Many people have uncomfortable symptoms associated with the throat – sore throat, perspiration, hoarseness, difficulty with swallowing. In most cases, these symptoms are a sign of colds caused by bacteria or viruses. But if such phenomena are observed for a long time and do not pass, then they can testify to a much more dangerous disease – throat cancer.
Description of the disease
Malignant tumors of the throat, fortunately, cannot be considered among the most common cancer diseases. At the same time, such a disease cannot be called very rare. Throat cancer occurs in about 4% of cancer patients.
Localization of the disease
The disease begins with a small tumor located in the throat, or more precisely, in a layer of epithelial tissue lining the surface of the larynx or pharynx. If we consider tumors in the pharynx, then these formations most often affect the nasopharynx. This localization of the tumor is especially dangerous, since the tumor can germinate into the air cavities of the skull.
Gradually, the tumor grows in size and affects surrounding tissues. In the final stage of the disease, lymph nodes can be affected, as well as tumor metastases are formed in other parts of the body. In the end, in most cases, the patient dies either from massive bleeding from tumor-affected blood vessels, or from aspiration of blood or food.
The tumor can affect the various parts of the larynx – the lower (below the vocal cords), the middle (in the region of the vocal cords) and the upper one (above the vocal cords). The over ligamentous department is most often affected (two thirds of cases). Also, this localization is characterized by rapid tumor development and early metastasis. The ligamentous department is affected in about a third of cases. As a rule, the tumor develops slowly, that allows it to be detected on time and begin treatment. Subligamentous localization is infrequent, it is characteristic only for 3% of cases. The location of this type of cancer is very dangerous; it is characterized by diffuse development. Tumor localization in the larynx among all cases of throat cancer occurs in about 55% of cases, in the pharynx – in 45% of cases.
Types of the disease
From the histological point of view, almost all cases of laryngeal cancer (98%) refer to squamous cell carcinoma.
From the morphological point of view, the following varieties of squamous cell cancer of the throat are distinguished:
- well differentiated.
Non-squamous cancer develops relatively quickly and forms many metastases, actively sprouting into the surrounding organs. This type of disease is most common. Usually it is located in the upper part of the larynx or in the ventricle of the larynx. Often, this type of tumor spreads from one part of the larynx to another. Non-squamous cancer leads to a decrease in the laryngeal lumen, which causes the patient to have shortness of breath and loss of voice.
Squamous cancer is characterized by the presence of cells, which eventually become squamous. This type of disease does not develop so quickly compared to others. Metastases with it also almost do not appear. Most often, tumors with squamous cells are observed in the region of the vocal cords.
Well differentiated cancer significantly involves healthy tissues in the pathological process. Treatment of this type of disease is the most time-consuming.
Causes of the disease
Unlike many other cancers, throat cancer has a clearly established dependence on certain unfavorable factors. And tobacco smoking is in the first place among these factors. In fact, it can be argued that throat cancer is a disease of heavy smokers. More than 85% of patients with throat cancer have such an addiction as smoking.
The second important factor is sex. Throat cancer is predominantly a male disease. Approximately 95% of patients are men over 50 years of age. In women, the disease is relatively rare, but this does not mean that a woman, especially a smoker, does not have a chance to get sick with this ailment. At a young age, the disease also rarely occurs; therefore, the elderly age is another negative factor.
Other factors contributing to the disease are the following:
- inhalation of toxic fumes;
- work with hazardous chemicals (chemical industry, paint and varnish production, construction and repair);
- improper diet, plenty of smoked and salted food, lack of fresh vegetables and fruits;
- alcohol abuse;
- non-compliance with oral hygiene;
- hereditary factors;
- infectious mononucleosis;
- tumors of the neck and head of another localization;
- radiation exposure.
The disease manifests itself in severe form not immediately, but develops over long months or even years. Unfortunately, people often do not notice unpleasant symptoms in time, and they seek help from a doctor only when the disease turns into an incurable form. Meanwhile, throat cancer in the early stages has well-recognized symptoms. An exception to this rule is only the zero stage (precancer), in which pathological changes in the tissues do not manifest themselves in any way and can be detected only with an occasional diagnostic examination of the respiratory organs.
