Throat cancer (laryngeal carcinoma) often becomes apparent in its early stages with typical signs such as hoarseness or a scratchy throat. Find out here how you can recognize the disease, how it is treated and what the prognosis is!
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Quick overview: throat cancer
definition: Throat cancer is a malignant tumor in the larynx area. Tumors can arise above, below or on the vocal folds.
Signs: Possible symptoms include persistent hoarseness, coughing, difficulty clearing the throat, difficulty swallowing and breathing, and a feeling of a foreign body in the throat.
Treatment: Depending on the location and stage of the cancer, a (partial) removal of the larynx may be necessary. Further measures include radiation and chemotherapy.
forecast: If a larynx tumor is discovered early, the chances of recovery are good. After 5 years, 75 to 90 percent of those affected are still alive.
Article content at a glance:
Throat cancer: You should know these 7 symptoms!
What is throat cancer?
Laryngeal cancer is a malignant cancer of the larynx. The disease usually arises in the superficial cell layer (squamous epithelium) of the vocal folds. That is why the tumors are also called squamous cell carcinomas. However, so-called small cell larynx carcinomas are extremely rare.
Interesting to know: The larynx is the connecting piece between the throat (pharynx) and windpipe (trachea). It is an important producer of sound and is crucially involved in voice formation. It also closes the entrance to the trachea when swallowing so that no food or liquid can enter the respiratory tract.
Classification by location
Squamous cell carcinoma of the larynx is differentiated according to the location of the tumor. This influences the spread to the lymph nodes and, as a result, the course of the disease.
Glottic carcinoma (vocal cord carcinoma): The disease is often glottic carcinoma. They directly affect the vocal folds of the vocal cords.
Supraglottic carcinoma: The supraglottic tumors grow above the vocal cords and only later spread to the vocal cords.
Subglottic carcinoma: Carcinomas of the subglottis form below the vocal cords and are very rare.
Incidence of throat cancer
Laryngeal cancer is the rarest malignant tumor of the upper respiratory and esophageal tract. In Germany, 1 in 100,000 women and 4 in 100,000 men become ill each year. The age at which most people become ill is around 67 years.
Throat cancer: possible signs
What exactly throat cancer feels like varies depending on the location and size of the tumor. The following symptoms and signs are possible in this regard.
Symptoms of glottic carcinoma
Glottic carcinomas (vocal cord carcinomas) often cause symptoms at an early stage. Particularly typical first signs are:
- Hoarseness that persists over a long period of time
- Scratchy throat
- recurring compulsion to clear the throat
- chronic cough
In the case of advanced, large tumors, breathing difficulties occur with an audible breathing noise and, in some cases, shortness of breath.
Signs of supraglottic carcinoma
Hoarseness only occurs in supraglottic carcinomas when the tumor has progressed. Signs of supraglottic carcinoma can include:
- difficulties swallowing
- Sore throat that occasionally radiates to the ears
- Foreign body sensation
Symptoms of subglottic carcinoma
Due to their anatomical location, subglottic carcinomas often go unnoticed and only cause symptoms in an advanced stage. These are often:
Causes and risk factors for throat cancer
In throat cancer, normal cells change into malignant cancer cells and multiply uncontrollably. This mainly happens due to external influencing factors. These primarily include smoking and chronic alcohol consumption.
Other risk factors for throat cancer include:
Throat cancer often develops from precursors, so-called precancerous lesions. These include
leukoplakia (white area in the mucous membrane that cannot be wiped off),
hyperplasia (excessive proliferation of mucous membrane cells) and
dysplasia (excessive proliferation and a changed appearance of mucous membrane cells).
Precancerous lesions do not always, but often, progress to cancer. If they are known, they should either be treated or checked regularly.
Human papilloma viruses (
HPV), especially types 6 and 11, is triggered.
Other risk factors include frequent (occupational) contact with carcinogenic substances, such as wood and metal dust, paints and varnishes containing chrome and nickel, and a weakened immune system, for example as a result of an HIV infection.
