WFUBMC Home

>

Comprehensive Cancer Center

>

Types of Cancer

>

Throat Cancer

>

index

Wake Forest Baptist Approach Head and Neck Cancer -------------------------------------- View Head and Neck Cancer Clinic Video -------------------------------------- With the incidence of head and neck tumors at twice the national average in our region, the Head and Neck Cancer Program is of prime importance.  A multidisciplinary physician team meets regularly to evaluate cases. Each new patient is evaluated by the appropriate clinicians (surgeons, medical and radiation oncologists), and a treatment plan is recommended to the patient and referring physician.  This multidisciplinary coordination allows for better patient convenience and timing of appointments, as well as closer and more effective physician consultative planning and disease management decisions. Active research is being conducted in the areas of tumor biology and Positron Emission Tomography (PET) scanning of head and neck tumors.  Clinical trials in the areas of cancer prevention, cancer treatment and symptom management are offered to our patients with head and neck cancer. 3D Conformal and Intensity Modulated Radiation Therapy Among the newer treatment options for cancer of the prostate, brain, lung, and head and neck are two methods of focusing radiation on the tumor and surrounding at-risk tissues while optimally sparing nearby normal tissues, 3-dimensional (3D) conformal radiation therapy, and intensity modulated radiation therapy (IMRT).  This approach uses anatomic computed tomogrphic and/or magnetic resonance images of the patient, computer-generated radiation dose calculations, and a computer-controlled linear accelerator to conform or “paint” the radiation dose very precisely to match the shape of the tumor to be treated, avoiding critical structures that may be only millimeters away. When the linear accelerator radiation beam intensity is varied, or modulated, over space and time during the patient’s treatment, hence the term “Intensity Modulated” radiation therapy. In combination with advanced imaging techniques like magnetic resonance spectroscopy and positron emission tomography that image both tumor anatomy and biology, IMRT holds great promise for improving local tumor control and survival, even in the most resistant and aggressive human cancers.  Brachytherapy Brachytherapy, which literally means “short therapy”, involves the implantation of radioactive sources in or near a tumor, a procedure which typically involves the collaboration of a surgical oncologist and radiation oncologist.  A full range of brachytherapy treatment options are available for treating cancers of the prostate, breast cervix, uterus, vagina, head and neck, soft tissues, brain, and eye.  In fact, with the availability of both high dose rate (HDR) and low dose rate (LDR) brachytherapy technology and expertise, virtually any area of the body can be implanted if appropriate.  Brachytherapy is often used as a “boost” in conjunction with external beam radiation, particularly for locally advanced cancers.   Cancer - throat or larynx Throat anatomy Oropharynx Definition: Cancer of the throat is cancer of the vocal cords, voice box (larynx), or other areas of the throat. Alternative Names: Vocal cord cancer; Throat cancer; Laryngeal cancer; Cancer of the glottis Causes, incidence, and risk factors: People who smoke or otherwise use tobacco are at risk of developing throat cancer. Excessive alcohol use also increases risk. Smoking and drinking alcohol combined lead to an extreme risk for the development of throat cancers. Most cancers of the throat develop in adults older than 50. Men are 10 times more likely than women to develop throat cancers. Symptoms: Abnormal (high-pitched) breathing sounds Cough Coughing up blood Difficulty swallowing Hoarseness that does not resolve in 1 to 2 weeks Neck pain Sore throat that does not resolve in 1 to 2 weeks, even with antibiotics Swelling in the neck Unintentional weight loss Signs and tests: An examination of the neck and throat may show cancer of the throat. The sputum (what is coughed up) may appear bloody. A lump may appear on the outside of the neck. A laryngoscopy, which is examination by use of a tube with a small lighted camera (laryngoscope), allows the physician to look into the mouth and down the throat to see the tumor. A neck or cranial CT scan or cranial MRI may show throat cancer. These tests will also help determine if the cancer has spread to lymph nodes in the neck. Biopsy and analysis of tissues that appear abnormal may confirm the presence of a cancerous tumor. Treatment: Treatment is aimed at completelyd removing the cancer and preventing the spread of the cancer to other parts of the body. When the tumor is small, either surgery or radiation therapy alone can be used to eliminate the tumor. When the tumor is larger or has spread to lymph nodes in the neck, combination radiation and chemotherapy is often used to preserve the voice box and is successful in most cases. Surgical removal of the tumor, including all or part of the vocal cords (laryngectomy) may be necessary in some cases. If a laryngectomy is required, a surgical prosthesis (artificial vocal cords) may be implanted, voice aids may be used, or speech therapy may be recommended to teach alternative methods of speaking. Many patients also need swallowing therapy after treatment to help them adjust to the changes in the structure of the throat. Support Groups: The stress of illness can often be eased by joining a support group of people who share common experiences and problems. See cancer - support group. Expectations (prognosis): Throat cancers can be cured in 90% of patients if detected early. If the cancer has spread to surrounding tissues or lymph nodes in the neck, 50-60% of patients can be cured. If the cancer has spread (metastasized) to parts of the body outside the head and neck, the cancer is not curable and treatment is aimed at prolonging quality of life. After treatment, patients generally need therapy to help with speech and swallowing. A small percentage of patients (5%) will not be able to swallow and will need to be fed through a feeding tube. Complications: Airway obstruction Difficulty swallowing Disfigurement of the neck or face Hardening of the skin of the neck Loss of voice and speaking ability Spread of the cancer to other body areas (metastasis) Calling your health care provider: Call your health care provider if symptoms indicate cancer of the throat, especially hoarseness or change in voice with no obvious cause that lasts longer than 1 week. Also call your health care provider if you find a lump in the neck that does not go away in 2-3 weeks. Prevention: Minimize or avoid smoking and excess alcohol use.

Review Date:3/21/2008 Reviewed By:Stephen Grund, MD, PhD, Chief of Hematology/Oncology and Director of the George Bray Center Center at New Britain General Hospital, New Britain, CT. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.