced stages, whereas patients have a good chance of surviving and undergoing less intrusive treatments if the cancer is caught in an early stage.
 
Resources
 
Aetna InteliHealth (2006). Throat Cancer (Larynx and Pharynx). Retrieved June 19, 2007, from the Aetna InteliHealth Web site: http://www.intelihealth.com/IH/ihtIH/WSIHW000/9339/10853.html.
 
American Medical Network (2004). Larynx and Pharynx (Throat Cancer). Retrieved June 19, 2007, from the American Medical Network Web site: http://www.health.am/diseases/more/
larynx_and_pharynx_throat_cancer/.

Gastrointestinal Tract (n.d.). Throat and Larynx Cancer: Symptoms, Stages, and Treatments. Retrieved June 19, 2007, from the Gastrointestinal Tract Web site: http://www.gitract.info/articles/mouth/throat-larynx-cancer.php.

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.