Defination of Throat Cancer

Cancer that forms in tissues of the pharynx (the hollow tube inside the neck that starts behind the nose and ends at the top of the windpipe and esophagus). Throat cancer includes cancer of the nasopharynx (the upper part of the throat behind the nose), the oropharynx (the middle part of the pharynx), and the hypopharynx (the bottom part of the pharynx). Cancer of the larynx (voice box) may also be included as a type of throat cancer. Most throat cancers are squamous cell carcinomas (cancer that begins in thin, flat cells that look like fish scales). Also called pharyngeal cancer.

What is Cancer?

Cancer cells are very similar to cells of the organism from which they originated and have similar (but not identical) DNA and RNA. This is the reason why they are not very often detected by the immune system, in particular if it is weakened. Cancer cells usually have an increased ability to divide rapidly and their number of divisions is not limited by telomeres on DNA (a counter system to limit number of divisions to 40-60). This can lead to the formation of large masses of tissue and in turn may lead to disruption of bodily functions due to destruction of organs or vital structures.

Causes

Throat cancer appears to occur as a result of damage to the DNA in the cells in your mouth and throat. Using tobacco and excessive alcohol consumption can damage these tissues. The combination of smoking or chewing tobacco and excessive drinking creates a much higher risk of oral and throat cancer. Excessive exposure to ultraviolet light also can cause damage. Damage to cells may cause them to malfunction and mutate into cancer cells.

Throat Cancer Signs and Symptoms

An early indication of oral and throat cancer is one or more changes in the way the soft tissues of your mouth usually look or feel.
Signs and symptoms may include:
* A sore in your mouth that doesn't heal or increases in size
* Persistent pain in your mouth
* Lumps or white, red or dark patches inside your mouth
* Thickening of your cheek
* Difficulty chewing or swallowing or moving your tongue
* Difficulty moving your jaw, or swelling or pain in your jaw
* Soreness in your throat or feeling that something is caught in your throat
* Pain around your teeth, or loosening of your teeth
* Numbness of your tongue or elsewhere in your mouth
* Changes in your voice* A lump in your neck
* Bad breathMost oral cancers arise on the lips, tongue or on the floor of the mouth. They also may occur inside your cheeks, on your gums or on the roof of your mouth.

Throat Cancer Diagnosis

Diagnosis initially involves you and your dentist or doctor discussing the history of your signs and symptoms and your doctor performing an examination of your mouth. To determine whether abnormal-appearing areas within your mouth are cancerous, your doctor will need to take a small tissue sample (biopsy) to be examined in the laboratory.
Almost all oral and throat cancers are of the squamous cell type (squamous cell cancer or carcinoma). Squamous cells are firm and flat, and they form the lining of the oral cavity and upper throat as well as the surface of your skin. Squamous cell cancer begins with abnormal cells located only on the surface. As it progresses, the malignant cells invade deeper layers of the oral cavity and upper throat and may spread to your lymph nodes as well as to other parts of your body.
For your doctor to determine if the oral or throat cancer has spread, and if so how far it has spread, you'll need to undergo imaging procedures, which may include:
* X-ray. Your doctor may want to see dental X-rays as well as X-rays of your head and chest.
* Computerized tomography (CT) or magnetic resonance imaging (MRI) scan. A CT scan allows your doctor to see your organs in two-dimensional slices. Split-second computer processing creates these images as a series of very thin X-ray beams are passed through your body. An MRI scanner uses no X-rays. Instead, a computer creates tissue-slice images from data generated by a powerful magnetic field and radio waves. These images can be viewed from any direction or plane. These images help determine the extent of the mass and whether the cancer has spread to nearby lymph nodes.
* Ultrasound. This imaging technique uses no radiation. Instead, it combines high-frequency sound waves and computer processing. Ultrasound is especially good for providing information about the shape, texture and makeup of tumors and cysts. While you relax on a bed or examining table, a wand-like device (transducer) is placed next to your head. It emits inaudible sound waves that are reflected back to the transducer (similar to sonar). Those reflected sound waves are then translated into a moving image by a computer.
Many oral and throat cancers aren't detected until they're far advanced. When detected early, squamous cell cancer can often be successfully treated.

