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
• 咽管是你喉咙的一部分

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. 癌症这个词指的是恶性生长. 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:

• 吸烟或使用任何烟草制品
• 过量饮酒
• 家族病史
• 维生素A缺乏
• 少吃水果和蔬菜
• 抑制免疫系统
• Infections caused by certain viruses such as:
  • 巴尔病毒
  • 人类乳头状瘤病毒 (HPV)
• 辐射暴露
• 过度食用腌肉或鱼
• 吸食大麻
• Occupational exposure to certain materials such as in:
  • 镍精炼
  • 木工
  • 使用纺织纤维

Symptoms

喉癌可能导致:

• 喉咙痛
• Feeling that something is caught in the throat
• 咀嚼或吞咽困难
• 下颌或舌头移动困难
• 声音变化或嘶哑
• 语音质量的变化
• 头痛:头部、喉咙或颈部疼痛
• 颈部肿块
• 不明原因的体重减轻
• 咳血

诊断

You will be asked about your symptoms and medical history. 会做一次身体检查. 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, 结合你所有的测试结果, 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, 还有一些健康的细胞.

预防

To help reduce your chance of throat cancer:

• 不吸烟或使用烟草制品. If you do smoke or use tobacco products, talk to your doctor about how to quit.
• 饮酒要适量. Moderate alcohol intake is a maximum of 2 drinks per day for men and a maximum of 1 drink per day for women.
• 吃健康的饮食 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. 口咽癌. 纽约外科肿瘤科. 2015年7月,24 (3):509 - 520.
• Genden EM, Sambur IM，等. 人类乳头状瘤病毒 and oropharyngeal squamous cell carcinoma: what the clinician should know. Eur Arch otorhinolyngol. 2013 Feb;270(2):4052018
• 头颈癌. EBSCO DynaMed网站. 可以在: http://www.dynamed.com/condition/head-and-neck-cancer/.
• Mehanna H, Evans M，等. 口咽癌: United Kingdom National Multidisciplinary Guidelines. [J]喉. 130年5月,2016 (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 国家癌症研究所网站. 可以在: http://www.cancer.gov/types/head-and-neck/hp/adult/oropharyngeal-治疗-pdq1.
• 张国强，张国强，等. 头颈部癌症. 版本1.2018. In: National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology (NCCN Guidelines). NCCN 2018 2月NCCN网站.