Conditions: Throat Tumors
Because of the location, tumors of the throat threaten the functions of swallowing, breathing, and talking and at times can be lethal. Fortunately, diagnosis and treatment of throat cancers has improved greatly in recent years. Evaluation involves a specialist’s examination, looking in the throat with a scope and performing a biopsy and/or imaging if needed.
ANATOMY
The throat (pharynx) is anatomically divided into three parts: the nasopharynx at the back of the nose, the oropharynx behind the oral cavity, and the hypo pharynx just above the esophagus. The larynx (voice box) is in front of the hypopharynx and is the entryway into the trachea.
Oropharyngeal Cancer
The oropharynx, which is the middle part of the throat, contains the tonsils, base of tongue, the soft palate, and intervening tissues, such as on the back (posterior) surface. This important and complex anatomical segment has long been the site of cancers, especially squamous cell carcinoma, and more recently has increased incidence due to exposures with the human papilloma virus.
Tonsil cancer
Tonsils (technically, the “palatine tonsils”) are lumps of tissue in the sides of the oropharynx. While tonsils may become swollen and/or infected, certain characteristics of an enlarged tonsil raise suspicion for possible cancer. These include a history of smoking with or without heavy drinking, the presence of one or more lumps in the neck, one tonsil being significantly larger than the other, and bleeding from a tonsil. The three most common types of tonsil cancer are squamous cell carcinoma with the p16 protein present, squamous cell carcinoma with the p16 protein absent, and lymphoma.
base of tongue cancer
The very back of the tongue, which is not visible when looking directly through an open mouth, is called the base of the tongue, and its surface has a layer of tissue identical to the tonsil. In fact, this tissue is often called "lingual tonsil” meaning tonsil of the tongue. The base of the tongue is a specific site within the broader anatomic area called the oropharynx. As with palatine tonsils, the lingual tonsils can develop into cancers of various types described above (p16 positive squamous cell carcinoma, p16 negative squamous cell carcinoma, and lymphoma, among others). A growth in this location is can grow surprisingly large before it is noticed, and often the first indication of a problem is the development of a lump in the neck which represents spread of the cancer to a lymph node.
larynx (voice box) cancer
A cancer located on a vocal cord may be apparent even when small because here, even a small change in the vocal cord surface creates hoarseness. Generally, any. hoarseness lasting more than a month should be evaluated by an Ear, Nose, and Throat surgeon. If a cancer arises in the voice box above or below the vocal cords, however, it may not create symptoms until it has grown fairly large, at which time difficulty with breathing or swallowing may indicate a problem.
Nasopharyngeal carcinoma
Nasopharyngeal carcinoma is unique type of cancer that arises in the nasopharynx, which is at the corner between the nasal airway and the throat. It is thought to arise from a combination or risk factors including exposure to a specific virus (Epstein-Barr virus), significant ingestion of smoked fish, and southeast asian heritage. Because of the location, nasopharyngeal carcinoma is often identified relatively late, when the tumor has spread to a lymph node on the side of the neck or when the tumor has blocked one of the Eustachian tubes, causing one-sided fluid and hearing loss in an adult.
Other throat tumors
Beyond those listed above, there is a long list of additional tumors that can arise in the throat throat, parapharyngeal space tumors (schwannoma, glomus tumor, deep lobe of parotid tumor), minor salivary gland cancers, liposarcomas, and more. The mainstay of diagnosis is pathologic examination of the tissue under a microscope, but radiologic imaging (such as ultrasound, CT, or MRI) often contribute.
Get the most from your throat tumor appointment
Appointment time is valuable. Below are some suggestions to make the most of your appointment. This preparation will help you and your doctor maximize efficiency and accuracy, freeing up time for questions and answers.
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