Is the Lump in Your Neck a Sign of Throat Cancer?

April 23, 2020
Dr. Terry Day examines a patient

Human papillomavirus (HPV) is serious – as in cancer serious. It can affect girls, boys, women and men of all ages. And it’s preventable.

Wait, did you say “HPV”?! Isn’t that the virus that causes cervical cancer?

The answer is Yes!

HPV is a virus that can be transmitted by skin-to-skin contact, through a cut or scrape, and is commonly transmitted during intercourse or oral sex. HPV is a common term that has been used for many decades. Initially it was well known to be associated with cervical cancer and a vaccine was developed, primarily advertised for young girls in the 1990s. Today we recommend that girls and boys receive the vaccine and the FDA has approved it for everyone in the age group, as it can affect both boys and girls. In fact, throat cancer related to HPV is most common in Caucasian men from 40 to 60 years old but they contracted the virus in most cases as a teenager.

How is HPV related to a lump in the neck?

It was not known that HPV could cause throat cancer until the early 2000s when physicians noticed a dramatic spike in the number of throat cancer cases. The number of throat cancer cases has continued to rise and has surpassed cervical cancer in the number of incidents.

Unfortunately, there currently isn’t an FDA-approved test to diagnose the HPV virus. For women, pre-cancerous and cancerous cells related to HPV can be detected early via a pap smear. In men, there is typically no indication unless cancer develops. Most frequently, a lump in the neck caused by a swollen lymph node is the most common indicator of throat cancer, while a persistent sore throat is also a common symptom. If you have a lump in your neck or persistent sore throat, please seek medical attention by seeing your physician for referral to an Ear, Nose and Throat (ENT) specialist.

“Many adults who learn they have HPV-related throat cancer assume HPV was transmitted from their spouse,” says MUSC Health Oncologist Terry A. Day, M.D. “But in reality, they likely transmitted the virus at a younger age and it was undetectable until it led to something more serious.” Unfortunately, we as parents often aren’t up to date on the long-term effect of not getting our kids vaccinated, especially boys. Thankfully, the FDA has now approved the vaccine up to age 45.

What can I do to prevent HPV?

The primary goal is to prevent HPV-related cancer by vaccinating against the virus. Everyone – male and female – should receive the complete series of HPV vaccines. Unfortunately, many people do not complete all the necessary vaccine rounds and therefore remain susceptible to HPV.

How will MUSC Health diagnose a lump in the throat?

To identify the cause of a lump in the neck or persistent sore throat, MUSC Health Head and Neck Tumor Center will complete a comprehensive exam that may include a five minute clinic exam, sometimes with our innovative digitally recorded endoscopic video imaging of the oropharynx (throat at the back of the mouth). If the cause is diagnosed to be cancer, the treatment goal is to achieve the best functional outcome with the least side-effects and highest cure rate.

“The first cancer treatment is our best opportunity for success,” says Dr. Day. “So even if it requires travel or time out of your life, it’s important to seek the best fit for you in terms of treatment. In fact, it’s always a good idea to get more than one clinical opinion.” One of the most exciting new treatments that does not require any surgical scars on the skin is transoral robotic surgery whereby the tumor is removed through the mouth with a magnified 3D robotic system. Another curative option often includes radiation treatments without surgery but each patient should decide which is best by consulting with their radiation and surgical physicians.

MUSC Health offers one of the most comprehensive multi-disciplinary teams to treat throat cancer. This means that a group of over thirty specialists from several disciplines – including head and neck specialists, oncologist (cancer experts), pathologists, speech and swallowing specialists, and dentists – will weigh in to determine the best treatment plan. Treatments for cancer of the throat range from medication to surgery or radiation. Surgery to remove throat cancer can be non-invasive, conducted through the mouth without incisions. Radiation is a more advanced treatment, and statistics show that its cure rate matches surgical success rates.

MUSC Health also offers a “nurse navigator” to guide you through the complex cancer treatment arena. The nurse navigator can assist with scheduling appointments on the same day and arrange lodging for out of town patients.

What should I do if I have a lump in my throat?

The MUSC Health Head and Neck Team would be pleased to assist you or your family or friends. Please give Julie Akers, Head and Neck Nurse Navigator, a call at 843-792-8363 to schedule an appointment with our team. We look forward to meeting you, to help you on your path to a healthy quality of life.

Keywords: ENT, Cancer, HPV