The word cancer is a very emotive one naturally.
Throat cancer encompasses a wide variety of diagnoses and is probably better referred
to as head and neck cancer. If you imagine the head and neck to involve two conduits
or passages, one that allows food to enter the body and the other that allows for breathing
and production of voice, then you can then imagine a cancer can occur at any point in
either of those two conduits, for example, in the mouth, in the gullet, or in the voice
box. There are other structures in the neck as well—lymph nodes, the thyroid gland and saliva
glands. So cancer can occur in any of these parts.
There are over 11,000 new cases of head and neck cancer diagnosed in the UK every year.
The vast majority of them occur in the larynx or the voice box. They tend to be more common
in men, almost twice as common in men and also tend to occur mainly in those over the
age of 65. Unfortunately, over the last few years, the incidence of head and neck cancer
has been increasing. That's partly because we're picking up cancers in a much earlier stage.
It's predicted that the incidence may fall particularly for voice box cancers. That
is partly due to some of the victories we have in our campaign and fight against smoking.
The biggest risk factor for head neck cancer by far is smoking tobacco. Alcohol consumption
also increases your risk of developing throat cancer but not as much. Interestingly, those
who smoke and drink develope a multiplier effect and they are at higher risk. We’re
also learning about other risk factors, for example, HPV infection. That's the human papillomavirus.
It’s thought that over 50% of tonsil cancers are related to HPV infections.
Because the term throat cancer encompasses a number of different diagnoses, there also
a number of different symptoms to be aware of. The important ones are firstly, a hoarse
or husky voice that has persisted for perhaps more than three or four weeks. Second, dysphagia
or difficulty in swallowing particularly if this is getting worse over a period of time. Third,
an unexplained neck lump. Again, if this has lasted for more than two or three weeks and
is not connected to an obvious infection or sore throat, then that is something to be
concerned about. There are others but these are the important ones to remember.
Firstly, be aware of the symptoms, the red flag symptoms that can occur in head and neck
cancer, If you're worried, seek attention particularly if you're in the high risk group
and by that what I mean is if you’re perhaps over 40, are a smoker, and you drink. If you
are worried, insist on seeing a specialist, someone with the expertise and access to diagnostics,
who is able to diagnose the condition promptly. When you see a specialist, he or she will
take a detailed history encompassing all the relevant risk factors and then perform a thorough
examination. During this examination, it's important to examine all the different subsides
of the head and neck to ensure that a cancer isn't missed in any of these areas. Nowadays,
we are able to use a flexible nasendoscope, which allows us to examine the conduits I
spoke about earlier. So examining the gullet, the voice box, and the back of the throat.
It's a painless procedure done in outpatients and it's really an excellent tool that gives
us a really excellent view of all these areas that were hitherto very difficult to examine. Once
an examination is completed, your specialist may then request some scans and perhaps even
a biopsy.
My take home messages about head and neck
cancer are as follows. The single most effective thing you can do to avoid developing head
and neck cancer is to stop smoking tobacco. Remember the red flag symptoms. My top three
are persistent hoarseness, two; dysphagia or difficulty in swallowing that isn't getting better or
getting worse, and three; an unexplained neck lump. If you have any of these symptoms, my final
tip is to seek attention from an expert, someone who has access to modern diagnostic technology
and who works as part of a multidisciplinary team.