Throat Cancer: What to Know

Medically Reviewed by Zilpah Sheikh, MD on February 07, 2024
11 min read

Throat cancer is any cancerous tumor that grows in your throat or your voice box. Your throat, or pharynx, is muscular and starts behind your nose and stops in your neck. Your voice box, or larynx, is right under your throat. It's made of cartilage and contains vocal cords that allow you to speak.

About half of throat cancers happen in the throat itself, while the other half start in the voice box. Usually, cancer in your throat starts in the flat cells that make up your throat lining.

These diseases tend to grow quickly. That's why getting diagnosed and treated early on gives you the best chance to get rid of the cancer and keep a good quality of life. Learn as much as you can so you’ll know what to expect.

Most types grow in the flat, thin cells that line the throat and voice box.

The two main types of throat cancer are:

  • Pharyngeal cancer. Your throat (pharynx) is a tube that runs from your nose to your esophagus. Your esophagus carries food from the bottom of your throat to your stomach.
  • Laryngeal cancer. Your voice box (larynx) sits at the bottom of your throat and contains your vocal cords.

Doctors break these groups down even further, identifying them by where they are. Pharyngeal cancer may happen in your:

  • Nasopharynx. This is the upper part of your throat behind your nose. In the U.S., cancer in this part of your throat is rare.
  • Oropharynx. This part is behind your mouth. Cancer is most likely to grow in the tonsils, the back of the tongue, or the soft palate (the soft area behind the roof of your mouth).
  • Hypopharynx. That's the narrow area behind your voice box.

Cancer can grow in the three parts of the voice box itself. Laryngeal cancer may happen in your:

  • Glottis. This holds your vocal cords.
  • Supraglottis. This is the area above the glottis (including cancer of the epiglottis, which is like a flexible lid to your windpipe).
  • Subglottis. This is the area below your vocal cords and above your windpipe.

Your doctor will tell you what stage your cancer is. This gives you an idea how much the cancer has grown and if it has spread to other parts of your body. The stage will help your doctor decide on the best treatment options for you. Each type of cancer has its own rules for staging, which describes how advanced the disease is.

Throat cancer has 5 stages:

Stage 0. You'll have abnormal cells in your throat that might become cancerous. Stage 0 cancer is also called carcinoma in situ.

Stage I. Your cancer is in a very early stage. It is 2 centimeters or less in size and limited to your throat.

Stage II. Your tumor is 2-4 centimeters in size and hasn't spread to your lymph nodes.

Stage III. Your throat cancer is larger than 4 centimeters or it has spread to your nearby lymph nodes.

Stage IV. Your cancer may be any size, but it has already spread to other places including:

  • Your neck, trachea, thyroid, esophagus, jaw, mouth, or other places
  • Lymph nodes that are large or on the other side of your neck. It may also affect more than one lymph node.
  • More distant parts of your body, such as your lungs.

Your throat cancer could be at any stage when it's first diagnosed. Many cases aren't caught until after throat cancer has spread to one or more nearby lymph nodes. Stage III and IV throat cancers are harder to treat and more likely to come back after treatment.

One of the challenges in medicine is that so many illnesses share the same symptoms. A plain sore throat or a cough usually isn’t a big deal. More often than not, they go away on their own. But sometimes, they’re symptoms of something more serious, such as throat cancer. When you have throat cancer you may have:

  • Voice changes such as cracking, hoarseness, or trouble speaking clearly
  • Trouble swallowing, chewing, or breathing
  • A feeling like something’s caught in your throat
  • A sore throat, cough (possibly with blood), or earache that won’t go away
  • A headache
  • Pain in your ears or neck
  • A neck lump or soreness that doesn’t go away
  • Unexplained weight loss
  • Jaw stiffness
  • Bleeding in your mouth or throat
  • Loose teeth
  • Bad breath
  • Ulcers in your mouth or throat that don't go away

See your doctor right away if any symptoms last more than a few weeks. But keep in mind that many conditions that aren’t cancer have these same symptoms.

What does throat cancer look like?

Usually, it doesn't look like much or will be hard to see. That's because throat cancer is usually in parts of your throat you can't easily see. They're usually small and may be under the surface. Only 20%-30% of people with this cancer will be able to see anything.

If you can see something, you may notice:

  • One side of your throat looks different than the other
  • Red or white patches in your throat
  • Swelling

In most cases, your doctor will need to use a scope to see throat cancers. They'll look like a mass on one side of your neck.

