Key Symptoms of Throat Cancer: What to Watch For

What is Throat Cancer?

Throat cancer is a type of head and neck cancer. It usually develops in the flat cells that line the moist mucosal surface of the throat (pharynx). Some throat cancers involve the voice box (larynx).

The National Cancer Institute estimates that about 71,100  Americans will receive a diagnosis of head and neck cancer in 2024, resulting in about 16,000 deaths. The major types of head and neck cancer are cancers of the oral cavity, pharynx, and larynx. 

Throat Anatomy 

The throat (pharynx and larynx) is a muscular tube through which air, food, and liquids enter the body. It is located behind the oral cavity (mouth) and nose and connects to the trachea (windpipe) and esophagus (food pipe). The larynx (voice box) is located in the throat and helps in forming speech. 

Throat Cancer Types

Throat cancer can develop in any of the structures in the throat. It is classified according to where the cancer originated:

• Nasopharyngeal cancer develops in the nasopharynx, the part of the pharynx just behind the nose.

• Oropharyngeal cancer develops in the oropharynx just behind the mouth, where the tonsils are present.

• Hypopharyngeal cancer or laryngopharyngeal cancer develops in the hypopharynx or laryngopharynx, the lower end of the throat, just above the windpipe and food pipe.

• Laryngeal cancers involve the voice box and vocal cords. Depending on where the cancer is located within the larynx, there are three types of laryngeal cancer.:

  • Glottic cancer involves the vocal cords.

  • Supraglottic cancer is located in the upper part of the voice box and involves the epiglottis, a small flap-like cartilage that prevents food from entering the breathing tube.

  • Subglottic cancer is present in the lower part of the voice box, below the vocal cords.

Importance of Recognizing Signs of Throat Cancer

Recognizing the symptoms of throat cancer can help you get a timely diagnosis and treatment. Almost all throat cancers are curable if found in the very early stages. If a throat cancer is found before it has metastasized (spread to surrounding lymph nodes or distant organs), the cure rate is 50%, meaning about one-half of people can be cured. Throat cancer that has spread outside the head and neck is generally not curable.

Throat Cancer Risk Factors

Risk factors for developing throat cancer include:

• Cigarette smoking and use of chewing tobacco or smokeless tobacco products.

• Heavy alcohol use.

• Certain viral infections, such as human papillomavirus (HPV) and Epstein-Barr virus.

• Gastroesophageal reflux disease (GERD).

• Exposure to toxins or harmful chemicals, such as perchloroethylene (used in dry cleaning), certain solvents in the textile industry, and asbestos (fibers used in building material for insulation, flooring, roofing, and automotive parts). Studies show that asbestos exposure increases the risk of developing laryngeal cancer by approximately 40%.

• A diet low in fruit and vegetable intake and high in red meat and processed meat intake.

• Certain inherited genetic syndromes like Fanconic anemia and dyskeratosis congenita are linked to a high risk of head and neck cancers.

Symptoms: What Does Throat Cancer Look Like?

Common symptoms of throat cancer can include a persistent cough, changes in voice such as hoarseness, difficulty swallowing, sore throat, a lump in the throat, ear pain, and weight loss.

Early Warning Signs: What Does Throat Cancer Feel Like In The Beginning?

• Persistent Sore Throat: A sore throat that lasts for more than two weeks can be a sign of throat cancer.

• Voice Changes: Changes in your voice, such as sounding hoarse, for more than two weeks should be evaluated by a healthcare provider.

• Dysphagia or Odynophagia: Trouble swallowing or pain with swallowing can be a symptom of throat cancer as well as a side effect of throat cancer treatment.

• Unexplained Weight Loss: Losing weight without trying can be an early sign of throat cancer.

Symptoms of Advanced Throat Cancer

• Lump in the Neck or Throat Area: Many throat cancer patients develop a painless lump in the neck that develops when cancerous cells accumulate in a lymph node. The lump can be seen and felt from the outside and is usually located about 2 inches below the jawline. Sometimes, this lump is mistakenly diagnosed as an infection and treated with antibiotics. When the lump does not go away with antibiotic therapy, doctors start looking for other causes, leading to a diagnosis of throat cancer. 

