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Cancer of the throat is cancer of the vocal cords, voice box (larynx), or other areas of the throat.


Symptoms
Abnormal (high-pitched) breathing sounds
Cough
Coughing up blood
Difficulty swallowing
Hoarseness that does not resolve in 1 to 2 weeks
Neck pain
Sore throat that does not resolve in 1 to 2 weeks, even with antibiotics
Swelling in the neck
Unintentional weight loss
Treatment
Treatment is aimed at completely removing the cancer and preventing the spread of the cancer to other parts of the body.

When the tumor is small, either surgery or radiation therapy alone can be used to eliminate the tumor.

When the tumor is larger or has spread to lymph nodes in the neck, combination radiation and chemotherapy is often used to preserve the voice box and is successful in most cases.

Surgical removal of the tumor, including all or part of the vocal cords (laryngectomy) may be necessary in some cases. If a laryngectomy is required, a surgical prosthesis (artificial vocal cords) may be implanted, voice aids may be used, or speech therapy may be recommended to teach alternative methods of speaking.

Many patients also need swallowing therapy after treatment to help them adjust to the changes in the structure of the throat.

Causes
People who smoke or otherwise use tobacco are at risk of developing throat cancer. Excessive alcohol use also increases risk. Smoking and drinking alcohol combined lead to an increased risk for the development of throat cancers.

Most cancers of the throat develop in adults older than 50. Men are 10 times more likely than women to develop throat cancers.

Tests & diagnosis
An examination of the neck and throat may show cancer of the throat. The sputum (what is coughed up) may appear bloody. A lump may appear on the outside of the neck. A laryngoscopy, which is examination by use of a tube with a small lighted camera (laryngoscope), allows the physician to look into the mouth and down the throat to see the tumor.

A neck or cranial CT scan or cranial MRI may show throat cancer. These tests will also help determine if the cancer has spread to lymph nodes in the neck.

Biopsy and analysis of tissues that appear abnormal may confirm the presence of a cancerous tumor.

Prognosis
Throat cancers can be cured in 90% of patients if detected early. If the cancer has spread to surrounding tissues or lymph nodes in the neck, 50 - 60% of patients can be cured. If the cancer has spread (metastasized) to parts of the body outside the head and neck, the cancer is not curable and treatment is aimed at prolonging and improving quality of life.

After treatment, patients generally need therapy to help with speech and swallowing. A small percentage of patients (5%) will not be able to swallow and will need to be fed through a feeding tube.

Prevention
Minimize or avoid smoking and excess alcohol use.

Complications
Airway obstruction
Difficulty swallowing
Disfigurement of the neck or face
Hardening of the skin of the neck
Loss of voice and speaking ability
Spread of the cancer to other body areas (metastasis)

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Esophageal cancer is a cancerous (malignant) tumor of the esophagus, the muscular tube that moves food from the mouth to the stomach.

Symptoms
  • Backwards movement of food through the esophagus and possibly mouth (regurgitation)
  • Chest pain unrelated to eating
  • Difficulty swallowing solids or liquids
  • Heartburn
  • Vomiting blood
  • Weight loss
Treatment

When esophageal cancer is only in the esophagus and has not spread, surgery is the treatment of choice. The goal of surgery is to remove the cancer.

See:

  • Esophagectomy
  • Esophagectomy - minimally invasive

Sometimes chemotherapy, radiation, or a combination of the two may be used instead of surgery, or to make surgery easier to perform.

If the patient cannot tolerate surgery or the cancer has spread to other organs, chemotherapy or radiation may be used to help reduce symptoms. This is called palliative therapy. In such cases, the disease is usually not curable.

Other treatments that may be used to improve a patient's ability to swallow include endoscopic dilation of the esophagus (sometimes with placement of a stent to keep the esophagus dilated), or photodynamic therapy. In photodynamic therapy, a special drug is injected into the tumor, which is then exposed to light. The light activates the medicine that attacks the tumor.

Causes

Esophageal cancer is relatively uncommon in the United States. It occurs most often in men over 50 years old. Two main types of esophageal cancer exist: squamous cell carcinoma and adenocarcinoma. These two types look different from each other under the microscope.

Squamous cell esophageal cancer is associated with smoking and alcohol consumption.