Early throat cancer symptoms

Most people with early throat cancer don't have any symptoms. If you do, you may see a lump or mass on one side. Usually, it won't hurt, but sometimes you may have some pain in the back of your throat. You may also have trouble swallowing.

Nobody knows for sure why throat cancer happens, but some things can make it more likely. Like other cancers, it arises when cells in your throat pick up genetic changes that make them grow too much or spread to other places. Those rapidly growing cells can turn into a mass.

Many things can make throat cancer more likely, including:

  • Using tobacco, whether you smoke or chew it
  • Drinking too much
  • Infections, including human papillomavirus (HPV) and Epstein-Barr virus
  • Not eating enough fruits and vegetables
  • Having gastroesophageal reflux disease (GERD)
  • Exposure to toxins, including asbestos, nickel, or sulfuric acid

Some other factors you can't change also influence your risk.

  • Sex. Men are five times more likely to get it than women.
  • Age. Most people get diagnosed after age 65.
  • Race. African American men get throat cancer more often than other groups do.

There are well over 100 kinds of HPV. About 40 of them can spread if you have sexual contact with another person’s genitals, mouth, or throat. You can get oral HPV from oral sex. The more sexual partners you have, the more likely you are to get HPV and throat cancer. The infection goes away for most people in 1 or 2 years. But it doesn't always leave your system and can cause throat cancer years later.

Experts don’t know if having HPV alone can lead to cancer, or if you have to have another risk factor for it to happen (like being a cigarette smoker). But it causes about 70% of oropharyngeal cancer in the U.S. Cases continue to grow here, and there are more cases of throat cancer in men than cervical cancer in women, which is also caused by HPV.

Getting the HPV vaccine can protect you from the types of HPV that can cause throat cancer. It may prevent it. Some evidence shows that there’s possible herd immunity if enough people assigned female at birth get the vaccine. But it’s still recommended for all young people. In the U.S., 54.5% of teens aged 13-15 got two or three doses.

You should get the HPV vaccine if you’re:

  • 11-12 years old
  • A young adult up to 26 years old
  • Over 26, but it may not be as protective if you've already been exposed to HPV

You should get two doses spaced 6-12 months apart. If you start it later, you’ll need a third dose. (Children can get the first dose as early as 9 years old.)

To prevent throat cancer from HPV:

  • Get the HPV vaccine.
  • Limit how many sexual partners you have.
  • Practice safe sex by using things such as condoms and dental dams during oral sex.

Your doctor will examine you and ask about your general health, smoking and drinking habits, and sexual history.

They might use devices to get a closer look at your throat.

If the doctor thinks you may have cancer, they’ll order tests and procedures depending on what kind they suspect. Here are some common ones:

A biopsy collects a tissue sample that gets examined under a microscope to look for cancer cells. It’s the only way to know for sure if a tumor is cancer and what kind it is. The procedure may be done with surgery, fine needles, or an endoscope—a flexible tube with a camera that’s lowered into the throat through your nose or mouth. A tool on the end will take the biopsy.

Imaging tests can help doctors find a tumor. They can also show how big it is and if it has spread. These include:

  • MRI or CT scan
  • PET scan
  • X-rays

If cancer of the oropharynx is found, the sample may be tested for HPV. Usually, individuals diagnosed with this virus have a better health outlook than those diagnosed with smoking-related cancer.

How to check for throat cancer at home

If you think you're at risk for throat cancer, it's a good idea to check for it at home. But keep in mind that throat cancers are usually hard to see and may be hidden in parts of your throat you can't see. Not seeing throat cancer doesn't mean you don't have it. To check for throat cancer:

  • Feel for lumps in your neck
  • Look at the back of your throat
  • Watch for red or white patches
  • Pay attention to any lumps, bumps, or ulcers

If you notice anything unusual that doesn't go away in a couple of weeks or gets worse or bigger, see your doctor. 

Doctors will try to get rid of the tumor, keep the cancer from spreading, and protect your ability to swallow and speak as much as possible.

Your treatment will depend on:

  • The stage of your cancer
  • Where it is located
  • Your general health
  • Your preferences

You may have one or more treatments. Talk to your doctor about your options to decide which option you think is best for you. Treatment options include:

Radiation therapy

Radiation uses high-energy rays to kill cancer cells. It’s given outside your body by a machine, or inside by radioactive seeds planted near the cancer. Sometimes, radiation is the only treatment needed if your throat cancer is caught early. But it can be used with chemotherapy or surgery to treat more advanced stages of the disease.

