White Spots in Your Throat

What is Throat Cancer?

Throat cancer is considered a type of head and neck cancer. Throat cancer typically refers to oropharyngeal cancer, which attacks the main part of the throat.^{1, 2}

However, cancer can also affect the sinuses, the lower part of the throat, the vocal folds, or any other part of the mouth, head, or neck.^{1, 3}

What Causes Throat Cancer?

Head and neck cancers in general are most often caused by tobacco and alcohol consumption. Exposure to other carcinogens (cancer-causing substances) in the environment can also contribute to it.^{4, 5}

Human papillomavirus (HPV) infection is implicated in an increasing number of cases. In the United States, HPV might be implicated in as many as 70% of throat cancer cases.^{4, 6, 7}

Throat cancer can be divided into two types, HPV-positive and HPV-negative. The former develop differently and tend to respond better to treatment.^{1, 3, 7, 8}

Are White Spots a Sign of Throat Cancer? 

White spots, patches, or lesions can be a sign of throat cancer. 

However, other conditions can cause white spots to appear in your mouth or throat.⁹ For example, tonsil stones, tonsillitis, and oral thrush (a fungal infection) can all appear as white spots. But these can generally be removed. 

The following conditions, on the other hand, cause lesions that can’t be scraped away:

1. Canker sores often appear white in the center. They have multiple causes but aren’t usually associated with any serious medical conditions.¹⁰
2. Oral lichen planus is an autoimmune condition that can cause white patches to appear in the mouth and sometimes throat. It isn’t linked to cancer, but can require its own medical treatment.¹¹

A condition called leukoplakia also causes white oral lesions to form. Sometimes the lesions appear as mixed white and red patches.⁸

Leukoplakia can be caused by tobacco use, and in some cases it is considered precancerous. Like leukoplakia, oral or throat cancer can also cause a mix of white and red patches to appear.

Other Signs and Symptoms of Throat Cancer

Beyond the appearance of white spots or lesions, throat cancer can have other signs and symptoms:^{1, 3, 12}

Changes in How Your Throat Feels

Throat cancer can cause regular daily activities to feel different. This may include:

• A sore throat that doesn’t go away
• Difficulty swallowing (dysphagia) or painful swallowing (odynophagia)
• Constant coughing or breathing problems
• Difficulty speaking, or a hoarse or raspy voice
• Trouble moving your tongue
• Changes in how your teeth fit together
• Mouth or throat numbness

Some of these symptoms can have other causes, such as a respiratory infection. If they persist or appear together with other symptoms, speak with your doctor. 

Notable Swelling or Lumps

Cancer can appear as a lump or thickening in the mouth or throat or even a visible lump in the neck. These lumps may occur instead of or in addition to white spots or patches.

In many cases, these lumps don’t cause any pain but are persistent and don’t shrink or disappear.

Pain

Throat cancer, as mentioned above, can cause your throat to be persistently sore and make swallowing painful. It can also cause pain in other parts of your mouth, or even ear pain.

You may also be in pain due to persistent coughing. A cough due to throat cancer may be bloody.

Weight Loss

Sudden or unexplainable weight loss can be caused by cancer. This is because cancer cells have greater energy demands than healthy cells and can sometimes alter your sense of fullness or appetite.¹³

You may also eat less if eating or swallowing is painful or difficult, further contributing to weight loss.

When to See a Doctor

You know better than anyone else if something in your body feels or looks different. If you have any combination of the above symptoms, especially if they last more than 2 weeks, see a doctor.

Even if you haven’t noticed any symptoms, keep up with regular dental appointments. Seeing your dentist regularly will allow them to do an oral cancer screening and check if anything in your mouth seems unusual.

According to Dr. Nandita Lilly, one of New Mouth’s in-house resident dentists, “it is important to detect oral cancer in its early stages since early detection will improve prognosis.”

Diagnosis

To diagnose throat cancer, your doctor will examine your mouth and throat for outward signs of cancerous growth. If abnormalities are found during the examination, they’ll perform a biopsy, taking a sample of tissue to examine under a microscope.^{2, 3}

Your doctor may also examine your throat with a medical camera with an attached light, known as an endoscope. In addition, you may be given a MRI scan, CT scan, or other type of scan.³

Treatment Options

There are several kinds of treatment for throat cancer. The exact treatment course will depend on the cancer’s precise location and extent (stage). In general, stage I throat cancer indicates a smaller tumor confined to one area of the throat. Later stages indicate more advanced cancer, with stage IV being the most advanced.

Your overall health and personal preferences will also play a role. Some treatments may be better for your situation than others. Or, you may not wish to pursue certain kinds of treatment.

Standard treatment options for throat cancer include:^{2, 3}

• Surgery
• Radiation therapy
• Chemotherapy
• Targeted drug therapy
• Immunotherapy

Immunotherapy is a new avenue of treatment that is currently being researched. It uses your body’s immune response to target and fight cancer cells. Your specific course of treatment may include one or more of these methods.

Each type of treatment comes with its own risks and side effects. Discuss your options in depth with your doctor.

What is the Prognosis for Throat Cancer?

HPV-positive and HPV-negative oropharyngeal cancer have significant differences in prognosis. They are considered to be distinct diseases and are often given different staging classifications.^{3, 7}

HPV-positive cancer tends to respond better to treatment. As of 2011, throat cancer caused by HPV infection had a median survival of over 10 years.¹⁴

HPV-negative throat cancer, which is often a result of lifelong smoking and/or drinking, had a median survival of under 2 years.¹⁴

People who are treated with more than one method of cancer treatment (surgery, chemotherapy, radiation) tend to live longer.⁸

Can You Prevent Throat Cancer?

HPV-negative throat cancer can be prevented by avoiding tobacco and moderating alcohol intake. These are the two most prominent risk factors for head and neck cancer, aside from an HPV infection.^{4, 5, 6}

HPV variants 16 and 18, which cause most HPV-positive throat cancer as well as cervical cancer, can be spread through sexual activity. Safe sex practices can reduce the likelihood of spread.^{5, 7, 14}

Vaccines for HPV are available. They can prevent HPV-positive throat cancer. These vaccines are only effective if you haven’t already been infected with the variants of HPV they protect against.^{1, 2, 4}

Because of this, an HPV vaccination is most often recommended for people in their teens and early twenties.⁴ Even if you’re older, however, you may be able to receive an HPV vaccine if your doctor confirms it is okay.

According to the American Dental Association (ADA), the HPV vaccination, as recommended by the CDC Advisory Committee on Immunization Practices, is a safe and effective intervention to decrease the burden of oral and oropharyngeal HPV infection.

A diet high in fruits and vegetables also has a protective effect against cancer.²

Summary

Throat cancer is a disease in which abnormal cells (cancer cells) are found in the throat. These cells have a risk of spreading to other parts of the body. It’s typically caused by tobacco or alcohol use or HPV.

White spots or lesions are one of several possible symptoms of throat cancer. If you notice these or other symptoms, talk with your doctor. They can examine what might be causing them.