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Throat Cancer

What is throat cancer?

“Throat cancer” is the general term for squamous carcinoma of the mouth, tongue, palate, voice box, pharynx or esophagus. Although other types of cancer may afflict these areas, squamous carcinoma is by far the most common. Any type of cancer can be a frightening prospect, but cancer of the throat is especially so because surgery routinely affects the ability to swallow and speak

 

Symptoms

What are the Symptoms?

Throat Cancers Generally Cause Pain, But Not Always!

A painless “knot” in the neck may be the first symptom. If you smoke, any mass in the neck should be evaluated immediately. If you are a non-smoker, as a general rule any new mass in the neck that doesn’t resolve itself after two weeks should be checked by your doctor. Often a sample of the mass can be removed with a small needle and a diagnosis can be made without an operative biopsy.

This photo illustrates a typical squamous carcinoma of the palate, which was painful.

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The second photo shows a classic ulcerative tongue cancer, which, strangely, wasn’t very painful.

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Hoarseness is another warning sign of possible throat cancer. Fortunately, most cancers of the voice box will cause hoarseness while the tumor is still small. In these cases, radiation may be used with good cure rates. If the tumor has grown larger, a combination of chemotherapy and radiation can cure the cancer. The voice box is removed only in rare cases. Other symptoms include unexpected weight loss, a feeling of “fullness” in the throat, nasal obstructions, visible physical changes, facial numbness and spitting up blood. (See Photo)

 

Some Additional Symptoms of Throat Cancer May Seem Odd. They Include The Following:

• Ear pain, where no infection, fluid or earwax are present.

• A persistent cough, which may be a sign of nerve damage caused by throat cancer or other lesions.

• Changes in the sense of smell or taste, which usually do not indicate cancer, but should be evaluated if the change is recent.

• Fluid in the ear, causing decreased or muffled hearing, indicating the possibility of a cancer blocking the eustachian tube.

• Nosebleed, which in smokers may be caused by sinus cancer, although nosebleeds otherwise are very common and harmless.

• Bleeding under a stable denture, which may indicate gum cancer.

• A non-healing “infected tooth,” accompanied by prominent lymph nodes, which does not respond to antibiotics, and which may be a sign of cancer around the tooth or in the lymph nodes. This tumor certainly looked cancerous, but it turned out to be a “pyogenic granuloma,” an infected scar next to a broken tooth.

 

Throat pain or a feeling of “fullness” may indicate the presence of a tumor on the vocal cords, which could cause a life-threatening obstruction of the airway. In most cases, however, that “full” feeling arises from a benign condition, like indigestion, gastric reflux, a virus, a hernia or a goiter.

 

In short, any new or unusual symptom in the head or neck should be evaluated, especially if it doesn’t respond to antibiotics. DON’T PROCRASTINATE! since pain in the head or neck usually is caused by a benign condition, you needn’t be afraid to schedule an appointment. If the diagnosis is cancer, surgery will be far less invasive with a greater chance of cure. This Photo illustrates the importance of seeking early treatment. The patient had a pre-cancerous lesion of the tongue called a “leukoplakia” (or “white patch”). Because he refused the simple surgical removal of the lesion, two years later part of his tongue was removed as the lesion had converted to true cancer.

Treatment

If your doctor thinks you might have throat cancer, he or she will probably recommend a biopsy, which often can be done in the clinic, but sometimes a brief visit to the operating room is necessary.  Your doctor will also order a CT scan, which will reveal a great deal about the tumor – its size, its location, how much it has spread, and which specific structures are involved. This photo is an example of what a CT scan looks like. It shows a jawbone eaten through with cancer, with a tooth floating in the middle of the tumor.