Throat cancer is a malignant tumor in the throat, which is characterized by asymptomatic are beginning, rapid growth, metastasis to lymph nodes and several organs.
The main method of treatment is considered a surgical technique, it may be combined with chemotherapy and radiation therapy.
This pathology is diagnosed in most cases in patients older than 40 years.
General data
Cancer of the pharynx identifies:
- 50% of all clinical cases on the tonsils;
- 16% – on the back of the throat;
- 10.5% – on the soft palate.
Reasons
Problems of cancer of the pharynx, lies in the fact that the reason for its occurrence, and the causes of the cancer other processes, is unknown. However, highlighted a number of factors that contribute to cancer of the pharynx.
Most often, this pathology developed in patients on the background of such factors as:
- genetic predisposition;
- endocrine disruptions;
- violations of the immune system, General and local;
- physical factors;
- chemical factors;
- inflammatory diseases;
- non-inflammatory pathology;
- pathogenic microflora;
- bad habits;
- somatic disease.
Throat cancer refers to a variety of pathologies, the occurrence of which genetic predisposition plays a major role. It is noticed that the chance of getting cancer of the pharynx is higher if the family at least one person was diagnosed with the disease.
Failures on the part of the endocrine system, which often was identified with cancer of the larynx, the following:
- diabetes – a violation of carbohydrate metabolism caused by the scarcity of insulin;
- hyperthyroidism – increased secretion (production) of thyroid hormones;
- hypothyroidism – lack of thyroid hormones
and some others.
As in the case of benign tumors of the pharynx, examines the role of female sex hormones in the development of cancer of the pharynx. It is revealed that this pathology is diagnosed in women in the age group of 50 years and older. Leaves open the following question: a cancerous degeneration of the tissues of the pharynx due to their age transformation (change) or human tissue processes, which are triggered by the restructuring of the hormonal levels during menopause.
There is increased incidence of cancer of the pharynx in patients with diseases of the immune system:
- congenital – they result from failure of fetal development (in particular, improper development of organs that form the immune system);
- acquired – immune deficiency, which developed after the birth (a notable example is AIDS – acquired immune deficiency syndrome).
Physical factors, against which there were throat cancer, are:
- mechanical;
- heat;
- radioactive.
The mechanical factor in the development of the disease are described the following effects on the tissues of the pharynx:
- medical procedures – the so-called iatrogenic factor (i.e., associated with medical actions);
- intentional or unintentional trauma, not associated with a medical intervention.
Medical procedures causing trauma to the tissues of the pharynx with risk of cancer, can be:
- diagnostic;
- treatment.
The fundamental factor is sloppy, rough perform such manipulations, which leads to the injury of the tissues of the pharynx.
This files most often mentioned the risk of injury arises in the performance of such diagnostic procedures, such as:
- posterior rhinoscopy examination of the nasal cavity with the nasopharyngeal mirror, introduced into the nasopharynx;
- pharyngoscopy endoscopic examination of the pharynx;
- laryngoscopy endoscopic examination of the larynx (during which the endoscope is introduced into the larynx through the throat);
- fibroesophagogastroduodenoscopy (fegds) – endoscopic examination of the esophagus, stomach, and 12 duodenal ulcer (during the endoscope is also inserted through the throat);
- duodenal intubation – the immersion of the probe into the 12-duodenum to fence its contents.
Therapeutic manipulation during which there is a risk to traumatize the pharynx and thus trigger a development in its tissues of the cancer process is:
- statement nasogastric (nosolutions) probe with the goal of decompression (unloading) of the stomach or parenteral nutrition if patient can not take food in the natural way;
- removal of existing tumors of the pharynx;
- plastic surgery on the throat;
- operations on neighboring organs and tissues, during which the throat can be damaged because of its close location
and several others.
Trauma of soft tissues of the pharynx occurs when:
- frequent inhalation of harmful substances, the particles which because of their size and shape can injure the mucosa of the pharynx or at the very least, irritate it;
- the infliction of wounds – incised, stab, lacerated, bitten, firearms and so on.
Thermal agent, contribute to the occurrence of cancer of the pharynx, is often the impact on the fabric high temperatures. It is observed in the following cases:
- inhalation of hot vapors in an accident (for example, by breaking the tube with hot water), when inhaled with the use of very hot solutions and so on;
- the application of hot solutions for the treatment of the throat (particularly during surgical intervention under anaesthetic or in the unconscious state of the patient, which in both cases shows no reaction to thermal stimulus);
- bad use of chilled instrumentation that has been processed by thermal methods
and several others.
The influence of low temperatures on the tissues of the oropharynx with the possible development of cancer process is much less.
The action of radiation, which can occur with cancer of the larynx, occurs when:
- carrying out diagnostic methods using sources of radiation;
- the course of radiation therapy for other malignant tumors;
- professional activities during which contact with radioactive substances is unavoidable;
- unauthorized access to the source of radiation.
