Actor-filmmaker Rakesh Roshan has been diagnosed with Throat Cancer (squamous cell carcinoma of the throat) and the 69-year-old filmmaker will undergo surgery on Tuesday. Actor Hrithik Roshan shared a heartwarming post on Instagram that said, “Asked my dad for a picture this morning... Knew he wouldn’t miss gym on surgery day. He is probably the strongest man I know. Got diagnosed with early stage squamous cell carcinoma of the throat a few weeks ago but he is in full spirits today as he proceeds to battle it. As a family we are fortunate and blessed to have a leader like him.”

Rakesh Roshan started his career in the 70s and shot to fame with films like Ghar Ghar Ki Kahani, Buniyaad, Kaamchor and Khoobsurat as an actor and he made his debut as a director with 1987 hit film Khudgarz followed by films like Khoon Bhari Maang, Koyala and Karan Arjun, Kaho Naa Pyaar Hai, Koi Mil Gaya and the superhero series, Krrish.

What is squamous cell carcinoma of the throat?

According to myvmc.com, throat cancer or squamous cell carcinoma of the tonsil is a part of cancers of the head and neck. In oncology squamous cell cancers of the head and neck are often considered together because they share many similarities – in incidence, cancer type, predisposing factors, pathological features, treatment of the cancer and cancer prognosis. Up to 30% of cancer patients with one primary head and neck tumour will have a second primary malignancy.

The pharynx is the continuation of the nose and mouth. It is a muscular tube that continues downwards through the neck and is responsible for the passage of both air (to the larynx, trachea and lungs) and food (to the oesophagus and then stomach). The pathways for food and air cross over in the pharynx. In addition, the auditory canal opens onto the upper part of the pharynx. The walls of the pharynx are composed of fascia and muscle layers all lined by a mucous membrane. The pharynx is divided into three different areas based on anatomical location: the nasopharynx (behind the nose); oropharynx (behind the mouth); and the laryngopharynx (behind the larynx).The tonsils are a ring of lymphoid tissue around the upper part of the pharynx. They consist of the lingual tonsil in the posterior part of the tongue, the palatine tonsils and the pharyngeal tonsils. Lymphoid tissue acts as a barrier against infection.

Causes, symptoms and early signs

Smoking and chewing tobacco, alcohol consumption, unhealthy diet are one of the key factors that lead to this particular type of cancer of the head and neck. According to myvmc.com, smokers are up to 25 times more likely to develop a cancer of the throat than their non-smoking counterparts. Passive smoking, tobacco chewing and cigar smoking are also risk factors for the development of throat cancers. Up to the point of development of overt carcinoma, many of the changes associated with cigarette smoking will reverse if the throat cancer patient quits smoking. Other risk factors include immune deficient states (such as post solid-organ transplant); occupational exposures to agents such as asbestos and perchloroethylene; radiation; dietary factors; a genetic predisposition to the development of throat cancer; and poor oral hygiene.General investigations into this type of throat cancer may show anaemia or abnormal liver function tests if the disease is very advanced, or due to the aetiology of the throat cancer. In the early stages of pharyngeal cancer general investigations tend to be normal.

How to cure it?

According to Virtual Medical Centre’s website, the best treatment of throat cancer is radiotherapy, but throat cancer surgery is also an appropriate option in specific cases, or the two treatments may be combined. Radiotherapy is usually preferred because it has a high cure rate, also treats regional lymph nodes and is associated with the potential for less post-treatment morbidity. Both radiotherapy and surgery are associated with similar cure rates.

Patients treated with local or regionally advance throat cancer are treated most succesfuly with a comined modality therapy of surgery, radiation therapy and chemotherapy.

Patients with recurrent and/or metastic throat cancer are, with few intentions treated with palliative intent. Chemotherapy can be used for transient symptomatic benefit. Drugs with single agent activity in this setting include methotrexate, 5FU, cisplatin, paclitaxel, docetaxel. Combinations of cisplatin and 5-FU, carboplatin and 5FU, and cisplatin and paclitaxel are also used.

The symptoms of throat cancer that may require attention are somatic pain from bone metastases, visceral pain from liver or lung metastases and neurogenic pain if nerve tissue is compressed. Coughing and breathlessness from lung involvement may require specific treatment. Improvement in throat cancer symptoms is an important measurement. Specific monitoring may be by thorough serial inspection of the head and neck region – looking for disease recurrence as well as second primary cancerous tumors. Ideally this would include a pan- /triple-endoscopy. There are no specific screening recommendations at the moment but several clinical trials in throat cancer are currently being undertaken into the benefit of different screening techniques.

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First Published: Jan 08, 2019 13:40 IST