Clear info about stage 4 throat cancer for patients and their loved ones: stage 4 means doctors are sure the cancer has spread outside the throat. All tests for staging throat cancer explained.

How can doctors be sure you have stage 4 throat cancer?

Once you are diagnosed with throat cancer, further tests -called staging – will be done to find out if the cancer cells have spread:

• within the throat or
   
• to other parts of the body.

Read about the 4 different stages of throat cancer.

The following tests and procedures may be used in the staging process:

• Chest x-ray to examine the organs and bones inside the chest
   
• Laryngoscopy: the doctor examines the larynx or voice box with a mirror or a laryngoscope: a thin, lighted tube
   
• Bronchoscopy: looking deeper inside the trachea and large airways in the lung for abnormal areas. A bronchoscope (a thin, lighted tube) is inserted through the nose or mouth into the trachea and lungs. Tissue samples may be taken for biopsy.
   
• CT scan (CAT scan): advanced X-rays: a computer linked to an x-ray machine makes a series of detailed pictures of areas inside the body, taken from different angles. A dye could be injected into a vein or swallowed to help the organs or tissues show up more clearly. This test is also called Computed Tomography, Computerized Tomography, or Computerized Axial Tomography.
   
• PET scan (positron emission tomography scan): a small amount of radionuclide glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells. The use of PET for staging throat cancer is being studied in clinical trials.
   
• Endoscopic ultrasound (EUS): A procedure in which an endoscope (a thin, lighted tube) is inserted into the body. The endoscope is used to bounce high-energy sound waves (ultrasound) off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. This procedure is also called endosonography.
   
• Thoracoscopy: A surgical procedure to look at the organs inside the chest to check for abnormal areas. An incision (cut) is made between two ribs and a thoracoscope (a thin, lighted tube) is inserted into the chest. Tissue samples and lymph nodes may be removed for biopsy. In some cases, this procedure may be used to remove portions of the esophagus or lung.
   
• Laparoscopy: a non invasive surgical procedure to look at the organs inside the abdomen to check for signs of disease. Small cuts are made in the wall of the abdomen, and a thin, lighted tube -called laparoscope- is inserted into one of the cuts. Other instruments may be inserted through the same or other cuts to perform procedures such as removing organs or taking tissue samples for biopsy.
   

Stage 4a and 4b throat cancer

When you have a stage 4 throat cancer, than doctors have found the throat cancer also to be somewhere else in the patient’s body:

• Stage 4a: Cancer has spread to nearby or distant lymph nodes
   
• Stage 4b: Cancer has spread to distant lymph nodes and/or other organs in the body.

Stage 4 throat cancer treatments

Conventional healthcare hasn’t a clear cut treatment to cure stage 4 throat cancer. We do know that conventional cancer treatments are more successful when they are supported by alternative cancer treatments.

Unfortunately you have to do your own research for alternative cancer treatments, as your doctor never studied for that.

Mostly palliative therapies will be suggested or you could try your luck in clinical trials. Normally stage 4 throat cancer patients have the following 4 options:

• chemotherapy
   
• clinical trials exploring new cancer treatments
   
• external or internal radiation therapy as palliative therapy to relieve symptoms and improve quality of life
   
• laser surgery or electro-coagulation as palliative therapy to relieve symptoms and improve quality of life

Since you will undergo aggressive treatments on your throat, do expect:

• to loose your speech or
• to have severe difficulties eating food.

Not being able to enjoy food nor to communicate could significantly decrease a person’s quality of life.

We all know that people that smoke, drink excessive amounts of alcohol or eat excessive amounts of salty meat have a higher risk in getting throat cancer.

When a smoker is already in palliative care, it is an option not to deprive him of his cigarettes for the sake of quality of life: the patient will die from his cancer, not from smoking another cigarette.

When there is still a possibility for a curing the throat cancer, then by all means stop smoking or anything else that’s considered to be not healthy! Make sure not to inhale coal, asbestos or diesel fumes and have a good oral hygiene.

What is stage 4 throat cancer summarized?

Cancer staging are tests to find out whether a diagnosed cancer has spread and if so, how far. Stage 4 is the worst of all stages.

A stage 4a throat cancer has spread to nearby or distant lymph nodes. A stage 4b cancer has spread to distant lymph nodes and/or other organs in the body.

There are 4 stages of throat cancer depending on the size of the cancer and where the cancer has spread to. Be aware that there are 2 ways of staging a cancer.

In stead of focusing on "the number" of your cancer stage, just ask your doctor what he means exactly!

Doctors need to know which stage of throat cancer you have to adjust their cancer treatment accordingly:

• in early stage throat cancers treatment often only involves removing the tumor with surgery
   
• in later stages when the throat cancer has spread (so called ‘mestastized throat cancer’) chemotherapy and or radiotherapy will be needed to destroy the cancer cells. Often the cancer won’t be killed completely.

Stages of throat cancer according to size

Stage 1 throat cancer

The cancer and is less than one inch and has not spread.

Stage 2

The cancer is between one and two inches and has not spread.

Stage 3

The cancer is more than two inches and has spread to one lymph node on the same side of the neck.

Stage 4 throat cancer

The cancer has spread to other tissues, namely the lips and mouth.

The cancer has spread to multiple lymph nodes on the same side of the neck or to one lymph node on the opposite side of the neck,
or one lymph node is greater than three inches in diameter.

Stages of esophagus cancer depending to where the cancer has spread

In this type of staging doctors try to have an indication where the cancer has spread or could have spread.

Stage O throat cancer

There is no cancer yet but there is a tumor in the innermost layer of tissue lining the esophagus (also called: ‘carcinoma in situ’).

Stage I

The tumor is a cancer that has just started to move inside the esophagus. In stage I the cancer has made its way to the next layer of tissue still inside the wall of the esophagus.

Stage II

• Stage IIA: The cancer is still inside the esophagus but has spread to the muscle or outer wall.
   
• Stage IIB: The Cancer may have spread to any of the first three layers of the esophagus and to nearby lymph nodes.

Stage III

In stage III doctors are sure that the cancer has spread to the outer wall of the esophagus and maybe to tissues or lymph nodes nearby.

Stage IV

• Stage IVA: The cancer has spread to the lymph nodes, be they nearby or distant.
   
• Stage IVB: The cancer has spread to distant lymph nodes and/or organs in other parts of the body.  

Stages of throat cancer summarized

Click the above stages of throat cancer picture to enlarge

• the lower the cancer stage, the more chance you have to undergo a successful throat cancer treatment
   
• when interpreting the stages of throat cancer given by your doctor, always ask exactly what he means.