Chemical factors that trigger the formation of cancer of the pharynx, may be any aggressive compounds. Often contact with them due to professional activities. This substances such as:
- benzene;
- toluene;
- formaldehyde;
- vinyl chloride;
- tetrachlorethen;
- acrylic;
- nitrile;
- styrene
and several others.
The risk of developing throat cancer increases with the presence of inflammatory diseases, especially chronic – and it’s not only diseases of the pharynx.
Most often these precipitating pathologies are:
- pharyngitis – inflammation of a mucous membrane;
- tonsillitis – an inflammatory process in the tissues of the tonsils;
- sinusitis – inflammation of the mucous membrane lining the frontal sinus;
- sinusitis – inflammation of the mucosa of the maxillary sinus;
- etmoidit – inflammatory process that develops in the mucous membrane of the ethmoid cells
and several others.
The role of infectious agents in causing cancer of the pharynx, is studied. Most likely, their impact is indirect: pathogenic microorganisms initiate an inflammatory disease, which, in turn, are a risk factor for cancer of the degeneration of the tissues of the pharynx.
Of all the infectious lesions of individual role in causing cancer of the pharynx plays a human papilloma virus (HPV).
From bad habits the most dangerous in terms of provoking cancer of the pharynx is considered to be non-Smoking. The role of nicotine a double – he:
- irritates the mucous membranes of the pharynx – at some point, its cells respond to this irritation start guidance;
- constricts blood vessels, which impairs blood flow to tissues, which in turn leads to their starvation and, as consequence, violation of the recovery processes.
It is revealed that 90% of all patients who had been diagnosed with cancer of the pharynx, used tobacco – Smoking or chewing it.
The negative role of alcohol in cancer of the pharynx are more pronounced than expected. Thus, among all patients with cancer of the pharynx about 75% used alcohol.
The most pronounced risk of developing throat cancer in people who both abused alcohol and smoked.
Patients with dentures throat cancer is detected more often. When ill-fitting dental prosthesis underneath accumulate remnants of alcohol and tobacco, which act as carcinogens in the mucosa of the pharynx.
Somatic diseases are risk factors against which the incidence of cancer of the pharynx above. Their role is that of such diseases (especially prolonged) develops a General depletion of the body, in front of it and runs a malignant guidance.
From non-inflammatory diseases to cancer of the pharynx have a value of:
- leukoplakia actinic mucous epithelium of the pharynx;
- erythroplakia – a disease of the mucous membrane of the pharynx as a persistent red spot with the formation of dysplasia (developmental disorders) of the epithelium.
The development of the pathology
Throat cancer can develop on the type:
- exophytic – an additional portion of the tissue;
- endophytic with invasion into the normal tissue of the throat.
Characteristics of exophytic tumors:
- located on a broad base;
- surrounded by inflammatory roller;
- has a bumpy surface;
- color – pink or grey;
- in some places there are ulcerations;
- when you touch bleeds.
One of the main features of this pathology is expressed in the endophytic growth type is the cancer grows in the tissue of the pharynx is very intense. But also endophytic form can occur in the form of ulcers, which are covered with dirty-gray patina and bleeding. A cancer is an ulcer most often detected on one of the tonsils and becomes the cause of its increase.
Another feature of cancer of the pharynx, lies in the fact that the initial period often takes place without any symptoms, and diagnosis is made quite late. Because of this, approximately 40% of all patients with cancer of the larynx diagnosed only in stage III and IV disease, and 45% of patients with this pathology was diagnosed for the first time, identify metastases to regional lymph nodes, which complicates the treatment and worsens the prognosis.
Throat cancer can occur:
- as a primary tumor;
- as a result of metaplasia (degeneration) of benign tumors of the pharynx;
- as a result of metastasis – the transfer of cancer cells from other organs and tissues.
In its histological structure cancer of the pharynx is in the form of forms, such as:
- limfoepitelioma;
- carcinoma;
- reticulocytosis;
- cytoblastema;
- a mixed tumor.
The first symptoms of cancer of the pharynx
The initial period of cancer of the pharynx, in most cases is asymptomatic. It can last from several weeks to several months, and only after this period of time begins to develop a clinical picture.
Symptoms of cancer of the pharynx are:
- foreign body sensation in the throat or feeling a lump;
- pain;
- swallowing;
- numbness;
- with the progression – General state.
The sense of having a foreign object in the throat or a lump is often the first symptom of cancer of the pharynx.
Pain syndrome joins after some time. Characteristics of pain:
- localization – throat;
- distribution can radiate to jaw, neck, ear;
- nature – aching;
- intensity – at first weak, then gradually increasing;
- the rise occurs later than the foreign body sensation in the throat.
Impaired swallowing may be accompanied by choking food.
Numbness develops on the part of the pharynx, but the mouth.
