Cancer of the throat begins in the pharynx, larynx (voice box), oesophagus (food pipe), or thyroid gland.
The disease is more common than many realise, in fact, numbers in New Zealand have doubled in the last two decades. Each year, doctors diagnose more than 500 new cases, and in some parts of the country, six patients are diagnosed with throat cancer each week.
Throat cancer is not always easy to detect. Often, the initial symptoms can be mild and easily mistaken for something relatively minor, such as an earache or a sore throat. For some patients, this means the disease may have advanced significantly before being diagnosed correctly.
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Early diagnosis is critical because, as with all cancers, delayed treatment means a much lower survival rate.
Living with cancer of the throat is extremely challenging, and even successful treatment can result in a reduced quality of life.
Throat cancer symptoms
Recognising the warning symptoms of throat cancer could save your voice, your ability to breathe and eat normally, and, ultimately, your life. Throat cancer signs vary, depending on where the cancer is located; however, common signs include:
- Sore throat, especially on one side
- A lump in your neck
- Ear ache
- Hoarse voice or persistent cough
- Difficulty swallowing
- Coughing up blood
If any of the above signs of throat cancer are persistent, severe, and unusual for you, have them checked by a medical professional. Get a second opinion if your doctor dismisses your symptoms and the problem doesn’t go away.
What causes throat cancer?
Throat cancer is on the increase in New Zealand. Although we do not know exactly what causes the disease, there are certain risk factors to be aware of. They include:
- Human papillomavirus (HPV) – This virus is now cited as one of the most common causes of throat cancer. Men are four times more likely to develop throat cancer associated with HPV.
- Oral sex - International studies have highlighted a significant growth in the number of throat cancers associated with oral sex (from 16% up to 70%).
- Smoking - The number of cigarettes smoked daily and length of time smoking. Some studies suggest that smoking might be responsible for as many as 60% of throat cancers.
- Excessive alcohol consumption – Alcohol is highly carcinogenic. The more you drink, the higher your risk.
- Epstein-barr virus (EBV) - Another common virus that increases your risk of developing throat cancer.
It’s important to remember that these risk factors are not the only precursors to throat cancer. Your age, general health, genetics, family history, and other lifestyle choices may also play a part.
How throat cancer is diagnosed
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Your doctor will make a physical examination of the throat region making a note of any unusual lumps or swollen areas. Blood tests can highlight signs of inflammation or other abnormalities. Your doctor may then recommend additional tests such as:
- Endoscopy - a tiny camera transmits images from inside your throat for the doctor to check for abnormalities.
- Laryngoscopy – a similar type of scope but for observing the voice box area.
- Biopsy - tissue samples are examined under a microscope to determine the presence of cancer cells. These can be taken through the endoscope or laryngoscope.
- Scans - X-Ray, Ultrasound, MRI, CT & PET produce images from inside the body to help doctors determine the size and spread of any cancer.
Throat cancer stages
Once doctors have made a cancer of the throat diagnosis, they will identify the specific stage of the disease. Throat cancer staging classifies your cancer on its size and how far it has spread. This information will help guide your medical team on choosing the best treatment options.
A basic outline of each throat cancer stage looks like:
- Stage 0 - also known as carcinoma in situ. This indicates the presence of abnormal cells in the throat’s lining that could turn cancerous.
- Stage I - very early-stage cancer; the tumour is smaller than two centimetres and has not yet reached the lymph nodes.
- Stage II - the cancer is larger than two centimetres but smaller than four. It has not yet reached the lymph nodes.
- Stage III - the tumour is bigger than four centimetres and has spread to a lymph node on the same side of the neck.
- Stage IV - the tumour may be any size and has spread to multiple lymph nodes (on both sides of the neck), as well as to other parts of the body, such as the lungs.
Treatment of throat cancer
There are a number of throat cancer treatment options available, depending on the stage of the tumour and where it started. Aspects such as your general health and age are also factored in. Your doctors and medical team will discuss the alternatives, and make a plan to eliminate the cancer while retaining as much of your normal throat function as possible.
SURGERY
- Endoscopic surgery - doctors operate on early, superficial throat cancers via laser and other surgical instruments.
- Laryngectomy - the removal of part, or all, of your voice box. This treatment may have a significant impact on your ability to speak.
- Pharyngectomy - the removal of part of your throat (pharynx). Reconstructive surgery will also be necessary.
RADIATION THERAPY
Doctors use high-energy particle beams to destroy the tumour. Radiotherapy can be used on its own to treat small, early cancers; or combined with surgery and chemotherapy for larger, more invasive cancers. It can be helpful in reducing the symptoms of advanced cancers.
CHEMOTHERAPY
Anti-cancer drugs destroy rapidly growing cancer cells. Chemotherapy is often combined with radiotherapy, and can also be used to reduce the size of the tumour before surgery.
Throat cancer survival rates
It’s difficult to find up-to-date figures for the survival rates of this disease in New Zealand. In Australia, five-year survival statistics for all head, neck, and throat cancers sit at around 70%.
Given that Australia outperforms New Zealand in many positive cancer outcomes, the stats are likely to be lower for Kiwis. Shortfalls in staffing and funding in New Zealand’s public health system mean long wait times for tests and specialist consultations. As with any cancer, early diagnosis is vital, yet recently, Counties Manukau District Health Board took nearly 12 months to follow up on an irregular throat scan. The patient was then diagnosed with throat cancer.
Preventing throat cancer
Current research highlights three factors that may decrease your risk of developing throat cancer.
- Get immunised against HPV. Immunisation is highly recommended for boys and girls aged 9 to 12 years. It’s free for everyone between the ages of 9 and 26, but becomes less effective as you get older. Throat cancers caused by HPV tend to respond better to treatment as compared with other types.
- Stop smoking. The Cancer Society lists smoking as “the greatest preventable cause of cancer in Aotearoa New Zealand.”
- Limit your alcohol consumption. Even moderate drinking could increase your risk of developing throat cancer by as much as 81%. That risk level is tripled if you’re a smoker.
Making healthy lifestyle choices can improve your chances of avoiding many types of cancer. Why not start now?
Are you prepared for life’s uncertainties?
You may not have throat cancer but that’s no guarantee it won’t happen to you or someone you love. Think about how health insurance can prepare you for the possibility.
And not all health insurance plans are the same. Some plans only pay for a tiny fraction of your treatment expenses.
Don’t let this happen to you. When buying health insurance, talk to a Policywise adviser about maximum benefit amounts for cancer treatments, non-Pharmac cover, inclusions, and any exclusions.
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