Treatment of Throat Cancer

There are many treatment options for throat cancer. Treatment strategy is decided based on several factors such as the location and stage of cancer, the type of cancer, your age and general health, and your personal preferences.

Treatment options for throat cancer include:

• Radiation therapy.
• Surgery.
• Chemotherapy.
• Targeted drug therapy.

Radiation therapy

This therapy uses high-powered energy beams such as X-rays to destroy cancer cells and shrink tumours. Radiation therapy can be given by a large machine placed outside your body (external beam radiation) or from small radioactive seeds and wires that are placed inside your body, in proximity to the cancer (brachytherapy). Radiotherapy damages normal cells of the body as well and therefore can cause side effects such as fatigue, nausea and vomiting, erythema of skin. Radiation therapy is considered as the preferred treatment for early-stage throat cancers and many patients may need only this treatment. For more advanced throat cancers, combination therapy of radiation therapy with chemotherapy or surgery may be considered. In very advanced throat cancers, radiation therapy can help to shrink the size of the tumour, reduce the signs and symptoms and make you more comfortable.

Surgery

The type of surgical procedure done for the treatment of throat cancer depends on the location and stage of your cancer. Surgeries done for throat cancer include:

• In the early stages of throat cancer when the growth is confined to the surface of the throat or the vocal cords, it can be removed surgically using endoscopy. After inserting the endoscope into your throat or voice box the doctor passes either a special surgical tools or a laser through the scope. Using these tools, the cancerous growth is removed.
• Laryngectomy: During this surgery all or part of the voice box is removed. If the tumour is small the part of your voice box that is affected by cancer is removed, leaving as much of the voice box as possible. This may help your doctor to preserve your ability to speak and breathe normally. If the tumour is big your entire voice box may have to be removed. After this your windpipe is connected to a hole (stoma) in your throat to allow you to breathe (tracheotomy). To restore your speech after surgery you may be referred to speech pathologist to learn to speak without your voice box.
• Pharyngectomy: For some types of throat cancer, surgery to remove all or part of the throat may be done. If your entire throat is removed the voice box is removed as well. Reconstructive surgery is done after the surgery to allow you to swallow food normally.
• Neck dissection: This surgery is done to remove the cancerous lymph nodes (neck dissection). It is done when the throat cancer has spread deep within your neck. During the surgery some or all of the lymph nodes may be removed to see if they contain cancer cells.

Complications of surgery include the risk of bleeding, infection and difficulty speaking or swallowing. The risk or extent of complication depends on the specific procedure you undergo.
Chemotherapy: During this treatment chemicals are used to kill cancer cells. It may be given along with radiation therapy while treating throat cancers. Certain chemotherapy drugs have been shown to improve the sensitivity of cancer cells to radiation therapy. However, combination therapy increases the risk of side effects of both treatments. Your doctor will discuss the possible side effects and also if combination therapy is likely to improve the prognosis.

Targeted drug therapy

Targeted drug therapy alters the specific aspects of cancer cells that promote their growth. Cetuximab is approved for targeted therapy for treatment of throat cancer in certain situations. Several other targeted drugs are being studied in clinical trials for efficacy in treatment of throat cancer. Targeted drugs may be given along with chemotherapy or radiation therapy.

Rehabilitation after treatment

This is an important aspect of treatment for throat cancers. Treatment for throat cancer results in several complications such as difficulty in swallowing and loss of speech. Your doctor will refer you to specialists during and after throat cancer treatment, to seek help for:

• Caring for a surgical opening in your throat (stoma) if you had a tracheotomy.
• Difficulty eating.
• Difficulty swallowing.
• Stiffness and pain in your neck.
• Speech problems.

Your doctor will discuss the treatment options, potential side effects and complications of the treatment and then decide on treatment that is most appropriate for you.

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