Throat cancer: symptoms, treatment
- Causes and predisposing factors
- Symptoms of Throat Cancer
- Diagnosis of throat cancer
- Treatment of throat cancer
- Prevention of throat cancer
It is here, the general route of air and food intake through the pharynx, is divided into two different "overpasses": the larynx and the upper sections of the esophagus.
It is here that the vessels pass, providing the brain with fresh oxygen.
It is here that superficially lie the plexus of nerves, the excessive irritation of which can cause disturbances in the work of the heart.
Only in this place it is possible to visually evaluate and palpate the only of all the glands of internal secretion, located superficially, just under the skin - the thyroid gland.
But it is this boundary function of the pharynx and larynx that caused the most frequent occurrence of malignant tumors of the neck organs from the tissues of their formers, united in the concept of "throat cancer".
In the throat, three anatomical regions are distinguished from the top down:
- The oropharynx
Most of the malignant tumors of this component of the throat appear in the nasopharynx (arch and lateral surfaces) and have a serious prognosis due to germination of the skull bones in the air cavities.
In other areas of the pharynx - tumors are rare.
The division of the anatomical areas of the larynx occurs in relation to the vocal cords:
- Nadvyazochny (together with an epiglottis covering the entrance to the respiratory tract during swallowing) department
- Ligature department
- Podvyazochny Department
Each of the localizations has its own prognostic features in the development of malignant tumors.
The nadvyazochny department of the larynx is affected most often by cancer (65%), the process is rapidly developing and cancer early metastasizes.
The course of the cancer of the vocal folds is longer, which allows to identify it at earlier stages and to treat it in time. It occurs in 32% of malignant lesions of the larynx.
Podkazochnoj localization of a cancer is diagnosed in 3%. However, the diffuse development and distribution of it in the submucosal layer of this larynx division - determines a more serious prognosis.
In general, in the structure of the incidence of malignant tumors, throat cancer occupies about the tenth place in the frequency of occurrence (1-4%). And 50-60% of them are cancer directly from the larynx. And 98% of all tumors of this localization, histologically account for the squamous cell variant or its variations (Tumor Schminke - lymphoepithelioma).
Causes and predisposing factors
- Smoking is active and passive.
- Alcohol abuse. When this factor is combined with smoking, the likelihood of contracting a swelling in the throat is doubled.
- Age over 60 years.
- Genetic predisposition. The risk of getting sick is three times higher if there is a malignant neoplasm of the localization in the family.
- Production hazards (coal and asbestos dust, benzene, petroleum products, phenolic resins).
- People who were treated for a previous malignant tumor with localization in the head-neck region. In addition to the possible local effects of chemotherapy and radiotherapy, it is also of great importance associated with aggressive treatment, a decrease in the overall immune status.
- Prolonged professional workload.
- Specific damage of the upper respiratory tract by the Epstein-Barr virus, which causes, in addition, an infectious mononucleosis.
- Human papillomavirus (HPV). Studies show an increase in the incidence of cancer of the throat by a factor of five in detecting signs of infection in this mucosal membrane with this virus.
- Chronic productive laryngitis with the presence of precancerous diseases and changes in this area (papillomatosis, leukoplakia, dyskeratosis, pachidermy, broad-based fibroma, cystic formations in the area of vocal folds).
- Chronic inflammatory diseases in the upper respiratory tract (sinusitis, pharyngitis, tonsillitis, tonsillitis, etc.).
- Non-compliance with oral hygiene and the presence of untreated teeth.
- Culinary preferences in the form of nutrition with salted and salted foods.
- Cicatricial changes in the mucous after trauma, burns, previous syphilis or tuberculosis.
Symptoms of Throat Cancer
Like all malignant tumors, cancer with localization in the throat is characterized by a number of common symptoms. These symptoms appear some time before the first clear clinical signs, allowing you to clearly determine the location of the tumor. Often, the appearance of this symptomatology is associated with an adverse manifestation of persistent smoking as a variant of the normal state of the chronic smoker and does not immediately appeal to the otolaryngologists. The length of this "silent" period also depends on the degree of malignancy of cancer cells.
