Throat cancer in men: symptoms and treatment, survival prognosis

About throat cancer

Throat cancer develops in the back of the mouth, tonsils, voice box, base of the tongue, sinuses and nasal cavity, salivary glands, soft palate, and lymph nodes in the neck.

The throat forms the entrance to the digestive and respiratory systems. It is a small but complex part of the body that connects the nose and mouth with the esophagus, which leads to the stomach, and the windpipe, which connects to the lungs. The throat allows us to swallow, breathe and speak. The main sections of the throat include:

• Throat: The main throat area behind the mouth and above the esophagus is divided into three parts:
  • The oropharynx includes the base of the tongue, soft palate, and tonsils.
  • The nasopharynx is the upper part of the throat behind the nose, above the soft part of the palate.
  • The hypopharynx, also called the hypopharynx, is located at the base of the throat, at the entrance to the esophagus.
• Larynx: voice box, consists of three parts:
  • vocal folds - contains the vocal cords.
  • glottis Supraglottis - the area above the vocal cords, including the epiglottis, the valve that keeps food from the respiratory system.
  • subvocal cavity - the area between the vocal cords and the trachea.

Types of throat cancer

There are several types and subtypes of the disease. They include:

Squamous cell carcinoma develops in thin, flat cells lining most of the throat. These cells look like fish scales when viewed under a microscope. This type of disease is the most common.

Adenocarcinoma begins in the glandular cells of the throat.

Sarcoma is a less common type of throat cancer that develops in the muscle fibers of the neck.

Laryngeal cancer and pharyngeal cancer are the two most common types of throat cancer.

Pharyngeal cancer is subdivided into three types:

• Nasopharyngeal cancer forms in the upper part of the pharynx, behind the nose.
• Oropharyngeal cancer forms in the middle of the pharynx, behind the mouth.
• Laryngeal cancer forms in the lower part of the pharynx, just above the larynx or voice box.

Treatment for pharyngeal cancer often depends on where the disease develops. Cancer of the oropharynx, or the base of the tongue and tonsils, is usually treated differently from a tumor that occurs, for example, in the back of the throat or the back of the pharynx. Treatment is also different from a tumor that forms in the larynx or throat area near and behind the larynx.

Larynx cancer Is a malignant tumor that has arisen in the larynx. Laryngeal cancer treatment often depends on where the disease is forming, whether it is above the glottis, part of the larynx, which consists of the vocal cords and the opening between them, under the glottis or from the vocal cords themselves.

In addition to squamous cell carcinoma and adenocarcinoma, other types of laryngeal cancer are:

• lymphoepithelioma;
• spindle cancer;
• verrucous cancer;
• undifferentiated cancer;
• lymph node cancers called lymphomas.

Throat cancer risk factors

Men are two to three times more likely than women to develop throat cancer. As with many cancers, the risk of developing throat cancer in men increases with age, with most people over 65.

Risk factors differ depending on where the swelling grows in the throat.

Common factors.

• Lack of fruits and vegetables: a diet low in fruits and vegetables may increase your chances of developing throat cancer.

Lifestyle.

• Smoking: smoking cigarettes, cigars can increase the likelihood of developing throat cancer.
• Alcohol consumption. Excessive alcohol consumption can increase your risk of developing most cancers.

Other reasons.

• Human papillomavirus (HPV) infection: Studies have shown that HPV infection is responsible for an increased incidence of throat cancer, especially among patients with oropharyngeal cancer.
• Gastroesophageal reflux disease (GERD): When acid moves from the stomach to the esophagus, acid reflux develops. Chronic reflux, or GERD, can increase the risk of throat cancer depending on its frequency and severity.
• Epstein-Barr virus (VEB): this common virus is transmitted through saliva. EBV can increase your chances of developing throat cancer.

Throat cancer symptoms in men

The signs and symptoms of the disease can be difficult to identify in the early stages of the disease. Many symptoms associated with a swollen throat, such as sore throat or hoarseness, may also accompany cold.

- Early signs of throat cancer in men.

The most common early sign of throat cancer is a persistent sore throat. If a sore throat lasts more than two weeks, the Cancer Society recommends seeing a doctor immediately.

