The most common type of throat cancer is called squamous cell carcinoma (SCC). This and other types of throat cancers are most often caused by environmental factors, including smoking or chewing tobacco. Infection with human papillomavirus (HPV) is an increasing cause as well. Additional exposures that increase the risk for throat cancers include alcohol and betel quid, a stimulant used in Asia.
This article reviews the appearance of several types of throat cancers and briefly describes their symptoms.
A White Patch
Some throat cancers begin as oral leukoplakia, a general term for a white lesion in the mouth of an unknown cause.
Leukoplakias are premalignant lesions, which means they’re not cancerous yet, but could develop into cancer. About 3% to 17.5% of these lesions are or will become cancerous in 15 years, while others go away independently.
Common symptoms of oral leukoplakia include a persistent cough and sore throat lasting for more than three weeks.
A Red Patch
Other throat and mouth cancers show up as red patches called erythroplakias. These are rare, isolated, velvety patches in the mouth and/or throat that typically show up in older patients.
Erythroplakia lesions are usually premalignant, but most of these red patches become cancerous, so it’s important to get them checked out. They typically affect middle-aged and elderly people, and are usually linked to tobacco and alcohol use.
Throat Ulcers
A classic sign of oral cancer is a persistent rough patch that looks like a sore and has a raised border. Unlike some ulcers and other lesions like canker sores, these are minimally painful.
A Lump in the Throat
A primary tumor of the throat can appear as a nodular mass on the floor of the mouth, tongue, tonsil, or wall of the throat. The mass will tend to be irregular, fixed, and relatively painless, but can interfere with swallowing and make you feel like you have something caught in your throat. This is most common in people with a long history of smoking.
A Lump in the Neck
Metastasis is the spread of cancer from its original location. Head and neck cancers can spread through the lymphatic system, which is another circulatory system of the body. In the lymphatic system, fluid flows to lymph nodes, where white blood cells act to remove or neutralize foreign substances and invaders such as bacteria, viruses, and cancer cells.
If throat cancer spreads through the lymph vessels, it will likely land in the lymph nodes of the neck. There, it can produce non-tender masses (lymphadenopathy) and then seed new tumors in other parts of the body.
When a primary tumor grows to a large size, it can cause difficulty swallowing or talking, earaches, headaches, spitting up blood, and sometimes partial airway obstruction.
A Swollen Tongue
Some throat cancers, specifically those associated with a human papillomavirus (HPV) infection, cause a swollen tongue.
Infection with HPV is one of the major causes of throat cancer. About 10% of men and 3.6% of women have oral HPV. Many cases clear on their own, but some persist for years, which is when cancer can develop.
HPV-related oropharyngeal cancers are limited to the throat, while those caused by smoking, tobacco use, or other environmental triggers are found in the mouth and lips as well.
The characteristic symptoms of HPV-associated throat cancer include a swollen tongue, tiny lumps inside the mouth, and mouth numbness. The persistence of symptoms is a telltale sign, particularly in younger people who do not smoke.
Hardened Tissues
Another type of throat cancer, submucous fibrosis, is defined by the hardening of mucosal tissues. It is most often caused by the chewing of betel nut in Southeast Asian cultures, but also sometimes seen in people who chew tobacco.
Submucous fibrosis is typically a precancerous disorder, but can become malignant in between 1.5% and 15% of cases.
These lesions typically start in the mouth and gums, but can also involve the throat. They can cause burning sensations after eating spicy foods, and cause pain when eating and difficulty opening the mouth.
Advanced Symptoms
Coughing up blood is extremely rare. It can result from timor cells eroding into blood vessels. This is a sign of end-stage disease with a grim prognosis. An additional symptom is loose teeth, which can develop as the tumor spreads to the bones of the jaw and teeth.
You may also notice changes in the voice if cancer spreads to the larynx. Large primary tumors can prevent swallowing, leading to poor nutrition. Weight loss and persistent fatigue may result from this or be the result of widespread metastasis.
A Word From Verywell
Symptoms alone cannot diagnose throat cancer. If you’re worried about cancers of the head and neck, perform periodic oral self-exams. Making regular dental visits can also be a good way to monitor for any unusual growths or lesions.
A diagnosis of throat cancer is made after much testing and examination by your doctor. Tests will include a physical exam, where your doctor will use their hands to feel for swollen lymph nodes and other nodules. They’ll also test to see if you have HPV.
They will do an endoscopy (a procedure in which a tiny camera is fed into your mouth through a tube), a biopsy of any suspicious lesions, and imaging like a computed tomography (CT) scan or magnetic resonance imaging (MRI).
If you’re a smoker and have unusual or persistent symptoms aligned with those above, speak to your doctor about getting further testing.