- Lack of appetite.
- Weight loss, weakness, weight loss, sleep disturbances.
- Subfebrile temperature.
The main signs suggesting cancer of the throat.
- Sensations of catarrhal irritation in the nasal cavity and throat.
- The resulting feeling of standing "lump in the throat" or stuck fish bone.
- Disturbances of swallowing and patency of dense food, and then of liquids, periodic poperyhivaniya liquid food, saliva.
- Unusual, unpleasant taste in the mouth.
- A paroxysmal dry cough that changes over time into a constant cough.
- The appearance of an admixture of blood in the saliva, sputum, separated from the nose.
- An increase in the group of cervical lymph nodes and a general edema of soft tissues, which is defined in the "thick-nosedness", previously not observed in the patient.
- Changes in breathing, accompanied by a feeling of inadequate inspiration and labored expiration.
- The appearance of pain in the larynx of different duration and intensity.
- Weight loss, which is associated with unpleasant sensations in the throat when eating with a relatively preserved appetite.
- Unpleasant, putrid odor from the mouth.
- An inexplicable, prolonged change in the usual voice of the voice, hoarseness without periods of improvement, followed by the loss of it.
- Pain in the ears with a significant decrease in hearing.
- Numbness and asymmetry of the lower parts of the face.
- Change of mobility and deformation of the neck skin, with causeless intradermal hemorrhages.
Continued more than two weeks, the changes described above require immediate treatment of the patient to a specialist (dentist, otolaryngologist)!
Local symptoms depend on the location and type of growth (exophytic, endophytic, mixed) of the tumor itself.
Tumors in the nasopharynx and oropharynx
- Anginopodobnye pain in rest and with swallowing.
- Increased groups of tonsils, their asymmetry, bleeding, the appearance of raids on them.
- Change in the form of the language, its mobility, taste sensations, accompanied by the emerging difficulty in the pronunciation of certain sounds.
- The appearance of non-healing long-term ulcerative defects when examining the nasal cavity and mouth.
- Nasal congestion, difficulty in nasal breathing.
- Nasal bleeding.
- Toothache, sudden loss of teeth.
- Dental bleeding.
- The nasal voice.
- Hearing changes.
- Non-retiring headache.
- Asymmetry of the face, feeling of numbness (manifestation of compression of the cranial nerves during the germination of the tumor into the base of the skull).
- Early increase in submandibular lymph nodes.
- Sensation of a foreign body in the throat, tickling and perspiration.
- Pain when swallowed, which spreads into the ear from the side of the lesion.
- Changes in the voice and a constant sore throat join in the late stages.
Localization in the vocal cords.
- Changes in voice, hoarseness.
- Sore throat, which is worse when talking.
- The loss of the voice completely.
This symptom appears already at the earliest stages of the disease.
- Pain, unpleasant sensations in the larynx when passing the food lump.
- Constant, with the phenomena of growth, shortness of breath and labored breathing, accompanied by "guttural" sounds.
- Changes in the voice and sore throat are associated with the localization of cancer in this area in the late stages.
It should be known that the younger the cancer of the throat, the more aggressive the disease develops and before there is metastasis to the lymph nodes.
In neglected cases, the main causes of death are:
- Massive bleeding from the vascularized blood vessels;
- Attachment of secondary infection during tumor decay with the development of sepsis;
- Aspiration with blood or food.
Diagnosis of throat cancer
- Interrogation of the patient with clarification of complaints.
- Examination of the shape of the neck, palpation of the lymph nodes.
- Inspection of the oral cavity, pharynx and larynx with the help of mirrors.
- Probing the bottom of the mouth, tongue, tonsils.