Prevention

Tobacco and alcohol are by far the most important risk factors for oral and throat cancer. You can greatly reduce your risk by not smoking and limiting the amount of alcohol you drink. Other steps you can take to help prevent oral and throat cancer or its progression include:
Use well-fitting dentures. If you wear dentures, be sure they fit properly and are well cleaned and rinsed. Oral irritation may increase your risk of oral cancer. Don't chew on the tissues on the inside of your mouth (inner cheek). Doing so irritates your oral tissues. This may occur during sleep, along with teeth grinding (bruxism). Talk with your dentist if this is a problem for you.
Limit your exposure to the sun. Ultraviolet light damages the skin on your lips and increases your risk of oral cancer. When you're out in the sun, use lip balm that contains sunscreen and wear a wide-brimmed hat to protect your face and lips.
Check your mouth and tongue periodically. Standing in front of a mirror, use your forefinger and thumb to pull facial tissue aside to get a good view and feel of the tissue on the inside of your lips, your cheeks and elsewhere inside your mouth, especially under your tongue.
Look for bumps and for changes in color. Use your thumbs and fingers to check for lumps and tender spots. If you notice changes, talk to your dentist or doctor. Oral and throat cancer can be successfully treated, but success depends on early detection.
Visit your dentist twice a year. Most dentists perform a thorough examination of your mouth during each visit. He or she should conduct a direct as well as indirect (mirrored) observation of all the tissues inside your mouth.
Eat a nutrient-rich diet. Aim for at least five servings of fruits and vegetables daily. A poor diet has been linked to oral and other cancers.

Throat Cancer Treatment

Doctors use surgery and radiation therapy to treat oral and throat cancer in the earliest stages. For cancer in more advanced stages, doctors use surgery combined with radiation therapy or radiation therapy combined with chemotherapy. Your treatment plan should be developed for you specifically based on multiple factors by an integrated team of doctors including surgeons, cancer specialists (oncologists) and oncologists who specialize in treating cancer with radiation (radiation oncologists). Treatment options include:
Surgery.
The type of surgery you may need depends on the size and location of the tumor. Doctors can surgically remove tumors that haven't grown into nearby tissues with relatively few side effects. However, if the tumor has invaded nearby tissues, the operation is more extensive. Sometimes surgeons need to remove bone tissue from the jaw or the roof of the mouth. To treat a cancer of your tongue or the upper part of your throat, your surgeon may need to remove tissues that you use to swallow and in some cases your voice box (larynx). If the cancer has spread beyond your mouth, your surgeon may also need to remove lymph nodes in your neck. You may not have any major side effects from surgery to remove a small tumor from your mouth. However, extensive surgery may require major adjustments in the way you chew, swallow, breathe and speak. You may need a prosthetic device in your mouth to replace removed portions of your teeth, gums and jaw. In more advanced cases, you may need to use tubes for feeding and breathing and an artificial voice aid for speaking.
Radiation therapy.
Radiation therapy uses X-rays to kill cancer cells. Doctors may use this therapy alone to treat small tumors or combined with chemotherapy to treat large tumors. Radiation therapy may also be used along with surgery to destroy small amounts of cancer cells that doctors can't remove during surgery.
Chemotherapy.
Chemotherapy uses drugs to destroy cancer cells. You take these drugs either through your veins (intravenously) or orally. The type of drugs and the length of treatment depend on the size and location of the tumor. In the case of a large and invasive tumor, chemotherapy may be used in combination with radiation therapy and in place of surgery.
Angiogenesis inhibitors. Cetuximab (Erbitux) is a medication that stops the growth of new blood vessels that cancers need to grow. This drug has recently been approved for use along with chemotherapy in cancers of the oral cavity.

