Treatment of throat cancer

If you are officially diagnosed with throat cancer, your pathologist will present you with many treatment options:

Chemotherapy – you’ll be given different and potent medicines, usually after you have surgery. These medicines are designed to kill any cancerous cells that may have been missed during surgery. They are also intended to stop precancerous cells from developing and spreading. In some instances, depending on the nature, stage, type, and location of your cancer, you may be given only chemotherapy. However, it tends to be combined with other types of therapies and treatments like radiation therapy and/or surgery.

Radiation therapy – This is often used as a stand-alone therapy depending on the type, size, location, nature, and stage of your cancerous tumors. It is preferred if your throat cancer is in the early stages. It concentrates unique radioactive energy on cancerous areas to kill the cancer cells and keep you in remission. There are three types of radiation therapy:

○ External beam radiation therapy

○ Internal beam radiation therapy

○ Systemic radiation therapy

Your pathologist will use a particular machine that will take detailed images of the affected areas before, during, and after the procedure to check for progress or issues of concern. Because it is targeted, the radiation mostly kills cancerous cells while leaving healthy cells untouched. Radiation therapy does have side effects, the most common of which are:

○ Skin reactions

○ Extreme fatigue

○ lymphedema

Chemoradiation – pathologists commonly refer to this therapy as chemoradiotherapy. This combines chemotherapy with radiation therapy. You’ll be given a combination of powerful cancer-fighting medicines and powerful radioactive x-ray beams which will effectively kill your cancerous cells and tumors. Your pathologist will recommend it if you have advanced-stage laryngeal cancer (cancer which has progressed to at least stage 3.) Chemoradiation works best if the disease is advanced but has not metastasized. This is a preferred treatment option if having surgery would mean removing your larynx or voice box. If your entire larynx is removed, you will be able to talk using a microphone up to a hole in your neck. Because chemoradiation is complicated and involved, you’ll be hospitalized for at least a few days. 

You’ll be given a cocktail of powerful medicines like:

○ Cisplatin and fluorouracil

○ Cisplatin (alone)

○ Carboplatin

○ taxol

             These medicines are generally given through an IV drip. Your pathologist will determine the amounts of radiation therapy you need before your planned treatment. You’ll have multiple blood draws before and while receiving treatment. These are designed to check the presence of specific proteins and other elements in your blood. They are also intended to monitor the overall effectiveness of your liver and kidney function.

Side Effects of the treatment –

There are side effects. These are a sore mouth and throat and difficulty in swallowing.

Surgery – your pathologist, will perform surgery on you if your cancer is in the early stages. The operation is done on either your larynx, pharynx or both, depending on the nature and location of your cancer. You’ll receive surgery as primary treatment if your cancer remains localized and is in the advanced stages. However, you will usually have surgery in conjunction with other forms of treatment like radiation therapy and chemotherapy. This combination is effective at killing all cancer cells and keep you in remission. Combination therapies are effective at shrinking the size of tumors which makes them easy to remove during surgery. Your pathologist may have to remove nearby lymph nodes if your cancer shows signs of spreading.

Targeted therapy – if you have throat cancer, you’ll likely have cells which have too much of a protein named as the epidermal growth factor receptor (EGFR). This is what helps your cancer cells grow out of control and essentially slowly take over your body. Most throat cancer cells have an abundance of this protein on their outer layer. Your pathologist may prescribe specific medicines which are designed to keep cancer cells from spreading and which will shrink the size of your tumors, especially if your cancer is in the early stages. You’ll be given at least one medicine. The medicines used in targeted therapy are:

 Monoclonal antibodies – these are genetically engineered molecules which are designed to target cells having specific antigens on their surface – these tend to be cancer cells. The antibodies destroy these cells while leaving healthy cells intact. This is why targeted therapy is preferred over chemotherapy because it only kills problems cells. Patients suffer from fewer side effects. The antibodies can do other things which include stopping tumors from growing and spreading, stopping cancer cells from tapping into new blood vessels in your body for resources to build, and making cancer cells behave more like healthy cells.