- Taking a smear from a visually altered mucosal site and needle aspiration from an enlarged and superficial lymph node to a cytological study to identify a cellular atypia that allows one to suspect a tumor.
- Examination with a laryngoscope and fibrolaringoscope. The change in the relief of the surfaces to be examined is visually determined with the formation of the so-called "plus-tissue", a change in the color of the mucosa in its projection, ulceration, plaque coating. In such cases, it is mandatory to take a sample of suspicious tissue for a histological examination (biopsy). Histological examination and only it - allows to differentiate inflammatory, benign and malignant processes occurring in the pharynx and larynx, among themselves. The result of the study determines the main directions of treatment.
- Investigation of the upper tracheal tubes with the help of a tracheoscope to clarify the degree of spread of the tumor and its deformation when squeezed from the outside.
- Research with ultrasound. This is the most available at the current stage of the method of radiation diagnosis. With its help, groups of deep lymph nodes are examined. Excess of normal size, changes in contrast, blurred borders, indicates a possible defeat of their tumor. In addition, the condition of the tissue surrounding the tumor and the possible compression of the main vessels and its degree are evaluated.
- X-ray examination of intracerebral sinuses, jaws (orthopantomography) and chest cavity (in the presence of metastases).
- Computer and magnetic resonance imaging with contrast. According to these studies, one can judge the true size of the tumor, its possible germination into surrounding tissues and metastasis to the lymph nodes.
- In addition, the phonetic properties of the larynx are examined to clarify the degree of immobility of the vocal cords, and change the shape of the glottis. To do this, use stroboscopy, electroglottography, phonetography.
Treatment of throat cancer
The standard set of methods for treating lung cancer does not differ in originality and includes a standard set used for cancer diseases: surgical treatment, chemotherapy and radiation treatment.
Unlike cancers of other localizations, some of the throat tumors in early (I-II) stages respond well to radiation treatment and chemotherapy (for example, limited only to vocal cords). The choice of volume of treatment is strictly individual, depending on the histological form of the disease and the localization of the tumor. In some cases, you can do without crippling operations.
The third and fourth clinical stages require the operation of surgery in combination with chemotherapy and radiation. In a number of cases, chemotherapy and irradiation are performed before surgery, to reduce the volume of tissues to be removed and to accurately determine the boundaries of the tumor, which may appear under the influence of death of some of the outer cancer cells.
The peculiarity of tumors of the lining of the larynx is a weak, and sometimes its complete absence, sensitivity to radiation therapy, with a few exceptions for tumors with high grades. Therefore, tumors of this localization require surgical treatment at any stage.
Along with the removal of the tumor, the greatest possible resection of the lymph nodes takes place, based on their peculiarities of location. Minimal germination of cancer in neighboring organs and tissues - will cause a minimally crippling level of operational benefit. Unfortunately, without crippling, disabling operations, in the late stages, to completely cure and prolong the life span of the patient, one can not do.
To the crippling operations include the removal of the larynx entirely and in combination with the tongue. In such cases, normal breathing and food intake are disrupted, not to mention the fact that they lose forever the opportunity to taste the food and participate in the conversation. Breathing is carried out with the help of a formed ankle with the skin along the front surface of the lower third of the neck.
Restorative operations after radical removal of the tumor, recently received a new development with the development of transplantation surgery and with the use of donor organs, artificial parts of the larynx. There are modern developments on the cultivation of the trachea from the patient's stem cells.
When carrying out the full complex of treatment, the five-year survival rate for throat cancer, on average, according to various sources, corresponds to the following data:
|Stage of throat cancer||Forecast.|
|0 stage (in situ)||96-100%.|
|1 st stage||78-80%.|
|4 th stage||About 25%.|
Prevention of throat cancer
It is necessary to exclude the impact of all possible risk factors.
Above all, smoking cessation. It is noted that the percentage of cured throat cancer among those who refused to smoke even at the stage after diagnosing their sad diagnosis is significantly higher than those who continued to condone their deadly habit.