Throat cancer belongs to the group of head and neck tumors. Most of those affected only become ill at an older age. The main risk factors are high tobacco and alcohol consumption. How can tumors in the throat area be treated and what are the chances of recovery?
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Quick overview: Frequently asked questions and answers
How does throat cancer start? Throat cancer often develops from precursors that can be recognized by whitish areas in the mouth. Other symptoms often go unnoticed for a long time. Later on, a sore throat and difficulty swallowing often occur.
Where does throat cancer spread? Throat tumors can spread to the lymph nodes. Cancer cells break away and form metastases (secondary tumors). There is also a risk that they will spread through the blood-lymph system and affect other organs such as the lungs.
Is throat cancer curable? The earlier the tumor is detected, the better the chances of recovery. If diagnosed early, 75 to 90 percent of those affected are still alive after five years.
Article contents at a glance:
The most common types of cancer in Germany
What is throat cancer?
Throat cancer (pharyngeal carcinoma) is a malignant tumor of the throat (pharynx). It belongs to the group of head and neck tumors.
According to the three anatomical sections of the throat, three types of pharyngeal carcinoma are distinguished:
Oropharyngeal cancer (oropharyngeal cancer): Oropharyngeal carcinomas occur in the so-called oral pharynx, the oropharynx. This extends from the base of the tongue and the soft palate with the tonsils and the uvula to the epiglottis, which closes the entrance to the larynx.
Hypopharyngeal carcinoma (pharyngeal cancer): Hypopharyngeal carcinomas affect the lowest section of the throat, the so-called pharynx, known in technical language as the hypopharynx.
Nasopharyngeal carcinoma (nasopharyngeal cancer): Nasopharyngeal carcinomas are malignant tumors of the so-called nasopharynx, the nasopharynx. This is located above the soft palate, behind the main nasal cavity.
About half of all malignant head and neck tumors are located in the upper part of the swallowing system, most of them in the oropharynx and hypopharynx.
Frequency of throat cancer
In Germany, around 9,350 men and 3,740 women develop carcinomas of the oral cavity and throat every year. Men are on average 63 years old at the time of diagnosis and women are 66 years old.
Throat cancer: What are the typical symptoms?
In many cases, a malignant tumor of the throat does not initially cause any symptoms, which is why it goes unnoticed for a long time. Only later in the course do symptoms usually appear, which vary depending on the location and size of the tumor:
Oropharyngeal carcinoma often causes a sore throat or difficulty swallowing, especially if there are tumors in the base of the tongue.
Pharyngeal cancer can also cause throat problems and difficulty swallowing. Hoarseness and shortness of breath may also occur.
Nasopharyngeal carcinomas can lead to obstructed nasal breathing, nosebleeds, ear pain and permanent tympanic effusion.
All head and neck tumors can also be accompanied by non-specific symptoms. These include unclear weight loss or swollen lymph nodes on the neck.
Tongue cancer: recognizing symptoms and avoiding risk factors
Throat cancer: causes and risk factors
A throat tumor arises – like almost all cancers – from genetic changes in the genetic makeup of the cells. Normal cells degenerate into malignant tumor cells and begin to grow uncontrollably. The exact reasons for this are not yet clear.
However, it is known that the following factors in particular increase the risk of throat cancer:
Tobacco and alcohol consumption: Smoking and regular heavy drinking are considered the most important risk factors for throat cancer. The combination of alcohol and is particularly dangerous Smoking: Alcohol increases the carcinogenic effects of smoking, which is probably due to the alcohol weakening the natural protective function of the mucous membrane.
HPV infection: Infections with certain types of human papillomavirus (HPV) are primarily associated with cervical cancer. But they can also lead to throat cancer. HPV type 16 appears to be a particularly common pathogen.
Infection with the Epstein-Barr virus (EBV): This virus from the group of herpes viruses, which causes so-called Pfeiffer’s glandular fever, appears to play a role in the development of nasopharyngeal cancer.
In addition, contact with carcinogenic substances such as formaldehyde can promote the development of nasopharyngeal tumors. The substance is contained in preservatives, disinfectants and lubricants.
Consuming large amounts of foods containing nitrosamines also appears to have an influence. The main sources are cured meat and sausage products as well as heavily salted fish.
In addition, a genetic predisposition is also suspected, as carcinomas occur more frequently within a family.
Precancerous lesions (precancerous lesions)
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
Dysplasia: excessive proliferation and a changed appearance of mucous membrane cells
Precancerous lesions do not necessarily develop into cancer, but they often do. You should therefore either be treated or checked regularly after diagnosis.
How is throat cancer diagnosed?
First, the medical history and current complaints are recorded. Doctors ask in particular about lifestyle habits such as alcohol and cigarette consumption as well as the patient’s profession.
This is followed by an examination of the mouth and throat as well as the head and neck area for a tumor or possibly enlarged lymph nodes. If throat cancer is suspected, tissue samples are taken from the mouth and throat and examined in the laboratory for cancer cells (biopsy).
Spread diagnostics
In order to be able to accurately assess the entire extent of a tumor within the mucous membrane, a thorough examination of the throat is usually carried out under anesthesia (panendoscopy). During the mirroring, tissue samples are taken from suspicious areas and then examined under a microscope.
Using imaging examination methods, the location and extent of a tumor can be determined in more detail. This is particularly important for planning therapy. The following can be used:
Throat cancer treatment: What are the options?
The treatment of pharyngeal carcinoma depends primarily on the type and location of the tumor. It must also be taken into account how far the tumor has already spread and what the patient’s health is.
Surgery of the tumor
For smaller tumors, surgery is the first choice. An attempt is made to remove all of the malignant tissue.
If the tumor is already very advanced, extensive operations are often necessary. In these cases, large parts of the throat and lower jaw as well as the cervical lymph nodes may have to be removed. In medical terminology, this removal is called a neck dissection. Surgical reconstruction then takes place.
Radiation and chemotherapy
Radiation therapy or chemotherapy is particularly necessary if all of the tumor tissue could not be removed during the operation. Alternatively, especially if the prognosis is unfavorable, the operation can be avoided and combined radiation chemotherapy (radiochemotherapy) can be carried out. Radiation from the inside is then possible, a so-called endoscopic afterloading brachytherapy, in which the radiation source is brought directly to the site of the tumor using a thin tube.
Good to know:
The diagnosis of throat cancer is also very emotionally stressful for many of those affected and can be accompanied by psychological comorbidities such as fatigue (persistent exhaustion) or depression. Therefore, professional psychological care is recommended for a tumor in the throat.
If it is no longer possible to cure the cancer, therapy aims to slow the growth of the tumor and alleviate the symptoms.
Prognosis and chances of recovery for throat cancer
The prognosis for throat cancer is favorable if it is detected early. On average, about 60 percent of people with throat cancer are still alive five years after diagnosis. Patients have a better prognosis if their cancer is due to an HPV infection. Then the rate is 75 percent. For other causes it is less than 50 percent.
If the cancer cells have invaded the lymph nodes, the survival rate drops by around half. Long-term healing is then often no longer possible.
How can throat cancer be prevented?
External factors play an important role in the development of throat cancer. To prevent this, we recommend:
a healthy lifestyle with moderate alcohol consumption and smoking cessation
Avoid unprotected oral sex with changing sexual partners
Vaccination against cancer-causing HPV types
Recommended vaccinations and vaccination intervals