- Progressive symptoms of throat cancer.

The three main types of throat cancer - larynx, laryngopharynx, and oropharynx, including oral cancer - have many symptoms in common. Many of the symptoms of throat cancer in men do not develop in the early stages of the disease. Signs of cancer may first be detected by a dentist or doctor treating another disease or condition. Common symptoms of throat cancer include:

• persistent cough;
• difficulty swallowing;
• a lump in your mouth, throat, or neck;
• hoarseness or other changes in voice;
• pain in the ear or jaw;
• white patches or sores in the mouth or throat;
• labored breathing;
• headaches;
• unexplained weight loss;
• swelling of the eyes, jaw, throat, or neck;
• bleeding in the mouth or nose.

Some throat cancer symptoms are specific to certain areas of the body. For example, voice changes may be a sign of cancer of the larynx (vocal larynx), but they rarely indicate cancer of the pharynx.

- Symptoms of metastatic throat cancer.

The swelling can spread locally to the lips, mouth, or nearby lymph nodes. A throat tumor that has spread to distant parts of the body is called metastatic throat cancer, which most often occurs in the lungs, bones, and / or distant lymph nodes.

Symptoms of metastatic cancer may depend on the part of the body to which the tumor has spread. For example:

• If the tumor has spread to the lungs, symptoms may include difficulty breathing or coughing up blood.
• If tumor metastases have spread to bones, symptoms may include pain or fractures of bones or joints.

Throat cancer stages

Making an informed decision about treatment begins with the stage or progression of the disease. The stage of throat cancer is one of the most important factors when evaluating treatment options. Disease staging, carried out TNM system, a generally accepted method based on three key components:

• T (tumor): describes the size of the original tumor.
• N (node): indicates whether cancer is present in the lymph nodes.
• M (metastasis): shows whether the cancer has spread to other parts of the body.

Further, each factor is assigned a number (0-4) or the letter X. A higher number indicates a more severe condition. For example, a T1 score indicates a small tumor, a T2 score indicates a medium tumor. The letter X means that the information cannot be evaluated.

After the T, N and M scores are established, one of the general stages is assigned:

• Stage I (stage 1 throat cancer): the tumor is small (2 cm or less across) and is limited to the throat.
• Stage II (stage 2 throat cancer): the swelling is larger (usually 2 cm to 4 cm), but still remains in the throat. There is no sign of spread to lymph nodes or distant sites.
• Stage III (stage 3 throat cancer): the tumor has spread beyond the throat and can spread to nearby tissues or organs. The tumor may or may not have spread to a nearby lymph node.
• Stage IV (stage 4 throat cancer): the tumor can be of any size and remain in the neck, or it can involve multiple lymph nodes. The tumor can also spread (metastasize) to distant sites such as the lungs.

Diagnostics

A thorough and accurate diagnosis is the first step in developing a throat cancer treatment plan. Oncologists use a wide range of tools and technologies designed to diagnose and assess disease with an emphasis on speed of treatment and timely results.

During the first two days after arriving at the oncology clinic, doctors perform a full range of diagnostic tests and carefully review your medical history and medical history. A physical examination will also be done. This information will help formulate treatment recommendations, taking into account the characteristics of the patient.

- Biopsy.

A tissue or cell sample from the throat is required for a biopsy and should be tested prior to treatment. The types of biopsies commonly used to diagnose throat and other head and neck cancers include:

• Targeted biopsy: In this procedure, a small section of abnormal tissue is cut out of the area. Since the larynx is located deep within the neck, specimen removal is difficult. Biopsies of this area are usually performed in the operating room, with general anesthesia used to prevent pain.
• Fine needle aspiration biopsy (TAPB): The procedure uses a very thin needle attached to a syringe to extract (aspirate) cells from a tumor or lump.

- Visualization studies.