Surgery

Surgeries to remove throat cancer will depend on where the cancer is and how advanced it is.

  • Surgery for small cancers. You may have surgery to remove all or a throat cancer that's small and hasn't spread to lymph nodes. Your doctor will use an endoscope and special tools or a laser to remove the cancer as completely as possible.
  • Laryngectomy. If your cancer is in your voice box (larynx), your doctor may remove part of it. They'll leave as much as they can to limit changes in your ability to speak and breathe normally. Sometimes, they may need to take out your whole voice box. If they need to do this, they'll attach your windpipe to a hole in your throat so you can breathe. This procedure is called a tracheotomy. You'll have options to help you speak without a voice box.
  • Pharyngectomy. This surgery involves removing part of your throat. You'll need your throat reconstructed so you can swallow normally.
  • Neck dissection. If the cancer has spread in your neck more deeply, your doctor may need to take out many lymph nodes to check them for cancer.

Chemotherapy

Chemotherapy drugs can kill cancer and stop it from spreading. It may be used before surgery to shrink tumors, or after to keep the disease from coming back. Some chemo drugs can make radiation work better.

Targeted therapy

Targeted drugs can starve cancer cells by blocking substances they rely on to grow. For example, throat cancers often depend on a protein called epidermal growth factor receptor (EGFR). A drug called cetuximab works by targeting EGFR. Targeted drugs may be used together with radiation, chemotherapy, or other treatments.

Immunotherapy

Some immunotherapy drugs are approved for head and neck cancers, including throat cancers. They work by taking the brakes off your immune system so that it can help get rid of the cancer. You're more likely to use this if the cancer can't be removed with surgery or if other treatments don't work.

Rehabilitation

You may need other treatments to help after surgery or other treatment to remove or get rid of throat cancer. Your doctor may suggest you see specialists to help you:

  • Take care of a surgical opening
  • Eat or swallow
  • Manage stiffness or pain
  • Speak

Palliative or supportive care

Palliative care is focused on relieving pain or improving quality of life. Your doctor can prescribe medication to help you manage pain when you have cancer at any stage.

You can't prevent throat cancer. But you can take steps to lower your risk, including:

  • Not smoking
  • Quitting smoking if you smoke
  • Drinking alcohol in moderation or not at all
  • Eating a diet with lots of fruits and vegetables
  • Taking steps to protect yourself from an HPV infection

Having throat cancer and undergoing treatment is hard. You may have lasting side effects. But there's a lot you can do to live a long and happy life.

  • Take care of yourself. Your treatment might take a lot out of you. So get enough rest, exercise when you can, and fill your plate with healthy food, such as fruits and veggies.
  • Quit tobacco and limit alcohol. Smoking and drinking can make treatments less effective, and they raise your risk of getting another cancer.
  • Keep your appointments. Your doctor will follow you closely for the first few years. They’ll look for signs that the cancer has come back.
  • See other specialists. If you're struggling with eating, swallowing, speaking, or other everyday activities, ask your doctor for referrals to a speech pathologist or other specialist who can help.
  • Don't forget your mental health. It's easy to forget mental health when you're worried about your physical health. If you're depressed, anxious, or managing other difficult emotions, reach out for help from a mental health professional.
  • Join a support group. It often helps to talk to other people who've been in your shoes. Ask your doctor or look for a support group in your area or online.

Throat cancer can be in your throat or voice box. It won't always be easy to tell if you have it, but to lower your risk you can take steps such as not smoking and protecting yourself against an HPV infection. Your treatment may include surgery, radiation, chemotherapy, targeted therapy, or other medicines depending on how advanced your cancer is and where it is located.

  • Is cancer in the throat curable?

Throat cancer can be curable, especially if it's caught early enough for a doctor to remove it with surgery. Ask your doctor what your outlook is based on your cancer.

  • Do people usually survive throat cancer?

The 5-year relative survival rate for cancer in the throat or larynx is about 60%-70% based on the most recent data. But recent treatment advances mean that your odds will be better. They also will depend on how advanced your cancer is.

  • What can be mistaken for throat cancer?

Throat cancer symptoms can be similar to common conditions, such as colds, sinus infections, or allergies.

  • How can I check for throat cancer at home?

If you're worried you have signs of throat cancer or think you're at risk, you can try to look for signs of it at home. Keep in mind, however, that throat cancer doesn't always have symptoms and can be in places that are difficult or impossible to see without a scope or other tools. If you're worried you have throat cancer, see a doctor.