You may be reading this because you’re worried about getting throat cancer. Maybe you’re waiting for test results. Or perhaps you or someone you care about just learned they have throat cancer.
This guide will help you understand how throat cancer is diagnosed and what your diagnosis means. Learning as much as you can may help you feel ready to talk with doctors about your care.
A throat biopsy is the first step in diagnosing throat cancer. A surgeon will remove cells or tissue to test for cancer. You’ll also get imaging tests, such as CT or MRI scans.
Your throat cancer diagnosis most often will describe where the cancer started, its type, and if it has spread. We use this information to create a custom care plan just for you.
Throat cancer diagnosis often starts with a physical exam. Your doctor will check for anything abnormal (not normal), such as a lump in your neck.
If something does not look right, your doctor may do an endoscopy. They’ll put a scope (a thin tube with a camera) into your nose and down your throat. They’ll look for signs of cancer.
Medical oncologist Dr. Devika Rao shares tips on what to expect during your first visit at MSK, and how to get ready.
We want to ensure your first visit is as productive and supportive as possible. Here are some tips on how you can best prepare.
At MSK, HPV testing is routine for many throat cancers. Many people have better treatment results if they have HPV-positive throat cancer instead of other types. We may be able to offer you a treatment plan with fewer side effects without affecting your chances for a cure.
Learning you have throat cancer can be overwhelming. You’ll hear many medical terms you've never heard before. We’re here to help you understand what they mean and why they matter.
The information in your diagnosis describes important details about the type of throat cancer you have. Your doctors use that information to create the best plan of care for you.
Genomic testing uses a sample taken from a tumor. We also consider sending blood samples as well, to learn more about the tumor’s genes.
We test for changes in more than 500 genes. At MSK, broad genetic testing of the tumor is a routine part of how we diagnose and treat throat cancer. We’re one of only a few cancer centers in the world to profile throat tumors as part of standard care.
Genomic testing tells us which genetic changes caused the throat cancer and made the cancer grow. The test results let us target those genes for treatment, a method called targeted therapy.
If we know which mutations you have, we know which treatments will work best on the tumor. Almost all of these genetic changes are only in cancer cells, not in normal cells. They cannot be passed on to your children.
If you learn you have throat, tonsil, or laryngeal cancer, we recommend you get an opinion at MSK right away. This will confirm you’re getting an accurate diagnosis and detailed information about the cancer.
It’s best to get an opinion from MSK before surgery or any other treatment. It can help you avoid treatment you may not need. It can make sure you have the right treatment. Getting an opinion may take a few days to a week. Sometimes it takes longer.
It’s common to get another opinion at a cancer center like MSK. There’s no need to worry you’re hurting your doctor’s feelings. They know they’re not experts in the type of cancer you have. MSK has more than 70 head and neck cancer experts.
Newly diagnosed? Hear advice from our patients.
Michael:
You have a diagnosis of cancer, and there's all this fear and there's apprehension and you're nervous and you're scared. You've got surgery in front of you. You've got quality of life issues ahead of you. What I wish I had known was that you can come out the other side of this journey.
Lorena:
When I received the news that I had cancer, it was devastating and I was lost, completely lost.
Ming:
You are meeting with a lot of different people, so what I would really recommend to patients is just do your best to take notes.
Michael:
Come to the appointment prepared. Come with questions.
Norma:
I had questions about my recovery. I had questions about the possibility of chemo. I was placed on a clinical trial, and I had questions about that.
Michael:
Prior to coming to MSK, my wife and I had been to a variety of different doctors, and we got a lot of different answers and no clear direction. It was the first time that a definitive plan was put in place where I actually had a recommendation of which way to go.
Ming:
My care team consisted of doctors, social workers, nurses.
Michael:
It's not just one doctor you're dealing with. You're dealing with all of MSK and their entire team approach to your care.
Lorena:
The way they greet me, it was just overwhelming. I was so happy. It was 100% personalized for me.
Norma:
I was told to expect patient-centered care and I kind of felt that from the beginning, from that first day that I walked in.
Ming:
There were even people there just to hang out with me and to kill time. If you need something, ask. And even if it's something small like, “Nothing tastes good,” or “Everything tastes awful and I can't eat any of this,” it's important to tell someone and they can help you address your needs as a patient
Lorena:
One of the programs that I found helpful was Integrated Medicine. For example, acupuncture. It helped me to calm down; and then after the treatment, it managed the pain.
Norma:
I immediately used the nutrition program because it was amazing. I used their PT program. I used their Visible Ink program, which is wonderful and it gives you tremendous emotional support.
Lorena:
Another thing that is very helpful is the MSK Patient Portal. You can set up appointments. You can request prescriptions. You can also use the portal for a telemedicine visit. On the days that you don't have any energy, telemedicine is there for you. There is no difference at all between being seen in person or telemedicine.
