Throat Cancer: Symptoms, Diagnosis, and Treatment of Cancer in the Mouth and Throat

The exact causes of throat cancer are not yet fully understood by experts; however, several causes are known and are considered significant risk factors. External factors play a major role in its development.

Smoking is one of the most important factors. Tobacco smoke contains numerous carcinogenic substances that damage the mucous membrane in the pharynx. Regular smoking can therefore significantly increase the risk of pharyngeal cancer. The combination of alcohol and smoking is particularly problematic, as alcohol further weakens the protective function of the mucous membrane.

Human papillomaviruses (HPV) are also suspected of promoting carcinomas in the head and neck region. HPV is mostly known for the diseases it causes in the genital area. For example, it has been proven that some HPV strains are the primary cause of cervical cancer.

The proportion of tumors caused by HPV in the throat has risen significantly in recent years.

In addition to infections, chronic irritation of the mucous membrane is also considered a possible risk factor. Frequent heartburn, for example, can cause stomach acid to repeatedly enter the throat. This can alter the mucous membrane, which may increase the risk of throat cancer.

Furthermore, occupational exposure can play a role. People who regularly work with chemical substances such as formaldehyde are at increased risk. Overall, it appears that throat cancer usually results from a combination of several factors. 

Last but not least, hereditary factors can also play a role in throat cancer.

Throat cancers can occur in various areas of the throat © RFBSIP | AdobeStock

Pharyngeal carcinomas can develop from various precancerous conditions (known as precancerous lesions). These often progress to cancer.

The following precancerous conditions may precede the development of throat cancer:

• Leukoplakia (white patches, leukokeratosis): White, non-removable areas on the mucous membranes in the mouth. It is promoted by tobacco and alcohol use, viral infections, mechanical irritation, iron deficiency, vitamin A and B deficiency, and poor oral hygiene.
• Hyperplasia: an excessive increase in the number of mucosal cells.
• Dysplasia: Excessive formation of mucosal cells accompanied by changes in the cells’ appearance.

Precancerous lesions are often discovered by chance. Once diagnosed, they should either be treated by a doctor or monitored regularly. This can help prevent the development of a malignant tumor later on.

Symptoms of throat cancer often do not appear until the disease is advanced. As a result, throat cancer is often diagnosed at a late stage, when the tumor has already grown larger or metastases have formed. 

One of the first signs is often painless swelling of the lymph nodes in the neck. Enlarged lymph nodes may indicate that the disease has spread.

Other symptoms depend on the specific area of the throat where the tumor is located. 

The following symptoms may indicate oral cavity cancer or throat cancer:

For nasopharyngeal cancer:

• frequent nosebleeds
• Persistent runny nose
• difficulty breathing through the nose
• chronic sinusitis
• Hearing loss (a result of reduced ventilation in the middle ear)
• Tinnitus (ringing in the ears)
• In cases of large tumors: nerve damage in the brain, resulting in visual disturbances (double vision) and facial pain.
• Headaches

In cases of oral cavity and pharyngeal cancer:

• Difficulty swallowing
• Sore throat
• Ear pain
• Impaired tongue function (speech problems)
• Chewing muscle spasms, resulting in difficulty opening the mouth
• Bleeding in the throat or mouth
• Bad breath

In cases of oropharyngeal cancer:

• Difficulty swallowing
• Sore throat
• Excessive salivation
• Bloody sputum
• Feeling of a foreign body in the throat
• Laryngeal involvement: Impaired vocal cord function with hoarseness
• Shortness of breath
• Noticeable weight loss (following involvement of the esophagus)

Since the symptoms initially appear harmless, throat cancer is often not suspected until a late stage. 

If throat cancer is suspected, a thorough medical examination is performed first. The treating physician asks about symptoms, possible risk factors, and medical history.

The mouth and throat are then carefully examined. Using special instruments, the doctor can detect changes in the mucous membrane. An endoscopic examination is often performed as well, allowing for a closer look at the throat and larynx.

If a tumor is still suspected, a biopsy is performed. During this procedure, a small tissue sample is taken and then examined in the laboratory. This tissue sample allows for a definitive diagnosis.

Imaging techniques such as CT or MRI help determine the size of the tumor, its exact stage, and how far it has spread. This information is crucial for determining the timing of the diagnosis and planning further treatment.

Treatment for pharyngeal cancer depends on the type and location of the tumor. For many types of tumors, it is possible to surgically remove the malignant tissue.

An important goal of treatment is to maintain the patient’s quality of life—that is, to allow them to

• eating,
• drinking,
• speaking, and
• breathing

.

There is no general prognosis for life expectancy in cases of nasopharyngeal cancer, as this depends on the individual case. In general, the treatment of nasopharyngeal carcinomas differs from that of oropharyngeal and hypopharyngeal carcinomas.

Treatment of nasopharyngeal carcinomas

The treatment of nasopharyngeal cancer depends on several factors. Key factors include the size of the tumor, the stage of the disease, and its exact location in the nasopharynx.

In many cases, surgery is performed first to completely remove the tumor. Such a procedure can be performed via various approaches, for example, through the mouth, throat, or lower jaw area.

In addition to surgery, radiation therapy plays an important role. Radiation therapy can be administered either after surgery or as a standalone treatment when surgery is not possible.

In certain cases, chemotherapy is also administered. The combination of chemotherapy and radiation therapy is frequently used for advanced-stage disease.

Ultimately, treatment depends on the individual course of the disease. Modern approaches to treating head and neck tumors aim to effectively combat the tumor while preserving as much healthy tissue as possible.

Side effects can occur with any treatment. These include, for example, difficulty swallowing, changes in the voice, or irritation of the mucous membranes. For this reason, potential long-term effects of the treatment are discussed with the patient in advance.

The prognosis for throat cancer depends heavily on the timing of the diagnosis, the stage, and the extent of the disease. If the tumor is detected early, the chances of a cure are significantly better.

Many patients wonder whether throat cancer is curable. In fact, the disease can be cured if the tumor is detected early and treated consistently.

In advanced stages, treatment can be more complex. Nevertheless, modern treatment methods allow for effective control of the disease and can improve life expectancy.

Organizations such as German Cancer Aid offer support and further information, providing comprehensive counseling to patients and their families.

How can you recognize throat cancer?

Many people wonder: Can throat cancer be detected early? Early signs may include difficulty swallowing, hoarseness, or painless swelling of the lymph nodes. It is therefore important to see a doctor for an examination if these symptoms persist.

What are the signs of throat cancer?

The signs can vary. Common symptoms include a sore throat, difficulty swallowing, hoarseness, or bleeding in the mouth and throat area.

Is mouth and throat cancer curable?

It depends on the stage of the disease and when it is diagnosed. If the disease is detected early, the chances of a cure are good.

How is throat cancer treated?

Throat cancer is usually treated with a combination of surgery, radiation therapy, and chemotherapy. The method used depends on where the tumor is located and how it has spread.