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Throat cancer: How the diagnosis works
First, the doctor asks about the medical history and current symptoms. Lifestyle habits such as alcohol and cigarette consumption as well as occupation are also of interest.
A thorough physical examination is then carried out, which includes examining the mouth and throat and scanning the head and neck for a tumor or any enlarged lymph nodes.
Laryngoscopy if laryngeal cancer is suspected
If the suspicion of laryngeal carcinoma is confirmed, an endoscopy can be carried out. This is done either through the mouth (loupe laryngoscopy) or – if there is a strong gag reflex – through the nose (transnasal fiberoptic laryngopharyngoscopy).
If a tumor is found, a thorough examination is usually carried out under anesthesia, during which tissue samples are taken and then examined under a microscope (biopsy). This allows the tumor stage to be determined.
Imaging examination procedures
The location and extent of a tumor can be determined using imaging examination procedures. This is particularly important for planning therapy. They come into question
- Computed tomography (CT) and
- Magnetic resonance imaging (MRI).
Further examinations follow to determine whether lymph nodes and/or other organs are affected. These include, for example, X-ray examinations of the lungs or ultrasound (sonography) of the neck and abdomen.
Treatment of throat cancer
Throat cancer can only be cured if it can be completely removed. That’s why, if your health permits, surgery is always an option. The extent of the operation depends on the stage, location and type of tumor.
Throat cancer: various surgical procedures
Smaller larynx tumors can be removed minimally invasively during an endoscopy using a laser, which removes part or all of the larynx and cervical lymph nodes.
Larger tumors often require open surgery and removal of the larynx (laryngectomy). The trachea and esophagus are completely separated from each other and those affected have access to the trachea through their neck to enable breathing. This permanent tracheotomy is called a tracheostomy.
From a certain stage of the carcinoma, the cervical lymph nodes must also be removed so that tumor cells do not settle in the small organs. Removal of the lymph nodes on both sides of the neck is also called “neck dissection” by experts.
After removal of the larynx
In order to restore the ability to speak after the larynx has been removed, a connection (voice shunt) is created between the trachea and esophagus or the lower throat (hypopharynx), into which a voice prosthesis is inserted. It is also possible to learn the so-called esophageal replacement voice.
Those affected learn a technique with which air movements can be controlled arbitrarily into the esophagus. Through intensive training, a bulge gradually forms in the area of the entrance to the esophagus, which practically takes over the function of the vocal folds, making speaking possible. An alternative is to use an electronic language aid.
Chemo-radiation therapy for throat cancer
In the case of subglottic carcinomas, radiation therapy is usually carried out to the tumor area and the lymphatic drainage pathways after the operation. For glottic and supraglottic carcinomas, radiation is recommended for more advanced stages. Combined chemo-radiation therapy can also be carried out alongside the operation.
In the case of inoperable tumors, as well as those that have already formed daughter tumors in other organs, radiation therapy or combined chemo-radiation therapy can be used as an alternative to surgery. This procedure is also recommended for those affected for whom an operation would pose too great a risk due to their general health.
Targeted therapy
Targeted therapies intervene in certain signaling pathways of cancer cells. They thereby inhibit further tumor growth, while healthy cells are largely spared.
The substance cetuximab is available in combination with radiation therapy or chemotherapy for the treatment of advanced larynx cancer that has already spread (metastasized) to other organs or has returned after initially successful treatment. It is directed against binding sites (receptors) of the so-called epidermal growth factor EGF.
Is throat cancer curable?
The chances of recovery from throat cancer depend on whether and to what extent the tumor has already spread metastases to lymph nodes (metastasis). Metastases are cancer cells from the original tumor that travel through the bloodstream to other organs of the body and settle there.
Particularly in the case of small larynx carcinomas, a complete cure is possible if early diagnosis and treatment takes place. If the tumor is located above the vocal cords, the 5-year survival rate is 82 to 100 percent in stage I and 82 to 92 percent in stage II.
If the cancer is already advanced, the 5-year chance of survival is less than 40 percent. Those affected with successfully treated larynx cancer and no new tumors have appeared after 5 years are considered cured.
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