Many people observed unpleasant symptoms associated with throat – sore throat, tickle in the throat, hoarseness, difficulty swallowing. In most cases these symptoms are a sign of colds caused by bacteria or viruses. But if such phenomena are observed for a long time and do not pass, they may indicate a much more dangerous disease – cancer of the throat.
Description of the disease
Malignant tumors of the throat, fortunately, cannot be attributed to a number of the most common cancers. At the same time, such a disease cannot be called very rare. Throat cancer occurs in about 4% of cancer patients.
The structure of the throat
You must first define the concept of “throat” from a physiological point of view. The throat is the colloquial name of the front half of the neck, located in front of the spinal column. At this point, is how the ways in which the lungs supplied with oxygen, and the ways in which the stomach receives the food. Just in the area of the throat a common path for food and air is divided into two – the oesophagus and the pharynx, which then goes into the trachea. In addition, in the vicinity of the throat are the vessels that supply blood to the brain, and are important plexus nerve, affecting the heart. In the area of the throat is one of the most important endocrine glands – the thyroid gland.
The pharynx is the upper part of the throat located above the larynx. From a physiological point of view, the pharynx is divided into three sections.
Below they are listed in order, from the highest to the lowest:
Localization of the disease
The disease begins with small tumors located in the throat, and more specifically, in the layer of epithelial tissue lining the surface of the larynx or throat.
If we consider the tumor in the throat, most commonly affects those formations nasopharynx. Similar tumor localization is especially dangerous because the tumor can grow in the air cavity of the skull.
The tumor gradually increases in size and affect the surrounding tissue. In the final stage of diseases can affect the lymph nodes and form metastases in other parts of the body. In the end, in most cases, the patient either dies from massive bleeding from the tumor blood vessels, or from aspiration of blood or food.
The tumor can involve different divisions of the larynx, the lower (below the vocal cords), medium (in the region of the vocal cords) and the upper (above the vocal cords). Nadzwyczajny Department is affected most often (two thirds of cases). Also for this localization is characterized by rapid tumor growth and early metastasis.
Ligamentous Department is affected in about a third of the cases. Typically, when such localization of the tumor develops slowly, which allows time to detect and start treatment. Subglottic localization is uncommon, it is typical for only 3% of cases. Due to the location of this type of cancer is very dangerous, it is characterized by the diffuse development.
Of all cases of cancer of the throat, the localization of the tumor in the larynx occurs in approximately 55% of cases, a break – in 45% of cases.
Varieties of the disease
From the histological point of view, almost all cases of cancer of the larynx (98%) are squamous cell cancer.
From a morphological point of view there are the following types of squamous cell carcinoma of the throat:
- high-grade differentiated
Neorogovevayuschy cancer develops relatively quickly and forms a large number of metastases and actively grow into the surrounding organs. This type of disease is the most common. Usually it is localized in the upper part of the larynx or laryngeal ventricle. Often there is a proliferation of this type of tumor from one part of the larynx to another. Neorogovevayuschy cancer leads to a reduction of the lumen of the larynx, causing the patient’s shortness of breath and loss of voice.
Keratinizing type of cancer is characterized by cells that become keratinized. This type of disease is not as rapidly evolving in comparison with others. Metastases, as well as virtually do not appear. In most tumors with keratinizing cells are observed in the region of the vocal cords.
When vysokomehanizirovannoe type of cancer, there is a significant involvement in the pathological process of healthy tissue. Treatment of this type of disease is the most labor-intensive and long-term.
The causes of the disease
Unlike many other cancers, throat cancer has a well established dependence on certain unfavorable factors. And in first place among these factors should be Smoking. In fact, it can be argued that throat cancer is a disease of heavy smokers. More than 85% of patients with throat cancer have such a harmful habit as Smoking.
The second important factor is gender. Throat cancer is a predominantly male disease. Approximately 95% of patients are men older than 50 years. In women, the disease is relatively rare, but this does not mean that a woman, especially Smoking, has no chance of Contracting the disease. At a young age the disease is also rare, consequently, old age is another negative factor.
