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)
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:
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