The American Cancer Society reported that in 2010, there are 6010 cases of death after stage 4 throat cancer out of 25,380 diagnosed cases; making it the 12th most common cancer in the United States. Throat cancer is the uncontrolled proliferation of “cancer cells” in the pharynx, nasopharynx, and larynx or sometimes even in the upper part of the esophagus. In about 90% of the cases, the proliferators are squamous cell carcinomas, which come from the epithelial lining of the aforementioned regions. The cancer cells spread to the lymph nodes, which are small, ball-shaped organs of the immune system, which function by filtering foreign substances from both the lymphatic fluid and blood. Throat cancer is further classified in stages, which indicate the extent to which the cancer cells have proliferated. Lower stages (1 and 2) involve cancers not bigger than 2 inches, and the spread is not very severe. Stage 3 cancers have already spread into the lymph nodes (usually larger than 6 centimeters); while stage 4 which is considered severe means that the cancer has already spread in the mouth and lips, creating identifiable signs in the face of the patient.
Smokers and heavy drinkers are at very risk of having throat cancer, most especially in their 6th and 7th decade of life. Lack of proper nutrition may increase the risk, but sometimes, cultural factors affect more, like chewing betel quid in some parts of Asia and drinking mate in South America. Moreover, people who have been infected with the human papilloma virus (HPV) are also at high risk. One common condition, the gastric reflux, becomes a risk factor when it becomes chronic. Occupational exposure may also heighten the chances of having throat cancer, and this poses the same for prior radiation therapy in the head and neck regions.
A chronic sore throat may be the first sign that a person has stage 4 throat cancer. This may be accompanied by cough and painful or difficulty in swallowing, called Dysphagia. A metabolic effect of throat cancer is apparent weight loss, probably due to thyroid gland inclusion. This can be detected through the palpation of a lump in the neck area, or internally felt at the back of the mouth, which may again lead to Dysphagia or aspiration. Furthermore, this may affect breathing because of blockage in the airway. The presence of blood in the sputum known as hemoptysis may also be an indication of throat cancer. Some changes are not easily considered, but may be indicators of throat cancer itself, like chronic hoarseness of voice, or complete voice change.
Earlier stages (1 and 2) of throat cancer may only require either radiotherapy for six to seven weeks or surgery (hemilaryngectomy, supraglottic or supracricoid laryngectomy or neck dissection if nodes are present), each having its benefits and complications such as hypothyroidsm, radionecrosis, xerostomia, laryngeal edema and mucositis. Advanced stages (3 and 4) often require surgery (partial or total laryngectomy or pharyngectomy, meaning the removal of larynx or pharynx, respectively) with adjuvant radiation, which begins about 6 weeks after surgery and continues for another six or seven weeks. Chemotherapy using Cisplatinum and 5-flourouracil may be used adjuvant to irradiation for advanced stages.
The treatment process of throat cancer does not terminate with the surgical or the medication stages, but continues with voice rehabilitation, which usually takes longer than the hospital phase itself. Depending on the severity of the cancer and the capacity of the patient, he or she can be fitted with a tracheostomal prosthesis, provided with an electrolarynx, or may just resort to pure esophageal speech if the patient has the ability, according to the post-surgery evaluation of a speech pathologist.
In many cases, there is a reoccurrence of laryngeal cancer within the first two years. This recurrence may be in the same site where the previous cancer developed. After a five-year period without the recurrence of the cancer, a patient may be declared completely cured. Stage 4 throat cancer prognosis for patients with stage 4 throat cancer have 50-60% survival rate within a 5-year period. This largely depends on the patient’s age, oral health and the size of the obtained tumor.
Oral and throat cancer may be prevented by the reduction of alcohol intake and cessation of smoking. According to the American Cancer Society, within 5 years of quitting smoking, the risk of acquiring throat cancer is cut into half, while within 10 years, the risk may be reduced to that of a person who does not smoke. If you have stage 4 throat cancer now, it is best to quit smoking or heavy drinking and see your doctor right away.