Other factors contributing to the disease include:
- inhalation of toxic fumes;
- handling hazardous chemicals (chemical industry, manufacture of paints, construction and repair);
- incorrect diet, a large amount of smoked and salted food, lack of fresh vegetables and fruits;
- the abuse of alcohol;
- non-compliance with hygiene of the oral cavity;
- hereditary factors;
- infectious mononucleosis;
- tumors of the neck and head in a different location;
- the radiation exposure.
Also the likelihood of disease increases following pathological processes and education in the larynx:
- chronic untreated inflammation of the upper respiratory tract (laryngitis, pharyngitis, sinusitis, etc.)
- chronic disease of the teeth and gums,
- scars ,
- pachydermia of the larynx.
Statistics show that cancer of the larynx is much more common in big cities than in rural areas. This suggests that the occurrence of the disease is also influenced by environmental conditions.
The disease appears in severe form immediately, but develops over many months or even years. Unfortunately, people often do not notice the time unpleasant symptoms, and seek help to the doctor only when the disease becomes incurable form. Meanwhile, throat cancer at early stages has a well-recognized symptoms. The exception to this rule has only zero stage (pre-cancer), in which pathological changes in the tissues does not manifest itself and can be detected only at random diagnostic study of the respiratory system.
In the early stages of the disease the patient usually suffers from pain, cramps or sore throat, dry cough. Very often these symptoms are accepted by the patients for cold symptoms. However, unlike OCR these signs are observed constantly and do not pass after some time, and gradually increase. It is important to note that the pain in the throat tumours do not disappear after taking painkillers, and the cough persists after taking protivokashlevyh drugs. Because throat cancer is most common in smokers, hacking cough patients usually refer to side effects of Smoking. At first, the cough may be intermittent, but then becomes permanent. May experience low-grade fever, anemia, numbness in certain departments of the face, subcutaneous hemorrhage, swelling of the lymph nodes in the neck or under the jaw.
As further development of the disease there are other symptoms – hoarseness (due to lesion of the vocal cords), the deterioration of taste, foreign body sensation in the throat, difficulty swallowing, bleeding from the throat. The tumor is large in size can obstruct breathing, and the patient has a shortness of breath. Possible severe headaches, pain in the neck or the ears, loss of sleep and hearing, blood or pus in the secretions from the nose. Discharge from the nose or mouth have an unpleasant odor. Also, the patients lose their appetite and, consequently, weight. Deteriorating General condition, there is irritability. The tumor becomes visible on the outside due to the swelling in the neck. In severe cases the patient loses the ability to open or close the mouth.
These symptoms are already on a neglected disease. Unfortunately, it is at such stages, most patients go to the doctor.
Depending on the location of the tumor symptoms may differ slightly. For tumors in the nasopharynx and the oropharynx the most characteristic anginophobia pain, bleeding from the nose from the tonsils, a feeling of nasal congestion, tooth pain and tooth loss, headaches, not removable by means of analgesics, increasing the submandibular lymph nodes.
When nadzwyczajny localization often manifest the following symptoms:
- foreign body sensation,
- the pain when swallowing.
The voice change in this localization are manifested only in the later stages of the disease.
When the tumor in the area of vocal cords most frequently observed pain when talking, change in voice, or its total loss. These symptoms can manifest themselves at the earliest stages of the disease.
When subglottic localization is often observed pain or discomfort during the passage of the bolus, and a permanent shortness of breath or difficulty breathing. Change voices join only at later stages of the disease.
