The throat, or pharynx, is divided into the nasopharynx (behind the nose), the oropharynx (behind the oral cavity), and the hypopharynx (behind the larynx). Any of these areas may be the site of the development of a malignant tumor. The signs and symptoms will be related to the location of the primary site.
- Painful swallowing, with radiation of pain to the ear
- Ear pain or fluid in the ear
- Neck mass
- A sore throat that fails to heal after 1 to 2 weeks, even with antibiotics [[link to Sore Throat section of this website]]
- Neck pain
- Unusual, high-pitch sounds when breathing
- Coughing up blood
- Changes in the voice with a muffled sound
- Hoarseness that fails to improve after several weeks
- Swallowing difficulties
- Nasal obstruction with nosebleeds
Malignancies of the pharynx can be caused by smoking, chewing tobacco, and alcohol use. Smoking combined with drinking alcohol multiplies the risk. Most cancers of the throat develop in adults older than fifty years of age. Men are ten times more likely than women to develop throat cancers. Chronic HPV and EBV infection and AIDS have been associated with the development of malignancies of the pharynx as well.
A very careful physical examination of the oral cavity, pharynx, larynx, and neck is performed in patients who have a history or symptoms suggestive of a malignancy in the head and neck area. Fiberoptic laryngoscopy to visualize the vocal cords, CT scanning, and MRI scanning of the regions involved are routinely employed. If findings suspicious for malignancy are identified, a biopsy is performed, most commonly under general anesthesia. Triple endoscopy, or an evaluation of the larynx and pharynx, the esophagus, and the bronchial passages, is often performed since these areas share common risk factors for the development of cancer.
Treatment depends upon the site of the primary tumor and the presence of spread to the neck or elsewhere in the body. Patients are usually treated with surgery, chemotherapy or radiation therapy. Depending on the tumor stage, a combination of these treatments may be used. Chemotherapy is often used simultaneously with radiation therapy for advanced tumors. For small tumors, either surgery or radiation therapy alone can be used for tumor removal.