Depending on the location of the tumor, the symptoms may be slightly different. Angina-like pains, nosebleeds from the tonsils, a feeling of nasal congestion, toothaches and tooth loss, headaches, an increase in the submandibular lymph nodes are most observed with tumors in the nasopharynx and the oropharynx.
Over ligamentous department has the following symptoms:
- sensation of a foreign body;
- pain when swallowing.
Changes in the voice for a given localization occur only in the late stages of the disease.
When the tumor is localized in the region of the vocal cords, patients feel the most frequent pain when talking, changes in the voice or its complete loss. These symptoms can manifest themselves at the earliest stages of the disease.
Pain or discomfort is usually observed when passing through the food lump, as well as constant shortness of breath with subligamentous localization. Changes in the voice are added only in the
late stages of the disease.
Various methods can be used to diagnose the disease. An otolaryngologist can rarely reveal the disease, especially at an early stage. Therefore, instrumental research methods are used first. Laryngoscopy is the simplest of these ones. This method consists in examining the surface of the mucous membrane of the larynx with a special lamp and mirror.
A biopsy plays great importance in identifying the disease and its differentiation from other pathological processes, in particular, inflammatory. This method consists in taking a piece of tissue from the affected area for analysis. To identify the scale of the pathological process, diagnostic methods such as MRI and radiography are used. They can detect the presence of
metastases, as well as determine the size and shape of the tumor.
The treatment strategy depends on the stage of the disease. At an early stage, surgery is the most effective method of treatment to remove the tumor. It can be carried out both in a traditional way, and with the help of a laser.
A chemotherapy course can be prescribed to a patient to prevent the recurrence. It should be borne in mind that in some cases, the operation may remove the vocal cords and the tongue (partially or entirely), which makes it much more difficult or impossible to speak and eat.
In the later stages, the removal operation may not be possible. Therefore, methods such as chemotherapy and radiotherapy are used. In radiation therapy, the tumor is irradiated with a stream of high-energy particles that kill cancer cells. The goal of radiotherapy can be both complete destruction of the tumor and its significant reduction or arrest of growth. Sometimes radiation therapy precedes surgery.
Contraindication to radiation therapy is the germination of a tumor in the esophagus and blood vessels, a serious condition of the patient. Chemotherapy uses cytostatic drugs that slow the division of cancer cells. Cytotoxic drugs can be administered intramuscularly, intravenously, orally, or directly into the area affected by the tumor. However, all measures for the treatment of the disease are likely to be ineffective if the patient does not get rid of the addictive habit of smoking. After the operation, the patient will need a rehabilitation course, including, in particular, speech skills one. In the event when the patient loses the ability to breathe due to the large size of the tumor, a tracheostomy operation is performed at which a tube is inserted into the trachea.
In case the disease is recognized in time (in the first stages), then the probability is high that the ailment will be able to be defeated. Thus, the five-year survival rate in patients with throat cancer in the first stage is 85%.
Patients’ five-year survival rate with the disease in the fourth stage is less than 20%. Much depends also on whether the patient agrees to an operation to remove the larynx and vocal cords (laryngectomy), which, as mentioned above, can make a person dumb.
The cancer of the throat is, above all, the disease of those who abuse alcohol and nicotine. That is why the rejection of these addictive habits greatly reduces the likelihood of the disease. Other risk factors include non-compliance with oral hygiene, as well as the continued inhalation of carcinogenic chemicals. In elderly men, the disease occurs especially often, so people in this risk group should monitor hygiene and avoid manipulation of toxic substances. Substances with increased carcinogenicity include asbestos, benzene, petroleum products, coal dust, phenolic resins.
When working with potential carcinogenic aerosols, respiratory protection devices, such as gauze dressings and respirators, should be used. If contact with carcinogenic substances is an inevitable consequence of the performance of professional duties (for example, for workers in the chemical industry or the construction industry), then in such a case there is a need for an annual inspection. In addition, it should be borne in mind that early diagnosis of the disease significantly increases the likelihood of recovery.