Throat cancer refers to cancerous tumors that develop in your throat (pharynx), voice box (larynx), or tonsils. Your throat is a five-inch-long muscular tube that begins behind your nose and ends in your neck above the esophagus. Your voice box sits just below your throat, and is made of cartilage and contains the vocal cords that vibrate when you talk. Tonsil cancer affects the tonsils, which are located in the back of your throat. Throat cancer can also affect the piece of cartilage (epiglottis) that acts as a lid for your windpipe. Most throat cancers are squamous cell carcinomas, which is a type of cancer that begins in thin, flat cells that look like fish scales.

According to the American Cancer Society, approximately 40,000 people are diagnosed with throat cancer each year. At Mount Sinai, the Head and Neck Institute surgeons have been at the forefront of throat cancer treatment for all types and stages. They have pioneered minimally invasive surgical techniques and conduct vast research to continuously improve patient outcomes. These efforts have led to Mount Sinai besting national averages in throat cancer outcomes and patients’ quality of life.

Types of Throat Cancer

Throat cancer can develop in the following regions of the throat:

• Nasopharynx: Nasopharyngeal carcinomas, which are rare in the United States, begin in the epithelial cells and affect the area behind the nose. Other cancers occurring in the nasopharynx include lymphoma (cancer of the immune cells) and adenocarcinoma (cancer of the minor salivary glands).
• Oropharynx. This middle region extends from the back of your mouth to your throat, and includes all of your soft palate, the tonsil region, and the farthest reaches of your tongue, extending down toward your voice box. Cancers of the oropharynx usually begin in the tonsil, soft palate, or tongue base. Malignant tumors usually begin in the lining and are called squamous cell carcinoma. However, these tumors can also arise in the white blood cells (lymphoma) or glandular cells (adenocarcinoma).
• Hypopharynx. The hypopharynx is located in the lower region of the throat, near the entrance to your esophagus and behind voice box. Hypopharynx cancers are most likely squamous cell cancer. Because of their close proximity to the larynx (voice box), the treatment for hypopharyngeal and laryngeal cancers is virtually identical.

Symptoms of Throat Cancer

Early signs and symptoms of pharynx cancer include the following:

• Development of asymmetrical tonsils
• Pain, such as a persistent sore throat or pain that shoots to one ear
• Difficulty or pain with swallowing
• A muffled quality to the voice
• A lump in the neck

Risk Factors for Throat Cancer

Risk factors for pharynx cancer differ, depending on which section of is affected. Risk factors for nasopharyngeal carcinoma include the following:

• Male gender: Nasopharyngeal carcinoma is more common in males than females.
• Race: Most commonly Chinese Americans, followed by other Asian-American groups, African Americans, Hispanics/Latinos, and whites.
• Diet: People living in areas where nasopharyngeal carcinoma is common, such as Asia, North Africa, and the Arctic, typically eat diets very high in salt-cured fish and meat. Indeed, the rate of nasopharyngeal cancer is dropping in southeast China as people begin eating a more Westernized diet.
• Evidence of the Epstein-Barr virus: Almost all nasopharyngeal cancer cells contain parts of the Epstein-Barr virus (EBV), and most people with nasopharyngeal cancer have evidence of this virus in their blood. But the link between EBV infection and nasopharyngeal carcinoma is complex and not yet completely understood. EBV infection alone is not enough to cause nasopharyngeal carcinoma, since infection with this virus is very common, and nasopharyngeal cancer is rare. Other factors, such as your genes, may affect how your body deals with EBV.

Risk factors for oropharyngeal cancer (see the Oral Cancer section) usually arise in individuals between the ages of 45-70 who have abused tobacco and alcohol. The human papillomavirus (HPV) has been found in approximately 80% of these tumors and probably plays a role in cancer development. This virus is transmitted through sexual contact.

Risk factors for hypopharyngeal cancers are most often associated with tobacco and alcohol use, especially in combination.