• Chronic Cough: Persistent coughing or coughing up blood can be throat cancer signs. 

• Ear Pain: Some people with throat cancer develop a dull earache in one ear.

• Dyspnea and Stridor: Difficulty breathing or high-pitched noisy breathing can be signs of laryngeal cancer.

• Changes in the Mouth and Throat: Carcinoma throat symptoms may also include problems with opening the mouth, moving the tongue, or changes in a tonsil.

How Throat Cancer is Diagnosed?

If your doctor suspects throat cancer based on your symptoms, medical history, and physical examination, they may order the following tests to confirm or rule out a throat cancer diagnosis:

• Endoscopy: This is a minimally-invasive procedure in which a healthcare provider uses a special tool called an endoscope which has a camera at its tip. It allows your doctor to directly visualize the inside of your throat on a video screen and look for any signs of throat cancer. 

• Laryngoscopy: Similar to endoscopy, this procedure is done using a laryngoscope that is inserted in the voice box. It has a magnifying lens that allows your healthcare provider to look at your vocal cords. 

• Tissue Biopsy: If your provider notices any abnormalities during endoscopy or laryngoscopy, they can use surgical instruments through the scope to collect a small sample of tissue for examination in the laboratory under a microscope. This is called a tissue biopsy and it can help to make a confirmed diagnosis of throat cancer. Pathologists can also look for signs of a common infection (human papillomavirus (HPV) infection). The presence or absence of the virus impacts throat cancer treatment. 

• Imaging Studies: Tests such as computerized tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) can help your healthcare team see how far the head and neck cancer has spread.

Stages of Throat Cancer

If an oropharyngeal cancer is found, the next step is to stage the cancer (determine the size and extent of the tumor). Knowing the stage helps your cancer care team with treatment planning. Doctors stage throat cancer as follows:

• Stage 0 or carcinoma in situ: Abnormal cells lining the throat that have the potential to become cancer cells.

• Stage I throat cancer: The tumor is less than 2 centimeters (cm) in size without spreading to the lymph nodes. 

• Stage II throat cancer: The tumor is 2 cm to 4 cm in size without spreading to the lymph nodes. 

• Stage III throat cancer: The tumor is either larger than 4 cm in size or has spread to a lymph node on the same side of the neck, with the size of the lymph node at least 3 cm. 

• Stage IV throat cancer: Advanced malignant tumors that can be of any size but with spread to:

  • Surrounding tissues such as the trachea, esophagus, thyroid, mouth, jaw, or neck.

  • A 3 cm of larger lymph node on the same side of the neck.

  • Any size lymph node on the opposite side of the neck from the tumor.

  • Multiple lymph nodes of any size on the same side of the neck.

  • Other parts of the body, such as the lungs.

Treatment Options for Throat Cancer

Treatment of throat cancer depends on various factors, such as the location and stage of the tumor, whether you have an HPV infection and your general health status. Treatment options include:

• Radiation therapy using high-energy X-rays or proton beams to kill cancer cells. 

• Surgery such as: 

  • Tumor resection of small or superficial throat cancers using endoscopy (cutting out, scraping off, or vaporizing the cancer with a laser device).

  • Laryngectomy (surgical removal of the voice box). If the tumor is large and the entire voice box is removed, the surgeon will create a stoma (hole in your throat) and connect it to your windpipe to allow you to breathe - this is called a tracheostomy. A speech pathologist can teach you how to speak without your voice box using special devices. 

  • Pharyngectomy or removal of part of the throat. Reconstructive surgery may be necessary to allow normal swallowing. 

  • Neck surgery or neck dissection to remove lymph nodes with cancer cells. 

• Chemotherapy (drugs to kill cancer cells or make them more sensitive to radiation therapy). 

• Targeted therapy (drugs that take advantage of specific changes in cancer cells and target them to prevent cancer cell growth). For example, a targeted therapy called cetuximab (Erbitux) is used for treating certain throat cancers.