The stage of the disease
In characterizing cancer diseases doctors use such a thing as a stage of the disease. The different stages correspond to certain symptoms. Also, different stages may apply different methods of treatment. The prognosis for recovery decreases with increasing stage of disease.
|Stage||Symptoms||The degree of tumor development||Prognosis of survival (for 5 years)|
|Zero||No||A small ulceration of the mucous membrane||About 100 %|
|First||Congestion of the throat, difficulty swallowing and talking, but the voice does not change||The growth of the tumor limited to one Department of the larynx, metastasis is not observed||80%|
|Second||Osiplosti, speech impairment||The gradual withdrawal beyond a single Department of the larynx, metastasis is not observed||75%|
|Third||Pain, loss of voice, up to a full, strong cough||Outside of the larynx, and invasion beyond larynx, the appearance of individual metastases||50%|
|Fourth||Loss of voice, pain when talking, swallowing||Germination in surrounding tissues, lymph nodes, metastasis||25%|
The speed of development of the disease depends on the age of the patient. In younger patients there is usually more transient manifestation of symptoms.
For the diagnosis of the disease can be used different methods. Not always a visual examination of the patient, the audiologist can identify the disease, especially at an early stage. Therefore, primarily used instrumental methods of research. The easiest of these is laryngoscopy. This method consists in examination of the mucosal surface of the larynx with the aid of special lamps and mirrors.
Of great importance in identifying the disease and differentiating it from other pathological processes, in particular inflammatory, plays a biopsy. This method consists in taking the analysis of a piece of tissue from the affected area. Also to identify the scale of the pathological process used diagnostic methods such as MRI and radiography. They reveal the presence of metastases, and to determine the size and shape of the tumor.
Treatment strategy depends on the stage of the disease. At an early stage the most effective treatment is surgery to remove the tumor. It can be performed in the traditional way, and with the help of laser.
Prevention of relapse or in preparation for surgery the patient can be administered a course of chemotherapy.
It should be borne in mind that in some cases the surgery can be removed the vocal cords and tongue (partially or entirely), which will significantly complicate or make impossible the speech and acceptance of food.
In the later stages of the operation to remove it may not be possible. Therefore, we use methods such as chemotherapy and radiation therapy. In radiation therapy, the tumor is irradiated with a flux of high-energy particles that kill cancer cells. The goal of radiation therapy could be the elimination of tumors and its significant reduction or stop of growth. Sometimes radiation therapy is preceded by surgical operation.
Contraindications to radiation therapy – tumor invasion into the tissue of the esophagus and blood vessels, a serious condition of the patient.
Chemotherapy cytotoxic drugs are used to slow the division of cancer cells. Cytostatics can be administered intramuscularly, intravenously, orally or directly to the area affected by the tumor.
However, all arrangements for the treatment of the disease are likely to be ineffective if the patient does not get rid of addiction to Smoking.
After the operation the patient will need rehabilitation, including, in particular, skills training.
In that case, if due to the large size of the tumor, the patient loses the ability to breathe, it makes the operation of tracheostomy, which is inserted into the trachea tube.
If the disease is detected in time (in the early stages), then it is likely that the disease will be able to win. So, five-year survival in patients with cancer of the throat in the first stage is 85%.
Patients with the disease in the fourth stage of the five-year survival rate is less than 20%. A lot also depends on whether agree the patient for surgery to remove the larynx and vocal cords (laryngectomy), which, as mentioned above, can make a person dumb.
Throat cancer is primarily a disease of those who abuse alcohol and nicotine. That is why the waiver of addictions greatly reduces the likelihood of disease.
Other risk factors include poor cleanliness of the mouth, and constant inhalation of carcinogenic chemicals. The older men, the disease is extremely common, so people who are in this risk group should monitor the hygiene and to avoid manipulation involving toxic substances. Substances with high Carcinogenicity include asbestos, benzene, petroleum products, coal dust, phenolic resins.
When dealing with a potential carcinogenic aerosols should be applied to devices for respiratory protection – gauze bandages and respirators. If the exposure to carcinogens is an unavoidable consequence of the performance of professional duties (for example, for workers in the chemical industry or the construction industry), then in such case the need arises in the passage of the annual preventive examination.
In addition, it should be borne in mind that early diagnosis of the disease greatly improves the chances of healing. This implies the need for regular inspection at the doctor-the otolaryngologist, the timely treatment of chronic respiratory diseases.