Risk Facters

A variety of factors that you can control increase your risk of oral cancer. These include:
* Use of tobacco. Tobacco can damage cells in the lining of the oral cavity and upper throat. Smokers are much more likely to develop oral or upper throat cancers than nonsmokers are. About 90 percent of people who develop these cancers use some form of tobacco. Tobacco use is more prevalent among men, so oral cancer is more common in men than in women. People who use smokeless or chewing tobacco are at even higher risk of cancers of the cheek and inner surface of the lips. Aside from oral and throat cancers, using smokeless tobacco can cause other serious health problems, including other cancers, gum disease and possibly cardiovascular disease.
* Excessive alcohol consumption. Alcohol also can damage cells inside your mouth and upper throat. Roughly three-fourths of people with oral and upper throat cancers are frequent drinkers of alcohol. The combination of alcohol and tobacco use significantly increases your risk.
* Chronic denture irritation. Irritation caused by dentures doesn't itself appear to be a factor in oral cancer. However, poorly fitting dentures can trap particles of tobacco and alcohol, and prolonged exposure to these known risk factors may further increase your risk of oral cancer. Prolonged exposure to ultraviolet light. Too much ultraviolet light can damage the cells on your lips and increase your risk of lip cancer. Almost one in three people with lip cancer have jobs that keep them outdoors for long periods of time.
* White patches on the tongue or inside of the cheek (leukoplakia). Most of the time leukoplakia isn't dangerous. But leukoplakia can be serious, as some of the patches may show early signs of cancer, and many cancers of the mouth occur in areas in which leukoplakia is adjacent. Leukoplakia may result from a variety of causes, including smoking or chewing tobacco products or ill-fitting dentures.
* Red raised patches inside the mouth (erythroplakia). Erythroplakia is more likely than leukoplakia to indicate a developing cancer. The majority of these are eventually diagnosed as cancer. These areas often bleed easily if scraped.
* Human papillomavirus (HPV). HPV is a group of sexually transmitted viruses that have been linked to most cases of cervical cancers. More recently, HPV has been found to be a factor in about one out of five oral cancers.

Precursors of Cancer and Cancer Prevention

A weak or non-functioning immune system, poor health, an unhealthy environment and advanced age (over 80) can contribute to cancer. In the majority of people cancer can be prevented with proper lifestyle which consists of a low-entropy diet, exercise, sleep, stress reduction, etc. In most cases cancer develops slowly over many years. With a positive change of lifestyle and healthy environment this trend can be reversed in the majority of cases (probably in 90% -> 95%) - the cancer will shrink and eventually disappear.

New Research in Cancer Treatment

Genetically engineered bacteria and virusesSome new promising research uses genetically engineered bacteria and viruses to infect and destroy cancer cells. This could be useful when cancer is already advanced and there are large masses of cancer cells. The potential drawback of these methods is the generation of large amounts of toxins from dying cancer cells, which in turn can suppress the immune system or even kill the patient.Also bacteria and viruses very often mutate which in turn can lead to infection and attack on healthy, non-cancerous cells.
Anti-cancer vaccines Anti-cancer vaccines or even custom-made anti-cancer vaccines for a particular patient and cancer type are also a very promising line of research. By providing fragments of cancer cells to the immune system, one can potentially get the immune system response to destroy live cancer cells. Cancer markers Another promising line of research is related to chemical substances which could be used to mark cancer cells. This in turn will allow easier recognition of these cells by the immune system.
Cancer growth retarders / inhibitors This line of research is related to the use of chemical substances which could retard / inhibit the growth of cancer cells. An interesting research topics are the substances blocking activity of telomerase, the enzyme responsible for the management/elongation of telomeres.Telomerase is found in high concentrations in 80% of tumors and allows tumor cells to gain "immortality" by removing restrictions on the number of cell divisions. This enzyme may also be useful in extending the lifespan of healthy cells and in turn extend the lifespan of the organism (cancer cells and their growth may hold much valuable information about fountain of youth and immortality). All the above mentioned methods show some promise.
However these methods by themselves do not provide reliable cancer treatment. It is possible that some of them in conjunction with the non-traditional treatment of cancer (listed below) will become the standard cancer treatment, in the 21st or 22nd century

"World Cancer Report" by Who

WHO (World Health Organization, division of UN) estimates that only 4% of all cancers are inherited /genetic and that the majority of cancers are preventable ("World Cancer Report", IARC Press, Lyon 2003). According to this report, various cancers are strongly linked to lifestyle and the environment. It lists many of these factors and carcinogens. Cancer world maps shown in the report illustrate that the majority of cancers are in developed countries - which indicates again a strong link between cancer, lifestyle, diet and environment. This statistical data is very consistent with the cancer model outlined in this paper."World Cancer Report" by WHO