Treatment for pharyngeal (throat) cancer is planned individually according to the location and stage of the tumour and your general health. The main methods are surgery, radiotherapy and chemotherapy, which may be used alone or in combination. The aim is to bring the disease under control while preserving swallowing, speech and breathing as far as possible.
How is treatment planned?
The treatment decision is made by a tumour board that brings together an ear, nose and throat surgeon, a radiation oncologist, a medical oncologist, a radiologist and a pathologist. Whether the tumour is in the oropharynx or the hypopharynx, involvement of the lymph nodes in the neck, a link with the human papillomavirus (HPV) in oropharyngeal tumours, and your own preferences all influence this decision. A single method is often sufficient for early-stage tumours, while advanced stages require a combination of methods.
Surgery
The aim of surgery is to remove the tumour together with a margin of healthy tissue around it.
- Surgery through the mouth (transoral surgery): Used for early-stage oropharyngeal tumours; performed through the mouth with the help of a laser or robotic systems, without an external incision, and recovery is faster.
- Open surgery: For larger or deeper tumours, the tumour is reached through an incision in the neck. In hypopharyngeal tumours, part or all of the voice box (larynx) may also need to be removed.
- Neck dissection: Removal of the lymph nodes in the neck; performed on one or both sides depending on the likelihood of spread.
- Reconstruction: When extensive tissue has been removed, pieces of tissue taken from other parts of the body (flaps) are used to rebuild the swallowing passage.
Radiotherapy
Radiotherapy targets tumour cells with high-energy rays. It is given alone for early-stage tumours; in advanced stages it is combined with chemotherapy, or given after surgery to destroy any remaining cells. Treatment is delivered in short daily sessions on weekdays over several weeks. Modern techniques focus the beam on the tumour and spare the surrounding salivary glands and swallowing muscles as far as possible. A dry mouth, soreness in the throat, changes in taste and skin redness are common side effects and are usually temporary.
Chemotherapy and other drug treatments
Chemotherapy is most often given at the same time as radiotherapy to enhance its effect. In some situations it is used before the main treatment to shrink the tumour, or to control the disease when it has spread. Drugs that act on specific targets in tumour cells and treatments that activate the immune system (immunotherapy) are also used in selected patients.
Support during treatment
Maintaining nutrition throughout treatment is very important; if swallowing becomes difficult, a temporary feeding tube can be used. A dental assessment, speech and swallowing therapy, dietitian support and stopping tobacco all contribute to the success of treatment.
After treatment
Once treatment is complete, regular follow-up visits are planned. At these visits, which are more frequent in the first years, examination and imaging where needed are used both to monitor recovery and to detect any recurrence at an early stage.
Frequently asked questions
Is surgery or radiotherapy better for pharyngeal cancer?
There is no single right answer. The choice depends on the location and stage of the tumour and the likelihood of preserving function; in some situations both methods give similar results.
Will I be able to eat during radiotherapy?
In the later weeks of treatment, swallowing may become difficult because of soreness in the throat. Your nutrition is monitored closely, and a temporary feeding tube is used for support if needed.
How soon should treatment start?
The aim is to start without unnecessary delay once diagnosis and staging are complete; however, completing the investigations needed to plan treatment correctly is also important.
This page is general information. Decisions about diagnosis and treatment are made for you personally, and only after an examination. If you have symptoms, see a doctor.