Norma:
I never felt that I couldn't call someone, even if it was the doctor's nurse, and just talk.
Ming:
The silver lining from being diagnosed with cancer is I taught myself how to be positive.
Lorena:
This experience taught me to live in the moment, and you learn how to live life in a better way.
When you learn you have throat cancer, you’ll have many questions for your cancer doctor at your first visit. Talking about treatment options with your doctor can help you feel better prepared to make decisions about your care.
There are few types of throat cancer. We’re experienced in treating them all, from the most common to the most rare.
This information describes each type of throat cancer and explains how we classify (sort) them.
The type of throat cancer depends on the type of cell where cancer started.
Most throat cancers are squamous cell carcinoma (SKWAY-mus sel KAR-sih-NOH-muh). Carcinoma means cancer. Squamous cells are thin, flat cells that look like fish scales. They’re in many kinds of tissues, including the lining of the throat and mouth.
There are other cancers that are much rarer. Lymphoma and cancer of the minor salivary glands (located in the voice box) also can start in the throat.
Laryngeal cancer starts in the larynx (voice box). It’s one of the most common types of head and neck cancer.
The larynx is at the top of your trachea (windpipe). It holds your vocal cords.
Here are the common signs and symptoms of laryngeal cancer.
People with aplastic anemia, a rare blood disorder, may be more likely to get laryngeal cancer.
Treatment for laryngeal cancer may include surgery, radiation therapy, or chemotherapy.
For more advanced (stage 3 or 4) laryngeal cancer which has spread, you may need chemotherapy, targeted therapy, or immunotherapy.
Tonsil cancer is a type of oropharyngeal cancer. It starts when cells in the tonsil grow out of control and form a tumor.
The main cause is the human papillomavirus (HPV). HPV-positive tonsil cancer is very curable.
A common symptom is one tonsil getting bigger. If both tonsils are growing, it’s less likely to be cancer. Talk with your doctor to be sure.
You can still get tonsil cancer if your tonsils were taken out. Cancer can start in the tissue that was left behind.
Treatment may include radiation therapy, surgery, chemotherapy, targeted therapy, or immunotherapy.
The oropharynx is in the middle of the throat, starting at the back of the mouth. It includes the tonsils, soft palate, and base of the tongue.
Cancer starts when cells in the oropharynx grow out of control and form a tumor. A common sign is a lump in the neck or throat.
The main cause is HPV. MSK tests all oropharynx cancers for HPV. Many people have better treatment results if they have HPV-positive throat cancer instead of other types.
Treatment for oropharyngeal cancer may include radiation therapy, chemotherapy, targeted therapy, immunotherapy or surgery. Many tumors can be removed by surgery.
The hypopharynx is the lowest part of the throat, where it meets the trachea (windpipe) and esophagus.
Cancer starts when cells in the hypopharynx grow out of control and form a tumor.
Here are the common treatments for hypopharyngeal cancer:
Your doctor may recommend getting chemotherapy and radiation at the same time (chemoradiation). It may help the tumor respond better to treatment.
For more advanced cancer, you may need chemotherapy, targeted therapy, or immunotherapy.
The nasopharynx is in the top part of the throat (pharynx). It connects the mouth and nose. Nasopharyngeal cancer starts when cells in the nasopharynx grow out of control and form tumors or lesions. The most common symptom is a lump in the neck.
Nasopharyngeal cancer is most common in parts of Asia, such as southeast China.
Radiation is the most common treatment. Your doctor may recommend getting chemotherapy and radiation at the same time (chemoradiation). It may help the tumor respond better to treatment. Some people may have surgery if the cancer comes back after treatment.
Tobacco is a main cause of throat cancer. Our Tobacco Treatment Program offers treatment options to help you quit, such as counseling and medicine. It’s open to people who never had cancer or a disease linked to tobacco. Learn why it’s never too late to quit using tobacco.
A cancer’s stage tells us how advanced the cancer is. Staging describes traits such as the tumor’s size, location, and whether it has spread.
There are 5 stages of throat cancer, including tonsil and laryngeal, from 0 to 4 (0 to IV). The lower the number, the less the cancer has spread. Your doctor may add a letter (A, B, or C) to these stages to give even more information.
Staging helps your doctor choose the best treatment options for you. The stage also helps them predict the outcome (result) of your treatment. Based on the stage, you also may be able to join a clinical trial.
The stage is based on:
Your doctor may use letters and numbers from the TNM system to describe the stage:
N0 means cancer is not in lymph nodes. N1, N2, or N3 means it’s spread to nodes.
M0 means cancer has not spread. M1 means it’s spread to distant organs, muscles, or bones.
