Throat Cancer

Throat cancer refers to a neoplasm that forms in tissues of the pharynx, which is the hollow tube inside the neck that starts behind the nose and ends at the top of the windpipe and esophagus. Most throat cancers are squamous cell carcinomas or those that begin in thin, flat cells that look like fish scales.

Types of Throat Cancer

The throat and the voice box are closely connected, with the voice box located just below the throat. More specific terms to describe the types of throat cancer include:

  • Nasopharyngeal cancer begins in the nasopharynx — the part of the throat just behind the nose.
  • Oropharyngeal cancer begins in the oropharynx — the part of the throat right behind the mouth that includes the tonsils.
  • Hypopharyngeal cancer or laryngopharyngeal cancer begins in the hypopharynx — the lower part of the throat, just above the esophagus and windpipe.
  • Glottic cancer begins in the vocal cords.
  • Supraglottic cancer begins in the upper portion of the larynx and includes cancer that affects the epiglottis, which is a piece of cartilage that blocks food from going into the windpipe.
  • Subglottic cancer begins in the lower portion of the voice box, below the vocal cords.

Risk factors:

  • Tobacco use, including smoking and chewing tobacco
  • Excessive alcohol use
  • Poor dental hygiene
  • Human papillomavirus (HPV)
  • A diet lacking in fruits and vegetables
  • Exposure to asbestos

Signs & Symptoms:

  • cough
  • hoarseness
  • Difficulty swallowing
  • Ear pain
  • A lump or sore that doesn’t heal
  • sore throat
  • Unexplained weight loss

Diagnostic Evaluation:

  • Endoscopy/laryngoscopy
  • Biopsy of a tissue sample
  • Imaging tests such as X-ray, computerized tomography (CT) scans, magnetic resonance imaging (MRI) and positron emission tomography (PET)

Medical Management:

Radiation therapy

Radiation therapy utilize high-energy particles, such as X-rays, to deliver radiation to the cancer cells, causing them to die. Radiation therapy can come from a large machine outside the body (external beam radiation) or from small radioactive seeds and wires that can be placed inside the body, near the locality of the cancer cells (brachytherapy).
Surgery
The types of surgical procedures you may consider to treat your throat cancer depend on the location and stage of your cancer. Options may include:

  • Surgery for early-stage throat cancer. Throat cancer that is confined to the surface of the throat or the vocal cords may be treated surgically using endoscopy.
  • Surgery to remove all or part of the voice box (laryngectomy).
  • Surgery to remove all or part of the throat (pharyngectomy).
  • Surgery to remove cancerous lymph nodes (neck dissection).

Chemotherapy
Chemotherapy uses chemicals to kill cancer cells. Chemotherapy is often used along with radiation therapy in treating throat cancers.
Targeted drug therapy
Targeted drugs treat throat cancer by altering specific aspects of cancer cells that fuel their growth. Cetuximab (Erbitux) is one targeted therapy approved for treating throat cancer in certain situations. Cetuximab stops the action of a protein that’s found in many types of healthy cells, but is more prevalent in certain types of throat cancer cells.

Nursing Considerations & Prevention

  • Avoid smoking or at least ask for help in stopping smoking.
  • Alcohol consumption should in moderation like twice a week.
  • Include fruits and vegetables in the diet since it includes antioxidants that would reduce the chances of throat cancer.
  • Use proper protection for breathing and the oral cavity when exposed to certain chemicals.
  • Assist the patient and the family in dealing with the psychological impact of the diagnosis of cancer, alteration of physical appearance, and possible need for altered methods of communication due to loss of voice.
  • The nurse can suggest interventions to reduce side effects of radiation therapy. Dry mouth (xerostomia) the most frequent and annoying problem. Pilocarpine hydrochloride can be used in increasing salivaPhoto credits: Mayo Foundation of Medical Education and Research

Photo credits: aurorahealthcare.org

Daisy Jane Antipuesto RN MN

Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.

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