Treatment of Throat Cancer

What is Throat Cancer?

Throat cancer can start in the pharynx (throat), larynx (voice box) or tonsils and is a type of head and neck cancer. They mostly always begin the pharynx and spread to other nearby structures in the throat. The symptoms of throat cancer depend upon where cancer begins. 

Though the exact cause of throat cancer is unknown, many people develop this condition following a Human Papilloma Virus (HPV) infection. Throat cancer life expectancy after five-year of diagnosis or the five-year survival rate is around 77%. Apart from standard throat cancer treatment options, many newer treatments have been developed to manage the condition.

Throat Cancer Treatment Options 

Getting diagnosed with throat cancer can make you anxious and fearful. Your doctor and multidisciplinary team will determine the most suitable treatment plan for you. If you are unsure about your treatment plan or wish to get more clarity about your throat cancer treatment options, ask your doctor for a second opinion.

Your throat cancer treatment plan will depend upon several factors, such as:

  • Type and location of throat cancer
  • Its spread
  • Type of cells in the biopsy report
  • Overall health

After evaluating your diagnostic test results, your doctor and healthcare team will decide how to treat your throat cancer. The standard treatment options include:

  • Surgery

Surgery is the treatment of choice for early-stage throat cancers. Since these cancers are localised, surgery can help remove the tumour entirely. In advanced stages of throat cancer, surgery is often combined with other treatments such as radiation therapy and chemotherapy. The stage and spread of your throat cancer will determine the extent of surgery. Advanced stages of throat cancer may require the removal of affected parts like your nearby lymph

nodes, larynx, jaws and structures in your mouth. This may affect your ability to speak, swallow, and breathe. Reconstructive surgery may be performed after throat cancer surgery to restore your appearance, enable you to speak, chew and swallow.

Your doctor will discuss with you the procedure and expected side effects.

  • Radiation therapy

Radiation therapy uses high-energy x-rays to kill cancer cells or prevent them from growing. This is usually the first line of treatment in early-stage throat cancers and may also be used in case of recurrence.

  • Chemotherapy

Chemotherapy is routinely used in treating different types of cancers. It is used in throat cancers to kill cancer cells that may remain after surgery. Used as a first-line treatment for throat cancers, chemotherapy may be used alone or in combination with other therapies, especially for advanced-stage cancers. The type of chemotherapy drug used depends on your cancer type and its stage. Discuss with your doctor any expected side effects of chemotherapy and throat cancer.

  • Chemoradiation

A combination of chemotherapy and radiation therapy, chemoradiation is used as the first line of treatment for laryngeal cancers as it helps invasive surgery and preserves the voice box. This treatment is also recommended for people who do not wish to undergo surgery or are not fit enough for one. Chemoradiation is also used following surgery to kill any remaining cancer cells.

Laryngeal cancers have a higher amount of Epidermal Growth Factor Receptor (EGFR), a protein found on the surface of the structure that stimulates the cancer cells to grow and divide. For this reason, EGFR proteins are higher in these cancers than in others. Targeted therapy uses drugs that specifically aim to kill or prevent the growth of cells with this protein. This treatment is used in some early-stage throat cancers, along with or in combination with other therapies.

Immunotherapy is a biological therapy that uses drugs to train your immune system to attack cancer cells. This treatment is relatively new for throat cancers and, therefore, is not used as the first line of treatment.

Treatment of Throat Cancer- By Stage

Stages 0, 1 and 2 Throat Cancer:

These early-stage cancers may be localised or spread to nearby lymph nodes. Treatment usually includes surgical removal of the tumour and the affected parts. If cancer recurs, surgery may be followed by radiotherapy or laser surgery. 

In the case of laryngeal cancers, the surgeon tries their best to protect the vocal cords.

Stages 3 and 4 Throat Cancer:

Stage 3 throat cancer is treated using a combination of chemotherapy and radiotherapy. People who are not good candidates for chemotherapy may be prescribed targeted therapy or just radiation therapy. 

In many stage 3 throat cancers, surgery may be recommended to remove the tumour with the affected lymph nodes. The surgeon may remove the voice box if stage 3 throat cancer affects the part below the vocal cords. Radiotherapy is almost always given after surgery to prevent a recurrence.

Stage 4 throat cancer is challenging to treat. These cancers are treated with radiotherapy, chemotherapy or targeted drug therapy. Since these cancers are advanced, surgery may be needed to remove the voice box and the surrounding lymph nodes.

Recovery and Follow-Up

When detected early, throat cancers can be successfully treated. Recovery following throat cancer treatment depends upon the type of treatment you have undergone, the extent of your cancer and your overall health and fitness. Many people who undergo throat cancer treatment may require speech therapy. After treatment completion, your doctor will ask you to come for follow-up visits, more so if you have a high risk of relapse or recurrence.

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