喉癌

定义

Throat cancer is the presence of cancer cells or tumor(s) in the throat. The throat is made of a number of structures and the term throat cancer represents all of these cancers including cancer of the:

• Epiglottis—flap in the throat that blocks the airways when you swallow food or drink
• Tonsils
• Soft palate—rear section of the roof of the mouth
• Pharynx—tube part of your throat

喉癌

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Causes

Cancer occurs when cells in the body divide without control or order. Eventually these uncontrolled cells form a growth or tumor. The term cancer refers to malignant growths. These growths can invade nearby tissues including the lymph nodes. Cancer that has invaded the lymph nodes can then spread to other parts of the body.

It is not clear exactly what causes these problems in the cells, but is probably a combination of genetics and environment.

风险因素

Throat cancer is more common in men, and in people aged 40 years and older. Other factors that may increase your chances of throat cancer:

• Smoking or use of any tobacco products
• Excessive alcohol consumption
• 家族病史
• 维生素A缺乏
• Diet low in fruits and vegetables
• Suppressed immune system
• Infections caused by certain viruses such as:
  • 巴尔病毒
  • 人类乳头状瘤病毒 (HPV)
• 辐射暴露
• Excess consumption of cured meats or fish
• 吸食大麻
• Occupational exposure to certain materials such as in:
  • 镍精炼
  • 木工
  • Working with textile fibers

Symptoms

Throat cancer may cause:

• 喉咙痛
• Feeling that something is caught in the throat
• Difficulty chewing or swallowing
• Difficulty moving the jaw or tongue
• Voice changes or hoarseness
• Change in voice quality
• Pain in the head, throat, or neck
• 颈部肿块
• Unexplained weight loss
• 咳血

诊断

You will be asked about your symptoms and medical history. A physical exam will be done. The doctor may feel for any lumps in your neck. You may be referred to an otolaryngologist, a doctor who specializes in head and neck surgery.

Your bodily fluids and tissues may be tested. 这可以用:

• 细针抽吸
• 切口 biopsy

Images may be taken to evaluate your throat and surrounding structures. 这可以用:

• 喉镜检查
• 之
• MRI scan
• PET scan
• CT scan

体格检查, combined with all of your test results, will help to determine the type and stage of cancer you have. Staging is used to guide your 治疗 plan. Like other cancers, throat cancer is staged from 1 to 4. Stage 1 is a very localized cancer, while stage 4 indicates a spread to other parts of the body.

治疗

Cancer 治疗 varies depending on the stage and type of cancer. A combination of therapies may be more effective. For example, surgery may be used in conjunction with chemo- or radiation therapy.

治疗 options for throat cancer include:

Surgery

Surgery removes the cancerous tumor and nearby tissue, and possibly nearby lymph nodes. 在极少数情况下, surgery to remove large tumors of the throat may also require removal of tissue for swallowing. As a result, food may enter the windpipe and reach the lungs, which might cause 吸入性肺炎. 在这种情况下，a 气管切开术 可能需要做什么. The windpipe will be attached to the skin through a hole in the neck, which is used for breathing.

放射治疗

This is the use of radiation to kill cancer cells and shrink tumors. 辐射可能是:

• External radiation therapy—radiation directed at the tumor from a source outside the body
• Internal radiation therapy—radioactive materials placed into the throat in or near the cancer cells

化疗

This is the use of drugs to kill cancer cells. 化疗 may be given in many forms including pill, injection, and/or via a catheter. The drugs enter the bloodstream and travel through the body killing mostly cancer cells, but also some healthy cells.

预防

To help reduce your chance of throat cancer:

• Do not smoke or use tobacco products. If you do smoke or use tobacco products, talk to your doctor about how to quit.
• Drink alcohol only in moderation. Moderate alcohol intake is a maximum of 2 drinks per day for men and a maximum of 1 drink per day for women.
• Eat a healthful diet, one that is 低饱和脂肪 丰富的 全谷物, 水果和蔬菜.
• See your doctor and dentist regularly for checkups and cancer screening.

参考文献

• Clump DA, Bauman JE, Ferris RL. Cancer of the oropharynx. 纽约外科肿瘤科. 2015年7月,24 (3):509 - 520.
• Genden EM, Sambur IM, et al. 人类乳头状瘤病毒 and oropharyngeal squamous cell carcinoma: what the clinician should know. Eur Arch Otorhinolaryngol. 2013 Feb;270(2):4052018 Nov 29-16
• 头颈癌. EBSCO DynaMed网站. 可以在: http://www.dynamed.com/condition/head-and-neck-cancer/.
• Mehanna H, Evans M, et al. 口咽癌: United Kingdom National Multidisciplinary Guidelines. [J]喉. 2016 May;130(S2):S90-S96.
• 口咽癌. EBSCO DynaMed网站. 可以在: http://www.dynamed.com/condition/oropharyngeal-cancer.
• Oropharyngeal Cancer 治疗 (Adult)–Health Professional Version National Cancer Institute website. 可以在: http://www.cancer.gov/types/head-and-neck/hp/adult/oropharyngeal-治疗-pdq1.
• Pfister DG, Spencer S, et al. 头颈部癌症. 版本1.2018. In: National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology (NCCN Guidelines). NCCN 2018 Feb from NCCN website.