Baran Sumer, M.D. Answers Questions On: Throat Cancer

There are actually several different types of throat cancer. Laryngeal cancer (cancer of the larynx, or “voice box”) and pharyngeal cancer are two of the most common types. In turn, pharyngeal cancers may affect the nasopharynx (upper part of the throat), oropharynx (middle part of the throat), or hypopharynx (bottom part of the throat behind the larynx that leads to the esophagus).

Cancers of the hypopharynx and vocal cords used to be primarily related to smoking and drinking alcohol. Today, however, viral infections such as HPV (human papilloma virus) are increasingly associated with certain throat cancers, particularly those in the tonsil and base of the tongue.

Because people are, in general, smoking and drinking a lot less than they used to, the incidence of traditional throat cancers associated with those behaviors is actually declining slightly. But if you look at the subset of oropharyngeal cancers that are virally based due to HPV, those are exploding in numbers.

Most patients with head and neck malignancies used to be in their 60s. Now, many of our patients with HPV-related cancers are in their 30s and 40s. So that places a premium on their function.

If they are going to be alive for decades after they're diagnosed and treated, it's extremely important to provide curative therapies with minimal side effects on their voice, their appearance, and their ability to speak and eat, because they’re going to be living with those side effects for the rest of their life.

Depending on the particular type and stage of cancer, we may recommend one course of action as more appropriate than the others. When two or three treatments are roughly equivalent, it’s really the patient’s preference.

In addition, as a leading academic medical center, UT Southwestern always has dozens of clinical trials going on to discover and improve evaluation and treatment techniques for throat cancers. So, when we are discussing options with patients, we are sure to include information about current clinical trials in which they may wish to consider participating.

The latest therapies are offering real progress in curing throat cancers while improving the post-treatment quality of life. Patients who have HPV-associated oropharyngeal cancers, in particular, tend to do very well. Their cancers are highly responsive to radiation and chemotherapy, so they can often look forward to a full recovery.

For all throat cancer patients (and, of course, people trying to minimize their chances of developing throat cancer), it makes sense to avoid alcohol and smoking. And because throat cancers can return months or years after treatment, and tend to raise the risk for other head and neck cancers in the future, it’s important for throat cancer survivors to receive regular checkups for the rest of their lives.