A variety of imaging examinations can be performed to aid in diagnosis, including:

• Computed tomography (CT): CT can provide information about the size, shape, and position of any tumors, and can also help identify enlarged lymph nodes that contain cancer cells.
• Magnetic Resonance Imaging (MRI): rarely, MRI can be used to investigate throat cancer. MRI scans provide a very detailed overview and can help determine if the tumor has spread to other areas of the neck or other areas of the body.
• Positron Emission Tomography (PET): patients diagnosed with throat cancer are additionally assigned a PET scan to determine if the tumor has spread to lymph nodes to determine the origin of the tumor when it was first found in the lymph nodes, or to check the body for metastases cancer cells.
• Radiography of the lungs: a chest x-ray may be done to check if it has spread lung cancer. Metastases will not be present in the lungs if the disease has not progressed.

- Other diagnostic procedures.

Other diagnostic procedures for evaluating throat cancer often include a range of tests used to look deeper in the throat. For example:

• Panendoscopy: This diagnostic test is used to examine the upper digestive system, including the larynx, esophagus, stomach, and the first part of the small intestine. During the procedure, the patient is given general anesthesia in the operating room, so you can examine the entire body for cancer. Endoscopes are used to look at the back of the throat, larynx, esophagus, and possibly the airways (trachea) and bronchi. Other parts of the nose, mouth, and throat, including the trachea (breathing tube) and esophagus, are also examined during this procedure. The doctor performing the procedure will look for any visible signs of a tumor. Doctors can use a biopsy instrument to biopsy pieces of tissue that look potentially cancerous.
• Laryngoscopy. During the procedure, your doctor may spray your nose or the back of your throat with lidocaine spray to avoid causing pain. Because the throat swelling is near other areas of the head and neck, the doctor may also examine the mouth, nose, and neck.
• Pharyngoscopy: As with laryngoscopy, your doctor may use a spray to numb the back of your throat. Because a throat swelling increases your risk of developing other types of head and neck swelling, your doctor will also check for signs of abnormalities in your mouth, tongue, larynx, and neck.

Throat cancer treatment

Throat cancer treatment options include surgery, radiation therapy, chemotherapy, immunotherapy, and targeted therapy. The options recommended for each patient vary based on a number of factors, including the type, stage, and progression of the disease. The cancer center's multidisciplinary team will answer your questions and recommend treatment options based on your unique diagnosis and needs.

Common treatments for throat cancer include:

- Surgical removal of the tumor.

Below are some of the surgical procedures for illness:

• Surgery for early stage throat cancer. A throat swelling confined to the throat or vocal cords can be treated surgically with endoscopy. The doctor may insert a hollow endoscope into the throat or voice box and then lower the special surgical instruments or laser. Using these instruments, the doctor can scrape, cut, or, in the case of a laser, remove a very superficial tumor.
• Surgery to remove all or part of the voice box (laryngectomy). For small tumors, the doctor may remove the portion of the vocal box that is affected by the tumor, leaving as much of the vocal box as possible. The specialist will retain the ability to speak and breathe normally.
• Larger, more extensive tumors may require deleting the entire voice box. After surgery, a breathing tube (stoma) is attached to the opening in the throat so that you can breathe (tracheotomy). If the larynx is completely removed, there are several ways to restore speech. You can work with a speech therapist to learn how to speak without a voice box.
• Surgery to remove part of the throat (pharynx). For a small throat swelling, only small portions of the throat may need to be removed during surgery.
• Surgery to remove most of the throat usually also includes the removal of the voice box.
• Surgery to remove cancerous lymph nodes (neck dissection). If the swelling in the throat has spread deep into the neck, your doctor may recommend surgery to remove some or all of the lymph nodes to see if they contain cancer cells.

Surgery carries risks of bleeding and infection. Other possible complications, such as difficulty speaking or swallowing, will depend on the specific procedure you are undergoing.

- Chemotherapy.

Chemotherapy can be used before and after surgery to remove the tumor to shrink or kill the remaining tumor cells. Chemotherapy can also be used as first-line therapy, alone or in combination with radiation therapy, for patients with advanced throat cancer.

- Radiation (radiation) therapy.

Radiation therapy, a common treatment for cancer, can be used as first-line therapy for early-stage cancers. Radiation therapy can also be used to treat recurrent tumors.

- Chemoradiation therapy.