• Immunotherapy to help your immune system identify cancerous cells and fight the cancer. This treatment is usually offered to people with advanced throat cancer that has not responded to standard treatment protocols.

• Palliative care: A palliative care team can help you manage throat cancer symptoms as well as the side effects of cancer treatment. 

Early detection and treatment can lead to successful treatment of throat cancer. Most throat cancers are curable if found early before they have spread to surrounding lymph nodes or other parts of the body. A laryngeal or pharyngeal cancer that has spread outside the head and neck is not usually curable. 

Coping Strategies and Support Systems

Receiving a cancer diagnosis can be devastating. Throat cancer can be particularly overwhelming because it affects daily activities, such as breathing, swallowing, and speaking. Some of the things that can help you cope include:

• Learn about your cancer so you can actively participate in treatment decisions.

• Talk to a trusted friend or relative to sort out your emotions and share your worries. Faith leaders and counselors are also options. 

• Join a support group for people with cancer. The Support for People With Oral and Head and Neck Cancer (SPOHNC) and the American Cancer Society (ACS) are good resources for finding support during and after cancer treatment.

• Keep all your follow-up appointments. This will allow your doctor to monitor your health and make changes in your treatment as needed.

• Practice self-care during and after throat cancer treatment by eating healthy, getting enough sleep, and avoiding stress. 

Long-Term Outlook and Survival Rates

The earlier a throat cancer is diagnosed, the higher the chances of successful treatment or cure. The relative 5-year survival rate for hypopharyngeal or laryngeal cancer is 80%. This means people with these cancers are, on average, 80% as likely to be alive after 5 years compared to people who don’t have this type of cancer.

Dietary and Lifestyle Adjustments to Prevent Throat Cancer

• Quit smoking, if you smoke.

• Avoid alcohol or drink alcohol in moderation (no more than one drink per day for women and two drinks per day for men).

• Eat a healthy diet consisting of fruits, vegetables, whole grains, lean proteins, and low-fat dairy. Avoid processed foods and red meats.

• Get the HPV vaccine (Gardasil, Cervarix) which protects against the majority of HPV-related cancers.

• Practice safe sex. Use condoms to protect against HPV. Avoid direct sexual contact (genital contact). Avoid multiple sexual partners. 

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Frequently Asked Questions About Throat Cancer

Is Throat Cancer Curable?

Most throat cancers are curable if detected early before they have spread. Throat cancers that have metastasized (spread) to surrounding tissues or lymph nodes are curable in 50% of patients. Cancers that have spread outside the head and neck are not curable.

How Can I Test Myself For Throat Cancer?

It’s not possible to test yourself for throat cancer at home. Throat cancer symptoms can be due to many other conditions. It is important to seek medical advice to get a proper diagnosis and treatment.

What to Do If You Have Symptoms?

Make an appointment with your doctor if you have throat symptoms such as sore throat, persistent cough, or hoarseness lasting more than 2 weeks. 

How Long Can You Have Throat Cancer Without Knowing?

How long you can have throat cancer without knowing depends on many factors, including the location of the tumor, the type of cancer, how fast it grows, and your overall health status. Some cancers can be present for months or years before they are detected. Seeking timely medical care for any unusual or persistent symptoms can lead to early diagnosis and treatment.

What Are 20 Warning Signs of Cancer?

20 warning signs of cancer are described below. However, keep in mind that different people may experience different signs and symptoms. If you notice any unusual changes in your body, you should talk to your healthcare provider as soon as possible.  

1. Unusual lumps or growths.

2. Unexplained weight loss.

3. Changes in toilet habits.

4. Gastrointestinal symptoms like nausea, vomiting, diarrhea, constipation, or bloating.

5. Skin changes.

6. Breast changes.

7. Abnormal periods.

8. Abdominal or pelvic pain.

9. Postmenopausal bleeding

10. Persistent cough.

11. Voice changes.

12. Changes in the mouth or soft palate, such as red or white patches.

13. Difficulty swallowing.

14. Chronic headache.

15. Unusual bleeding or bruising.

16. Frequent infections.

17. Chronic pain.

18. Fatigue.

19. Coughing up blood.

20. Blood in stool.