Throat Cancer Signs and Symptoms

Throat cancer is a general term for cancers that occur in the pharynx (the space behind the nose and mouth) or in the larynx (the voice box). While most throat cancers involve the same type of malignant cells, they are further categorized based on precisely where the cancer originated. For example, glottic cancer begins in the vocal cords, oropharyngeal cancer begins in the back of the mouth near the tonsils, and nasopharyngeal cancer begins just behind the nose.

Because the earliest signs of throat cancer closely mimic everyday illnesses, recognizing persistent, unexplained changes in your body is the most important step toward an accurate diagnosis.

What are the Early Warning Signs of Throat Cancer?

In the early stages, throat cancer can easily be mistaken for the common cold, allergies, or a run-of-the-mill sore throat. The earliest warning signs typically include a mild but persistent cough, a sore throat that will not go away, unexplained hoarseness, ear pain, and nasal congestion.

What are Common Throat Cancer Signs and Symptoms?

As throat cancer progresses past the earliest stages, the symptoms often become more specific. The exact symptoms you experience depend heavily on where the tumor forms. For example, if a tumor forms directly on the vocal cords (glottic cancer), hoarseness is almost always the very first symptom. However, if the tumor forms above the vocal cords (supraglottic cancer), voice changes might not happen until much later, and the first warning sign is usually pain when swallowing.

Voice and Breathing Changes

• Persistent hoarseness or changes in vocal pitch
• Chronic coughing, possibly expelling bloody phlegm
• Difficulty breathing or a sensation that something is caught in your throat

Pain and Discomfort

• A severe, persistent sore throat
• Frequent headaches and facial pain
• Pain when swallowing
• Unexplained changes in hearing or persistent earaches

Visible Physical Changes

• Swelling or noticeable lumps in the neck (particularly in the lymph nodes)
• Sores in the mouth or throat that do not heal
• Red or white patches within the mouth

The number one way to reduce your risk of throat or oral cancer is to avoid smoking, chewing tobacco and excessive alcohol use.

Caitlin McMullen, MD

Head and neck surgeon

How Tumor Location Affects Symptoms

While most throat cancers involve the same type of malignant cells, they are categorized based on precisely where they originate in the anatomy of the throat and voice box. The exact symptoms you experience depend heavily on this location:

• Glottic cancer (on the vocal cords): Because this tumor forms directly on the vocal cords, persistent hoarseness or a change in vocal pitch is almost always the very first symptom.
• Supraglottic cancer (upper larynx): Begins at the top part of the larynx and may affect the epiglottis. Voice changes might not happen until much later; instead, the first warning sign is usually pain when swallowing.
• Nasopharyngeal cancer (behind the nose): Begins in the upper part of the throat just behind the nose. Due to its location, it often presents with ear pain, changes in hearing, or frequent nosebleeds.
• Oropharyngeal cancer (back of the mouth): Begins near the tonsils and frequently causes a severe, persistent sore throat or a visible lump in the back of the throat.
• Hypopharyngeal cancer (lower throat): Begins just above the trachea and esophagus, often leading to significant difficulty swallowing or a constant sensation that something is caught in your throat.
• Subglottic cancer (lower larynx): Begins at the lower part of the voice box and is more likely to cause early breathing difficulties as the tumor encroaches on the airway.

What Symptoms Develop as Throat Cancer Advances?

As throat cancer advances, the tumor may encroach further into the airway and/or esophagus. When this happens, it often becomes significantly more difficult to breathe and swallow. Because eating becomes harder and more painful, patients often experience unintended weight loss.

If the cancer has spread to the lymph nodes, patients may notice swollen nodes in the neck or throughout the body. Additionally, if the cancer spreads to other regions, such as the lungs, patients might experience correlated symptoms like a severe cough or profound shortness of breath.

Frequently Asked Questions About Throat Cancer Symptoms

• How does a cancerous lump in the neck feel different from a normal swollen gland?

  It is normal for the lymph nodes in your neck to swell when your body is fighting off a routine infection. However, an infection-related swollen node is typically soft, tender to the touch, and moves slightly under the skin. A cancerous lymph node often feels hard, does not cause pain when pressed, and feels firmly fixed in place.

• Does HPV-related throat cancer cause different symptoms?

  Yes, it can. Oropharyngeal cancer linked to the human papillomavirus (HPV) often presents differently than throat cancers linked to smoking. HPV-related throat cancer frequently skips the "sore throat" or hoarseness phase entirely. For many patients, the very first and only symptom is a painless, swollen lump in the neck.

• Can throat cancer affect my hearing?

  Yes. Depending on the location of the tumor, particularly if it is nasopharyngeal cancer (located just behind the nose), it can affect the Eustachian tubes connecting the back of your throat to your ears, leading to ear pain, a sensation of fullness, or noticeable changes in hearing.

• How long should I wait before seeing a doctor for a sore throat?

  Because the early signs of throat cancer mimic a common cold or sore throat, it is easy to brush them off. However, if you have cold-like symptoms that don’t go away or worsen after a few weeks, it is highly recommended to seek medical attention for a thorough evaluation.

How Moffitt Cancer Center Approaches Throat Cancer

The Head and Neck Oncology Program at Moffitt Cancer Center boasts a multispecialty team that includes surgeons, physicians, oncologists, radiologists and supportive care professionals who work closely together to create the best possible outcomes for our patients. We offer comprehensive services such as screenings, diagnostics and treatment, all in one convenient location. Our team also spearheads a clinical trials program which means that our patients can access innovative, cutting-edge treatments and therapies that aren’t available anywhere else. Moffitt is proud to be the only National Cancer Institute-designated Comprehensive Cancer Center that’s based in Florida.

Learn more about our throat cancer services or schedule an appointment by calling us at 1-888-663-3488 or by completing a new patient registration form online. We do not require referrals to set up an appointment with our team.

References

Laryngeal & Hypopharyngeal Cancer | Throat Cancer
Throat Cancer Foundation: Types of Throat Cancer
Healthline: What Is Throat Cancer?
American Cancer Society: Signs and Symptoms of Oral Cavity and Oropharyngeal Cancer
American Cancer Society: Signs and Symptoms of Laryngeal and Hypopharyngeal Cancers
National Cancer Institute: Laryngeal Cancer Treatment