This therapy combines radiation therapy and chemotherapy. The therapy can be used as a first-line treatment for laryngeal cancer and can help patients avoid surgery and preserve the larynx or voice box.

Chemoradiation therapy can be used for patients who have decided not to undergo surgery or who are not healthy enough for surgery.

- Surgical intervention.

Surgery to remove the tumor is the preferred treatment for early-stage throat cancer. The throat consists of the pharynx and larynx. For advanced or recurrent tumors, doctors may combine surgery with other forms of treatment, such as radiation therapy and chemotherapy. These treatments can be used to shrink the tumor before surgery. Nearby lymph nodes can also be removed during surgery.

- Targeted therapy.

Laryngeal tumors and hypopharyngeal cancers usually contain high levels of epidermal factor receptor growth, or EGFR, a protein found on the surfaces of many cancer cells that helps them grow and divide. Because tumors of the larynx and hypopharynx contain more EGFR proteins than other cancers, it is possible to use drugs targeting this protein in combination with radiation therapy to treat some of the early stages of cancer throat.

Targeted drugs are also used alone or in combination with chemotherapy to treat some advanced or recurrent throat tumors.

- Immunotherapy.

Immunotherapy drugs designed to help the body's immune system identify and kill tumor cells, may help when cancer does not respond to first-line therapy (surgery and chemotherapy).

FDA approves special inhibitor drugs immune response checkpoints for the treatment of metastatic squamous cell carcinoma of the head and neck that do not respond to standard treatment.

Laryngeal cancer treatment

Laryngeal cancer treatment can be influenced by many factors, including preferences and goals, overall health, and stage of the disease.

Chemoradiotherapy may be a first-line option for early diagnosed laryngeal cancer and laryngeal preservation. Surgery may be required if the cancer is diagnosed at an advanced stage or recurs after treatment.

Other treatment options for laryngeal cancer include:

• targeted therapy;
• immunotherapy;
• chemotherapy;
• radiation therapy;
• clinical trials.

Pharyngeal cancer treatment

Treatment for pharyngeal cancer, including tonsil cancer, may depend on where the tumor is found in the throat, the stage of the disease, and the patient's overall health. Treatment options for pharyngeal cancer include:

• surgical intervention;
• radiation;
• chemotherapy;
• chemoradiation therapy;
• targeted therapy;
• immunotherapy;
• clinical trials.

Surgery may be the first line of treatment for many cases of pharyngeal cancer. The extent of surgery may depend on whether the tumor has spread to nearby lymph nodes and / or to the jaw, larynx, or other areas of the throat.

HPV-related throat cancer treatment options

Human papillomavirus (HPV) is the leading cause of many types of throat cancer. The Centers for Disease Control and Prevention estimates that HPV causes up to 70 percent of cancers that affect the back of the throat, tongue and tonsils, and some other parts of the throat and mouth. A cancer in the throat caused by HPV may respond better to treatment than a tumor caused by alcohol or tobacco use. Treatment options for HPV-associated tumor include:

• radiation (radiation) therapy;
• surgery to remove the tumor;
• chemotherapy;
• chemoradiation therapy;
• targeted therapy;
• immunotherapy;
• clinical trials.

Survival prognosis for throat cancer in men

The prognosis for survival depends on many different factors. So no one can say for sure how long a person will live. It depends on the:

• the type and stage of the cancer;
• level of physical fitness;
• previous treatment.

These are general statistics based on large patient populations. Remember, they cannot tell you what will happen in your individual case.

Survival statistics are available for each stage. The numbers below are survival rates for males. There are no statistics on the survival of women because the data are insufficient.

- Stage 1.

About 90 out of 100 adults (about 90%) live with cancer for 5 or more years after diagnosis.

- Stage 2.

Nearly 70 out of 100 adults (almost 70%) survive for 5 or more years after diagnosis.

- Stage 3.

Nearly 60 out of 100 adults (nearly 60%) survive for 5 years or more after diagnosis.

- Stage 4.

Unfortunately, there is not enough information about stage 4 throat cancer.

Stage 4 cancer can spread to tissues outside the throat, such as the thyroid gland, lymph nodes, or the digestive tract.