Throat Cancer

Throat cancer includes several types of cancer. They are differentiated by where in your throat the cancer originated.

• Nasopharyngeal cancer occurs behind the internal part of your nose, called the nasopharynx.
• Oropharyngeal cancer starts in the upper part of your throat called the oropharynx. It includes the soft palate, tonsils, and base of the tongue. 
• Hypopharyngeal cancer begins in the lower part of your throat, above the esophagus and trachea, called the hypopharynx or laryngopharynx.

Cancer in the voice box is called voice box cancer or laryngeal cancer.
 

Swallow Function Tests / Swallow Evaluations
A speech-language pathologist and/or radiologist assesses your ability to swallow and speak, possibly using an endoscope, fluoroscopy (using X-rays to record video of your internal swallowing function), or a modified barium swallow (which requires you to chew and swallow food that has been mixed with a metallic substance that shows up on X-ray imaging).

Endoscopy
A lighted tube is inserted in the throat to help your doctor identify lesions or tumors and what other structures might be affected.

Biopsy
A small sample of tissue is removed with a needle or another instrument (in your doctor’s office or in an operating room) and examined under a microscope to look for cancerous cells. The sample may be tested for the presence of HPV.

Advanced Imaging
CT, MRI, and PET scans can help doctors locate throat cancer, identify its type, and determine whether it has spread. We use the latest imaging technology to produce high-quality images while limiting your exposure to radiation.

Your treatment recommendations will be based on where in the throat your cancer is located, its stage, and its type. The presence of HPV is also considered. More advanced cancers may require a combination of treatments.

Radiation Therapy
MRI and CT imaging technology pinpoints the precise location of the tumor, and then beams of high-energy X-rays destroy the cancer cells. This targeted radiation treatment, often used before and/or after surgery, minimizes damage to surrounding healthy tissue.

Chemotherapy
These medicines kill cancer cells or stop them from growing. Chemotherapy is usually recommended in combination with other treatments. Our medical oncologists consider your tumor type and assess the risks and benefits before recommending chemotherapy as part of your treatment plan. We routinely combine the newest chemotherapy drugs with standard drug regimens to achieve a better response, fewer side effects, and improved quality of life.

Targeted Therapy 
Targeted therapy can help stop or slow the growth or spread of cancer by targeting specific aspects of your tumor's biology. Targeted therapies may be delivered in pill form or through onsite intravenous (IV) infusion.

Immunotherapy 
Typically reserved for people with advanced cancer that is not responding to other treatment, immunotherapy takes advantage of a person's immune system to help kill cancer cells. There are several FDA-approved options that can be delivered via oral medications or IV infusion.

Surgery
Head and neck surgeons carefully remove the tumor while preserving vital neighboring structures. Nearby lymph nodes may also need to be removed. If the entire voice box is affected, you may need a total laryngectomy, which will affect your ability to speak.

Some people may benefit from a minimally invasive surgical approach. Surgeons use this method to access the tumor through the mouth instead of through an incision in the neck. This approach shortens recovery time.

After surgery, you may need to breathe through a new airway in your throat called a stoma temporarily until swelling goes down. Some people may require a stoma permanently. Your doctor will meet with you periodically to evaluate your healing and determine whether it is safe to close the stoma and when you can safely eat and drink.

Microvascular Reconstruction
People who undergo more extensive surgeries may require an additional surgery called graft or flap reconstruction to repair the area where tissue was removed. Our expert team of sub-specialized head and neck reconstructive surgeons may perform this at the same time that your cancer is removed.

Rehabilitation Services 
Throat cancer treatment can lead to complications like problems with speaking, breathing, eating, or swallowing; nerve weakness or facial paralysis; or lymphedema. Speech therapists, physical therapists, and occupational therapists can help you improve your function.

Support Services
Social workers, psychologists, and palliative care experts can help you cope with the emotional and psychological effects often associated with cancer. 

Nationally Ranked Cancer Program
As a National-Cancer-Institute-designated Comprehensive Cancer Center, we are recognized for exploring new treatment opportunities through ongoing clinical trials. We offer you the latest research discoveries before they are available elsewhere. In addition, since 1973, Duke has been a member of the National Comprehensive Cancer Network (NCCN), which sets industry standards for safety and quality.

Advanced Surgical Techniques
Our surgical specialists are trained to remove tumors using a variety of tools, including transoral laser microsurgery (TLM) and transoral robotic surgery (TORS). These advanced techniques and tools increase surgical precision, reduce damage to surrounding structures, and help surgeons remove hard-to-reach tumors in the throat. They also require smaller incisions, which shortens recovery time.

A Team Approach
Our specialists -- otolaryngologists, oncologists, surgeons, radiologists, and others -- gather weekly to discuss complex cases. This cooperation means you benefit from a team of experts who provide a range of perspectives.