Pharyngeal Cancer

Pharyngeal cancer is a rare disease primarily associated with heavy use of tobacco and alcohol. Studies show the cancer is more common among asbestos workers than the general population. Treatment is effective, especially when the cancer is caught early

Often called throat cancer, this disease occurs more commonly in men. The prognosis is quite good compared to most other cancers, especially when compared to asbestos-related cancers such as mesothelioma and lung cancer.

Pharyngeal cancer develops on the pharynx, which is located behind the oral cavity, between the nasal cavity and larynx (Adam’s apple). The membrane-lined cavity includes structures such as the tonsil and back of the tongue.

The National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) program tracks cancer incidence in the U.S., and they group statistics of pharyngeal cancer with oral cavity cancer. Together, they make up 2.9 percent of all cancers.

Most people can live a long time with this cancer. Approximately 65 percent of all pharyngeal cancer patients live longer than five years and 44 percent survive more than 10 years.

Early diagnosis increases your chance of achieving five-year survival. Nearly 30 percent of patients are diagnosed in stage 1, and about 84 percent of that group lives longer than five years.

Men are two to three times more likely to develop pharyngeal cancer than women, and this discrepancy is mostly accredited to higher rates of smoking and drinking among men versus women. The majority of cases are diagnosed in men who are more than 50 years old.

Treatment for this cancer involves surgery, chemotherapy and radiation therapy for those diagnosed in stage 1 or 2. Chemotherapy, radiation therapy and immunotherapy are advised for people diagnosed in stage 3 or 4.

Symptoms of Pharyngeal Cancer

The most common symptoms of pharyngeal cancer include:

  • Painless lump in the upper neck
  • Swelling of the neck
  • Nasal congestion
  • Nosebleeds
  • Facial pain
  • Headaches
  • Ringing in the ears (tinnitus)
  • Changes in hearing
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Risk Factors Associated with Pharyngeal Cancer

Doctors do not yet understand the direct causes of pharyngeal cancer, but they have identified a number of risk factors. A risk factor is anything that increases your chance of developing a disease.

Risk factors associated with pharyngeal cancer include:

  • Tobacco use (including smoking and chewing tobacco)
  • Overconsumption of alcohol
  • Epstein-Barr virus (which causes mononucleosis)
  • Human papillomavirus
  • Asbestos exposure
  • Formaldehyde exposure
  • Eating salted fish

According to certain studies, the risk of oral and pharyngeal cancers among heavy drinkers and smokers may be as high as 100 times more than people who don’t smoke or drink. The combination of smoking and drinking together increases the risk far greater than either on their own.

Two common viruses — Epstein-Barr and human papillomavirus (HPV) — are associated with an increased risk of pharyngeal cancer. Approximately 90 percent of people get the Epstein-Barr virus in their lifetime, usually with few or no ill effects.

Around 75 percent of people get HPV in their lifetime and most people’s immune systems are strong enough to fight it off without lasting effects.

However, some pharyngeal tumors contain strains of Epstein-Barr and HPV. Doctors suspect these viruses play a role in some cases of this cancer.

When salt-cured fish and meat are cooked, a chemical called nitrosamine is released, which may increase a person’s risk of developing this cancer. Exposure to certain toxic chemicals — including formaldehyde and asbestos — may increase a person’s risk.

Research on Pharyngeal Cancer and Asbestos

Overall, research indicates a modestly positive association between asbestos exposure and pharyngeal cancer, albeit a weaker association than that of laryngeal cancer and asbestos.

In 2006, a study supported by a U.S. Senate committee and the National Institutes of Health reviewed the research on asbestos and pharyngeal cancer. A higher risk of pharyngeal cancer was observed among asbestos workers.

Quick Fact

In 2017, an estimated 49,670 new cases of pharyngeal and oral cavity cancer were diagnosed.

No clear evidence of a dose-response relationship was found, meaning more cases were not detected among those highly exposed, and any workplace exposure to asbestos may put someone at risk of pharyngeal cancer.

Researchers also noted an increased risk among asbestos workers who smoked cigarettes, suggesting a potential synergistic relationship.

Several studies have observed cancer rates in animals chronically exposed to asbestos by inhalation and found no increase in pharyngeal cancer.

Pharyngeal cancer is so rare that few studies are available to analyze for an association with asbestos exposure. This small amount of research — coupled with the absence of clear information on a dose-response relationship and the lack of supportive data from animal studies — is insufficient to draw conclusions about whether asbestos directly causes pharyngeal cancer.

Overall, the evidence is suggestive but not sufficient to confirm a causal relationship.

Cancer Screening Among Asbestos-Exposed Workers

Many cancers of the oral cavity and pharynx can be detected early with routine exams by your dentist or doctor.

Self-examination is also important. Doctors recommend you use a mirror to look at your mouth every month to check for abnormalities such as raised patches of red or white tissue. You can use a flashlight to check the back of your throat.

If you’re a former asbestos worker, or a heavy smoker and drinker, there are other cancer screenings you can request. For example, your doctor or dentist can use special dyes or lights to observe abnormal areas in your mouth and throat.

If abnormalities are detected, your doctor will collect a sample of the abnormal tissue with a stiff brush — called a brush biopsy — and have it examined for cancerous changes.

If you’ve ever worked with asbestos, it is important to monitor your healthy closely. Any changes to your mouth, throat, hearing or neck should be checked by a doctor. Make sure to mention your history of asbestos exposure.

Lung cancer and mesothelioma are more common among asbestos-exposed workers, so also make sure to monitor any changes to your lungs such as difficulty breathing and chest pain.

Early diagnosis of any cancer improves your chances of long-term survival. More effective treatments are available to those diagnosed early because tumors are smaller and easier to control.

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Michelle Whitmer, Content Writer at Asbestos.com

Joining the team in February 2008 as a writer and editor, Michelle Whitmer has translated medical jargon into patient-friendly information at Asbestos.com for more than eight years. Michelle is a registered yoga teacher, a member of the Academy of Integrative Health & Medicine, and was quoted by The New York Times on the risks of asbestos exposure.

Sources
  1. Surveillance, Epidemiology and End Results Program. (2017). Cancer Stat Facts: Oral cavity and pharynx cancer. Retrieved from https://seer.cancer.gov/statfacts/html/oralcav.html
  2. Institute of Medicine (US) Committee on Asbestos. (2006). Asbestos: Selected Cancers: Pharyngeal cancer and asbestos. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK20317/
  3. American Cancer Society. (2017, March 2). Treatment options for oral cavity and oropharyngeal cancer by stage. Retrieved from https://www.cancer.org/cancer/oral-cavity-and-oropharyngeal-cancer/treating/by-stage.html
  4. Cedars-Sinai. (n.d.). Pharyngeal cancer. Retrieved from https://www.cedars-sinai.edu/Patients/Health-Conditions/Pharyngeal-Cancer.aspx
  5. Duke University Medical Center. (2010, December 15). Epstein-Barr: Scientists decode secrets of a very common virus that can cause cancer. Retrieved from https://www.sciencedaily.com/releases/2010/12/101215121905.htm
  6. National Women’s Health Resource Center. (2012, January 11). Everything you need to know about HPV. Retrieved from https://www.womenshealthmag.com/health/hpv-facts-0
  7. American Cancer Society. (2016, August 8). Can oral cavity and oropharyngeal cancers be found early? Retrieved from https://www.cancer.org/cancer/oral-cavity-and-oropharyngeal-cancer/detection-diagnosis-staging/detection.html

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