Throat Cancer Treatment
Malignancies in the soft tissues at the back of the mouth which includes tonsils, base of the tongue, the larynx (voice box) and the top of the esophagus affects thousands of people above the age of 50. Throat cancer symptoms include persistent cough and sore throat for more than a few weeks, a lump at the back of the mouth, difficulty in swallowing, breathing or eating, pain, bleeding or sores that are not relieved by medications and voice changes that last more than a couple of weeks.
Confirmation of the diagnosis is usually done by doing a biopsy on the suspected area of involvement, revealing malignant cells in the tissue.
Treatment of throat cancer involves first determining the size and location of the tumor, the stage and degree of involvement of other parts of the body (metastasis or spread). A localized tumor that is small to medium in size may be treated with surgery. Complicated tumors that have local invasion may be decreased in size with radiation therapy, and surgery may later be considered if possible. Chemotherapy may be added to the treatment regimen when tumor cells have spread to distant sites like the liver. In addition, chemotherapy may also be considered in organ preservation, particularly of the larynx, which is in danger of being destroyed by cancer cells.
Other non-conventional forms of treatment include the minimally invasive robotic surgery and laser surgery for throat cancer.
Transoral Laser Treatment for Throat Cancer
Small and medium sized tumors that cannot be reached by robotic surgery may be resected with the use of lasers passing through the mouth (transoral). This is a minimally invasive technique that does away with an incision through the skin. Instead, head and neck surgeons pass an endoscopic instrument with a microscopic camera orally to view the delicate structures inside the neck and throat. Then they use laser microsurgery to cut the tumor piece by piece with high accuracy and precision, all without having to open the skin in the head and neck.
The advantages of using laser in this technique include:
- Lesser tissue trauma resulting in faster healing time and patient discharge, compared to traditional open surgery
- Lesser trauma to the tissues results in better results in terms of speech, swallowing and breathing
- Fewer complications from bleeding and infection because of the limited amount of tissue trauma
- No need for reconstructive surgery brought about by conventional open surgery, where a flap of skin may need to be transplanted from another body part to the head and neck areas
- No need for a tracheostomy (a surgical incision done on the larynx to facilitate breathing during surgery)
- Less incidences of tumor recurrence after two years
- Reduces the need for long and expensive treatments with chemo and radiotherapy
Possible limitations of using the minimally invasive laser microsurgery technique are the need for expertise on the head and neck surgeons and when the patient’s conditions and tumor size are not agreeable with the type of treatment. In the latter case radiation and chemotherapy may be indicated and these are usually recommended by the oncologist.
Siteman Cancer Center, “Transoral Laser Microsurgery”, https://www.siteman.wustl.edu/contentpage.aspx?id=2836
Mayo Clinic, “Throat Cancer”, https://www.mayoclinic.org/throat-cancer/treatment.html