Peptide receptor radionuclide therapy (PPRT) – this medicine is used to kill neuroendocrine tumors (NET). It is an extremely high dose of radiation which destroys tumors, keeps them from spreading, and keep you healthier. Though this medicine doesn’t kill normal cells, it may affect their overall function. You may feel very tired, you may have problems eating and digesting food, you may have high blood pressure, dehydrated skin, and swollen fingertips if you are receiving PPRT. Many other types of targeted therapies include hormone therapies, signal transduction inhibitors, apoptosis inducers, gene expression modulators, angiogenesis inhibitors, toxin delivery molecules.

 Immunotherapy – your pathologist will take cells out of your immune system, genetically engineer them to seek out and kill cancer cells, and then reintroduce them into your body. This treatment is preferred if traditional therapies like surgery and radiation therapy fail. 

These are the treatment options for laryngeal cancer.

The treatment options for pharyngeal cancer are:

● Surgery – 

● Radiation

● Clinical trials

● Chemotherapy

● Chemoradiation

● Targeted therapy

● Immunotherapy 

● Clinical trials

Stages of throat cancer

This is very important because it will tell your pathologist where your tumour is located, its size, extent, and severity. Grading of cancer also accompanies the staging of throat cancer. Because of their detail and accuracy, diagnosis test results are often used when staging and grading throat cancer. 

Doctors can use the Tumor, Node, Metastasis (TNM) system to understand the size and severity of your cancerous tumors. This is formulated using the results of diagnostic tests. Doctors ask themselves three main questions when using this staging system:

● A tumor (T) – how large are they and where are they located?

● Node (N) – has cancer has metastasized to your lymph nodes? Which lymph nodes and where are their locations if your cancer has indeed metastasized?

● Metastasis (M) – where has your cancer spread, what is the extent, location, and severity of the metastasis?

A pathologist will add a number from 0-4 to the TNM diagnosis when staging tumors. This is useful in indicating the exact size and location of the tumors. Doctors use centimeters when measuring the size of the tumors. A centimeter is about a fourth of an inch long. Pathologists often divide the primary stages into secondary stages. This helps them completely understand your tumors by describing them in as much detail as possible. Since your throat is divided into two sections, the larynx and hypopharynx, it follows that there are two sets of staging systems.

Tumors in the larynx

TX: this is the primary tumor. It is so small and located in such an obscure place at this stage that pathologists are unable to stage it. 

Tis: The tumor is referred to as carcinoma at this stage because it is located in only the first layer of tissue. Pathologists like to see to these tumors as being ‘in-situ.’ This type of cancer is in the precancerous stage.

Pathologists divide the larynx into three sections when using a numbering system to describe the stages of throat cancer:

Glottis tumors in the larynx

● T1: the tumor’s only location is in the vocal cords. You can still talk and drink/normally eat because it doesn’t affect the overall function of your vocal cords.

○ T1a: your tumor is located only in the right or left vocal cord

○ T1b: tumors are present on both sides of your vocal cords

● T2: Cancer has metastasized and is now it the supraglottis, the subglottis, or both. Because of its size and location, it may affect the functioning of your vocal cords, so you may experience some difficulty in talking, eating, and drinking. 

● T3: the tumor is only found in the larynx, but it completely inhibits the functioning of the vocal cords. You will have trouble eating, drinking, and talking at this stage. This type of tumor can metastasize to tissues in your larynx gland, the cartilage around the thyroid gland, or both.

● T4: the cancer has metastasized and is now found in various parts of your body.

○ T4a: the cancer has metastasized to your thyroid cartilage tissues and other tissues/organs.

○ T4b: your tumor has metastasized to your prevertebral space or your chest area. It can also enclose your arteries in these areas and inhibit their overall functioning.

Throat cancer is severe

As is evident, throat cancer is critical and can be life-threatening. This is why you must see a doctor immediately if you experience any of the symptoms mentioned above.

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