Violation of the General condition develops in the later stages and are caused by cancer intoxication due to contact with blood the decay products of the tumor. This symptoms such as:
The clinical picture of cancer of the pharynx, in specific cases depends on its localization:
- when spread on the soft palate deteriorating mobility, there is a twang of voice, the liquid food enters the nose during a meal;
- with the localization on the side of the throat cancer can grow in the vessels of the neck, to eat away at their wall and in order to provoke bleeding;
- the localization in the nasopharynx may the germination of the tumor in Eustachian tube and, as a consequence, the violation of its permeability, causing the hearing impairment.
Diagnosis
Throat cancer in the initial stages often is diagnosed accidentally when a patient visits the doctor for another reason. Because complaints may arise quite late, such a state of things not conducive to early diagnosis, therefore, have a value of additional methods of diagnosis – physical, instrumental, laboratory.
Data of physical examination:
- during the examination – with the progression of the disease is marked emaciation of the patient;
- palpation (feeling) – revealed an enlarged cervical and submandibular lymph nodes.
Instrumental methods of examination used in diagnostics of cancer of the pharynx is:
- pharyngoscope – inspection of the pharynx with a spatula. During pharyngoscope is biopsy – a fragment of the suspicious tissue with a subsequent study under a microscope.
Also used a number of instrumental methods that will help to estimate the prevalence of cancer. This:
Laboratory methods used in the diagnosis of cancer of the pharynx is:
- General blood test – a significant increase in ESR indicates the presence of guidance in the body;
- histological examination under the microscope studying biopsy material for the presence of malignant tissues.
Differential diagnosis of
Differential diagnosis of cancer of the pharynx is generally carried out with such diseases and pathological conditions, such as:
- benign tumors of the pharynx;
- foreign body of pharynx;
- tonsillitis – inflammation of tonsils;
- Wegener’s is an autoimmune inflammatory lesion of the vascular wall with the development of granulomas;
- syphilis throat – syphilitic lesions of the pharynx at erythematous (red spots), erosive (in the form of superficial erosions) or ulcers (to ulcers).
Complications
Complications of cancer of the pharynx are:
- acute otitis media is acute inflammation of the middle ear;
- chronic exudative otitis media chronic inflammation of the middle ear with the presence of fluid in it;
- chronic suppurative otitis media – a chronic inflammatory process with geobrowser;
- hearing loss – hearing loss;
- sinusitis – inflammation of one of the paranasal sinuses (maxillary, frontal, ethmoid, sphenoid);
- compression of the brain tissue – it compression during germination of cancer of the pharynx into the cavity of the skull;
- the collapse of cancer;
- nosebleeds – with the defeat of the nasopharynx;
- metastasis – migration of cancer cells to other organs and tissues with the formation of secondary tumor foci;
- cancer intoxication – poisoning of the body decay products of the cancer.
Treatment
The main treatment for cancer of the pharynx, is surgical. During the operation, which is carried out under General anesthesia, the tumor is removed together with the tissue located distance 1 see If the cancer is detected in the tonsil, it was removed together with the surrounding tissues. During germination of cancer of the pharynx, to the larynx resection is carried out throats and the removal of the larynx. After such operations in 3 months perform plastic surgery to restore the natural passage of food through the gastrointestinal tract.
Throat cancer I-II stage used only surgical treatment.
For cancer of the pharynx stage III the practice of combined treatment are surgery in combination with radiation therapy. The latter can be used as an independent method of treatment if:
- the operation cannot be done due to contraindications;
- the patient refuses surgical treatment;
- observed postoperative relapse.
Also in combination with surgery chemotherapy is applied.
Prevention
Specific methods of preventing cancer of the pharynx, like other cancers, no. The risk of their occurrence can be reduced if you adhere to these recommendations:
- prevention of endocrine malfunctions, immune deficiencies, somatic pathologies that can lead to the development of cancer of the pharynx, and if they have already developed their timely diagnosis and adequate treatment;
- avoidance of mechanical trauma to the throat (including through proper implementation of careful medical procedures), the impact of thermal and chemical factors, radiation;
- regular preventive checkups for the otolaryngologist, even in the absence of complaints;
- prevention, early detection and treatment of inflammatory and noninflammatory diseases of the throat and adjacent organs;
- sanation of chronic foci of infection in the body;
- quitting Smoking, chewing tobacco, alcohol consumption;
- adherence to healthy lifestyle – nutrition, regulated regime of work, rest, sleep, exercise;
- proper care of dentures.
The prognosis of pharynx cancer
The prognosis of throat cancer is complicated. The absence of complaints at the initial stage of development of pathology complicates the diagnosis.
Preventive examinations at an otolaryngologist allow you to detect cancer of the throat at I-II stage of the disease, which improves prognosis.
The surgical resection of the tumor is an effective method and improves the predictions, but it must be executed in a timely manner.
Indicators five-year survival rate after surgical treatment of the following:
- in patients with pharyngeal cancer I-II stage – 65-95%;
- in patients with pharyngeal cancer stage III after the combined treatment is 45-65%.
