Throat Cancer

Each year, smoking kills more people than AIDS, alcohol, drug abuse, car accidents, murder, suicide, and fires—combined! The use of tobacco increases the risk of contracting throat cancer. Throat cancer is one of the most prevalent cancers within the United States. Cancer of the larynx (or voice box) is a disease in which cancer (malignant) cells are found in the tissues of the larynx. The larynx is a short passageway shaped like a triangle that is just below the pharynx in the neck.

The pharynx is a hollow tube about 5 inches long that begins behind the nose and goes down to the neck to become part of the esophagus (the tube that goes to the stomach). Air passes through the pharynx and then the larynx on the way to the windpipe (trachea) and into the lungs. Food passes through the pharynx on the way to the esophagus. The larynx has a small piece of tissue over it, called the epiglottis which keeps food from going into it or the air passages. Throat cancer occurs when cells in the pharynx or larynx begin to divide abnormally and out of control.

Most throat cancer begins on the vocal cords, later spreading to other parts of the larynx and pharynx. One of the most reliable and earliest symptom of throat cancer is sudden, unexplained hoarseness in the voice. About 10,000 new cases of throat cancer occur in the United States per year, generally affecting older males who use chewing tobacco, or those who have been heavy smokers (cigarettes, cigars and/or pipe smokers), or alcohol abusers. Studies indicate that the incidence of throat cancer in women and young people has increased due to the greater use of tobacco and alcohol products in this bracket.

Throat cancer is more common in men, because smoking is a more common habit among males. Only one-fifth of the patients diagnosed with throat cancer will be women. Throat cancer is also closely associated with other cancers. Fifteen percent of throat-cancer patients also are diagnosed with cancer of the mouth, esophagus, or lung. Surprisingly another ten to twenty percent of these patients develop these cancers later on. Other people at risk include those who consume large quantities of alcohol, especially in combination with smoking.

The most affective way to prevent throat cancer is to cease the use tobacco products entirely and cut back on alcohol. When throat cancer affects the vocal cords, the first recognizable symptom is a change in the sound of the voice – particularly a hoarseness resulting in a deepening of the voice or a reduction in the volume of the voice. Other symptoms of throat cancer include: ·Painful or difficult swallowing ·Persistent sore throat ·The feeling of a “knot” in your throat (need to swallow) ·Swelling or pain in the neck.

·Enlarged glands in the neck ·A heavy cough ·Wheezing or raspy breathing ·Weight loss ·Coughing up blood ·A change in bowel or bladder habits, ·A sore that does not heal (the lack of the body to fight off diseases) ·Any unusual bleeding or discharge Many of these symptoms seem may seem commonplace to the general population, but it is important to seek medical advice if these symptoms are persist, reoccur, or last longer than two weeks. Regular screenings and self-exams can help to prevent and detect throat cancer in the early stages.

With early detection, almost 90 percent of throat cancer victims are able to survive five years or longer. Therefore, it is important to pay close attention to any warning signs that the patient may be experiencing in order to ensure the best opportunity for a long, healthy life. The type of treatment recommended for throat cancer depends largely on how far cancer has spread at the time treatment begins. The preferred treatments for the early stages of throat cancer are radiation therapy and surgery. A team of specialists may treat patients with oral cancer.

The medical team may include an oral surgeon; an ear, nose, and throat surgeon; a medical oncologist; a radiation oncologist; a prosthodontist; a general dentist; a plastic surgeon; a dietitian; a social worker; a nurse; and a speech therapist. The doctor might also use a test called a CT scan (CAT scan). This is a special type of X-ray that provides images of the body from different angles. A CT scan can help find the location of a tumor, help judge whether or not a tumor can be surgically removed, and help determine the cancer’s stage of development.

If your doctor suspects throat cancer, he will examine your throat using a procedure called laryngoscopy. This can be done with a long-handled mirror, or with a lighted tube called a laryngoscope. Once the surgeon performs the procedure they will search for any infected areas. If any, they will perform a biopsy. A biopsy is the removal of tissue during a surgical procedure. Once it is removed, they will send the sample to the laboratory to determine whether the tissue is cancerous or not. The only way to determine if the sample is cancerous is confirmation from the laboratory.

·Stage 0: Simple surgical stripping of the affected layer of tissue usually can treat throat cancers. ·Stage I or II: Throat cancers require surgery, radiation therapy, or both. Radiation therapy can be highly successful with these cancers, but, unfortunately, throat cancers rarely are found this early. ·Stage III or IV: Throat cancers likely will require some combination of surgery, radiation therapy and chemotherapy. In more advanced cases, chemotherapy may be given in combination with surgery and/or radiation. When throat cancer has not been detected until it has spread widely throughout the body, chemotherapy may be given alone.

Most cancers at later stages require the surgical removal of part or all of the larynx or pharynx. A surgery on the larynx is called a laryngectomy. A procedure done on the pharynx is known as a pharyngectomy. Laryngectomies are the most common throat-cancer surgery. It may require removal of the entire larynx, or partial. In either case, the patient will lose some speaking ability and require special techniques or speech rehabilitation procedures to regain the use of his or her voice. When cancer cells have stretched beyond the larynx or pharynx and into the lymph nodes.

A very risky surgery called neck dissection is in store. During this procedure, lymph nodes known or suspected to contain cancer cells are removed in hope of containing the cancer before it spreads throughout the body. After surgery, radiation therapy may be performed to destroy remaining cancer cells. Throat-cancer patients are at risk for developing other cancers in the mouth, throat or esophagus. There is still always a risk of having cancer spread to a different part of the body even if it is cured in one part of the throat. Even when the cancer is in remission, follow-up examinations are crucial to long-term health.

As with all cancers, the outlook is much better if throat cancer is discovered before it spreads to adjacent tissues, or throughout the body. Although many patients with earlier stages of throat cancer are cured through surgery or radiation therapy, many have to learn new ways to speak. Spoken communication may be restored with mechanical device of sound with an electrolarynx enabling the patient to mouth words while vibrating their neck and throat (See picture #2). Another more easily understood method of talking is esophageal speech. Air is injected into the esophagus, and reversed back up to produce sound for speech.

This is a very difficult procedure to master for the common person. A popular method of speech production following laryngectomy is the voice restoration procedure. A puncture is placed through the back wall of the trachea windpipe into the esophagus and held open with a one-way valved prosthesis. By occluding the opening in the neck (tracheostoma), air is directed through the voice prosthesis into the throat causing vibration of the soft tissue and generating voice. Fluent speech that is usually readily understandable is produced (See picture #3).

In conclusion, the evidence of the rise in the number of people being diagnosed with cancers caused by the use of tobacco products should be a sufficient warning to people to avoid the use of these products entirely. It is important to pay attention to symptoms that may indicate a potential problem and to seek medical attention as soon as possible. Family medical histories should be considered as well when reporting the development of unusual symptoms to the physician. As always, a healthy diet and regular exercise are the best preventative measures to take ensure a long and productive life.

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