Overview

Throat cancer is a growth of cells that starts in the throat. The throat is a muscular tube that begins behind the nose and ends in the neck. Throat cancer also includes cancer that starts in the voice box, which sits next to the lower part of the throat.

Throat cancer symptoms include sore throat, ear pain and trouble swallowing. Symptoms may vary depending on the part of the throat that's affected.

Treatment for throat cancer also may vary depending on the cancer's location. Treatments may include surgery and radiation therapy. Medicines, such as chemotherapy, targeted therapy and immunotherapy, also may be used.

Where throat cancer happens

Throat cancer is a broad term for cancer that starts in the throat. Different subtypes of throat cancer are named for the part of the throat where they start.

  • Behind the nose. The part of the throat that's behind the nose is called the nasopharynx. The most common type of cancer that happens in this part is called nasopharyngeal carcinoma.
  • Behind the mouth. The part of the throat that's behind the mouth is called the oropharynx. Cancer that happens here is called oropharyngeal cancer. It includes soft palate cancer, tonsil cancer and cancer that affects the back of the tongue.
  • The lower part of the throat. The lower part of the throat, just above the esophagus and windpipe, is called the hypopharynx. It also may be called the laryngopharynx. Cancer that happens here may be called hypopharyngeal cancer or laryngopharyngeal cancer.
  • The voice box. The voice box, also called the larynx, sits next to the lower part of the throat. It holds the vocal cords that vibrate to make sound when talking. Cancer that starts in the larynx is called laryngeal cancer. It includes cancer that starts in the vocal cords, called glottic cancer.

Symptoms

Some throat cancer symptoms are common to many types of throat cancer. Other symptoms may depend on where the cancer starts in the throat.

Common throat cancer symptoms

Signs and symptoms of throat cancer in general may include:

  • A sore throat.
  • Ear pain.
  • Pain with swallowing.
  • Swollen lymph nodes in the neck.
  • Trouble swallowing.
  • Weight loss.

Nasopharyngeal cancer symptoms

Nasopharyngeal cancer starts in the part of the throat behind the nose. Symptoms include:

  • Bleeding from the nose.
  • Facial numbness.
  • Hearing loss.
  • Nasal stuffiness.
  • Ringing in the ears, called tinnitus.

Oropharyngeal cancer symptoms

Oropharyngeal cancer starts in the part of the throat behind the mouth. Symptoms include:

  • A lump under the skin on the neck.
  • Pain with swallowing.
  • Swollen lymph nodes in the neck.
  • Throat pain.
  • Trouble swallowing.

Hypopharyngeal cancer symptoms

Hypopharyngeal cancer starts in the lower part of the throat. Symptoms include:

  • A lump under the skin on the neck.
  • Coughing up blood.
  • Ear pain.
  • Indigestion.
  • Swollen lymph nodes in the neck.
  • Pain with swallowing.

Laryngeal cancer symptoms

Laryngeal cancer starts in the voice box. Symptoms include:

  • Changes in your voice, such as hoarseness.
  • Cough that doesn't go away.
  • Coughing up blood.
  • High-pitched sound when breathing in.

When to see a doctor

Make an appointment with a doctor or other healthcare professional if you have any symptoms that worry you.

Causes

Throat cancer is caused by DNA changes inside cells in the throat. Exactly what causes the changes isn't always known. Healthcare professionals know that smoking, drinking alcohol and human papillomavirus (HPV) infection can cause these changes. But not everyone who has these risk factors gets cancer. And some people who get cancer have no risk factors for the disease. More research is needed to understand exactly what causes cancer in different parts of the throat.

Throat cancer starts when something changes the DNA in throat cells. A cell's DNA holds the instructions that tell the cell what to do. In healthy cells, the DNA tells the cells to grow and multiply at a set rate. The DNA also tells the cells to die at a set time.

In cancer cells, the DNA changes give different instructions. The changes tell the cancer cells to grow and multiply quickly. Cancer cells can keep living when healthy cells would die. This causes too many cells.

The cancer cells might form a mass called a tumor. The tumor can grow to invade and destroy healthy body tissue. In time, cancer cells can break away and spread to other parts of the body. Throat cancer most often spreads to the lymph nodes in the neck. Less commonly, the cancer can spread outside of the head and neck area. When this happens, the cancer most often goes to the lungs. When cancer spreads, it's called metastatic cancer.

HPV: A common cause of oropharyngeal cancer

HPV can cause the DNA changes that lead to throat cancer. More specifically, HPV is linked to many cancers that happen in the part of the throat that's behind the mouth, called the oropharynx.

HPV is a very common virus. It spreads through close contact, most often during sex. In most people, the immune system clears the virus on its own without treatment.

Sometimes, the immune system does not clear HPV, and the virus stays in the lining of the throat. Over many years, it can cause changes to cells in the throat that may lead to oropharyngeal cancer.

HPV is mostly linked to oropharyngeal cancer, which includes soft palate cancer, tonsil cancer and tongue cancer that affects the back part of the tongue. HPV has many types, but the one that causes oropharyngeal cancer is called HPV 16. Cancers that test positive for HPV tend to have a better prognosis than cancers that are negative for HPV.

Cancers that happen in other parts of the throat also can test positive for HPV, but this is less common.

Risk factors

Factors that can increase the risk of throat cancer include:

  • Tobacco use, including smoking and chewing tobacco.
  • Excessive alcohol use.
  • Viral infections, including human papillomavirus (HPV) and Epstein-Barr virus.
  • A diet lacking in fruits and vegetables.
  • Exposure to toxic substances at work.

Prevention

There's no sure way to prevent throat cancer. But you can take steps to lower your risk.

  • Don't use tobacco. If you don't use tobacco, don't start. If you use tobacco of any kind, talk with your healthcare team about strategies to help you quit.
  • Limit alcohol intake. If you choose to drink alcohol, limit how often you drink, and keep the amount small. For overall health, drink one or fewer drinks a day. Do not drink every day. The less you drink, the better.
  • Consider the HPV vaccine. Receiving a vaccination to prevent human papillomavirus (HPV) infection may reduce the risk of HPV-related cancers, such as throat cancer. Ask your healthcare team whether the HPV vaccine is appropriate for you.
  • Choose a healthy diet full of fruits and vegetables. The vitamins and antioxidants in fruits and vegetables may help lower the risk of throat cancer. Eat a variety of colorful fruits and vegetables.
By Mayo Clinic Staff