Barrett's esophagus, a complication of gastroesophageal reflux disease (GERD), significantly increases the risk for adenocarcinoma of the esophagus. Other risk factors for adenocarcinoma of the esophagus include:

  • Alcohol use
  • Male gender
  • Obesity
  • Poor nutrition
  • Smoking
Tests & diagnosis

Tests used to help diagnose esophageal cancer may include:

  • Barium swallow
  • Esophagogastroduodenoscopy (EGD) and biopsy
  • Chest MRI or thoracic CT (usually used to help determine the stage of the disease)
  • PET scan (sometimes useful for determining the stage of disease, and whether surgery is possible)
  • Endoscopic ultrasound (also sometimes used to determine the stage of disease)

Stool testing may show small amounts of (occult) blood in the stool.

Prognosis

Esophageal cancer is a very difficult disease to cure. When the cancer has not spread outside the esophagus, surgery may improve chances of survival.

Radiation therapy is used instead of surgery in some cases where the cancer has not spread outside the esophagus.

For patients whose cancer has spread, cure is generally not possible and treatment is directed toward relieving symptoms.

Prevention

The following may help reduce your risk of squamous cell cancer of the esophagus:

  • Avoid smoking
  • Limit or eliminate alcoholic drinks

People with symptoms of severe gastroesophageal reflux should seek medical attention.

Screening with EGD and biopsy in people with Barrett's esophagus may lead to early detection and improved survival. People who are diagnosed with Barrett's esophagus should be checked regularly for esophageal cancer.

Complications
  • Difficulty swallowing
  • Pneumonia
  • Severe weight loss resulting from not eating enough
  • Spread of the tumor to other areas of the body
When to contact a doctor

Call your health care provider if you have difficulty swallowing with no known

Gastric cancer is cancer that starts in the stomach.

Symptoms
  • Abdominal pain
  • Dark stools
  • Difficulty swallowing, particularly difficulty that increases over time
  • Excessive belching
  • General decline in health
  • Loss of appetite
  • Nausea and vomiting
  • Premature abdominal fullness after meals
  • Unintentional weight loss
  • Vague abdominal fullness
  • Vomiting blood
  • Weakness or fatigue
Treatment

Surgical removal of the stomach (gastrectomy) is the only curative treatment. Radiation therapy and chemotherapy may be beneficial. A recent study showed that for many patients, chemotherapy and radiation therapy given after surgery improve the chance of a cure.

For patients in whom surgery is not an option, chemotherapy or radiation can improve symptoms and may prolong survival but will likely not cure the cancer. For some patients, a surgical bypass procedure may provide relief of symptoms.

Causes

Several different types of cancer can occur in the stomach. The most common type is called adenocarcinoma, which starts from one of the common cell types found in the lining of the stomach. There are several types of adenocarcinoma. Because other types of gastric cancer occur much less frequently, this article focuses on adenocarcinoma of the stomach.

Adenocarcinoma of the stomach is a common cancer of the digestive tract worldwide, although it is relatively uncommon in the United States. It occurs most frequently in men over 40 years old. This form of gastric cancer is extremely common in Japan, Chile, and Iceland. The rate of most types of gastric adenocarcinoma in the United States has declined over the years. Experts think the decrease may be related to reduced intake of salted, cured, and smoked foods. Gastric adenocarcinoma occurs most frequently in men over age 40.

Diagnosis is often delayed because symptoms may not occur in the early stages of the disease, or because patients self-treat symptoms that may be common to other, less serious gastrointestinal disorders (bloating, gas, heartburn, and a sense of fullness).

Risk factors associated with gastric cancer are a family history of gastric cancer, Helicobacter pylori infection, blood type A, smoking, a history of pernicious anemia, a history of chronic atrophic gastritis, and a prior history of an adenomatous gastric polyp larger than 2 centimeters.

Tests & diagnosis

The following tests can help diagnose gastric cancer:

  • Complete blood count (CBC) to check for anemia
  • Esophagogastroduodenoscopy (EGD) with biopsy
  • Stool test to check for blood in the stools
  • Upper GI series
Prognosis

The outlook varies widely. Tumors in the lower stomach are more often cured than those in the higher area -- gastric cardia or gastroesophageal junction. The depth to which the tumor invades the stomach wall and whether lymph nodes are involved influence the chances of cure.

In circumstances in which the tumor has spread outside of the stomach, cure is not possible and treatment is directed toward improvement of symptoms.

Prevention

Mass screening programs have been successful in detecting disease in the early stages in Japan, where the risk of gastric cancer is very high. The value of screening in the United States and other countries with lower rates of gastric cancer is not clear.

The following may help reduce your risk of gastric cancer:

  • Don't smoke
  • Eat a healthy, balanced diet rich in fruits and vegetables
  • Taking a medication to treat reflux disease, if present
Complications
  • Fluid build up in the belly area (ascites)
  • Gastrointestinal bleeding
  • Spread of cancer to other organs or tissues