Hypopharyngeal Cancer

Symptoms

Hypopharynx cancer might include any of the following signs and symptoms:

• A sore throat that does not go away
• Persistent ear pain
• A lump in the neck
• Painful or difficult swallowing
• A change in voice
• Many people have no symptoms

These symptoms are also common in non-cancerous conditions. Most people with these symptoms do not have cancer of the hypopharynx.

Causes and Risk Factors

The exact cause is not known, but some causes might be:

• Occurs more often in ages 50 to 60, but can occur at any age
• Smoking or chewing tobacco
• Chewing tobacco
• Heavy alcohol use
• People who have Plummer-Vinson syndrome

Diagnosis

The doctor will pass a thin flexible tube with a light at the end (flexible endoscope) into the nostril to look at the hypopharynx. A local anesthetic spray might be used to numb your nose and throat. You will be instructed not to eat or drink anything for an hour afterwards or until your throat is no longer numb.

If a tumor is suspected, the doctor will take a biopsy and a pathologist will examine the tissue under a microscope.

Most hypopharyngeal cancers are one of three types of squamous cell carcinomas:

• Keratinizing squamous cell carcinoma
• Non-keratinizing squamous cell carcinoma
• Undifferentiated or poorly differentiated carcinoma

The doctor may also order other tests:

• Blood tests
• Imaging studies to determine if the tumor has invaded nearby tissues or other organs in the body.
  • Orthopantomography (Panorex) - a panoramic X-ray of the upper and lower jaw. It shows a view from ear to ear and it helps determine if a tumor has grown into the jaw bone.
  • CT scan - A special type of x-ray that makes a series of detailed pictures, with different angles, of areas inside the mouth and neck. A computer is linked to the x-ray machine. A dye may be injected into a vein or swallowed in a pill to help highlight the organs or tissues on the x-ray. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
  • MRI - (magnetic resonance imaging). A machine that uses a magnet, radio waves, and a computer to make detailed pictures of areas inside the mouth and neck. This procedure is also called nuclear magnetic resonance imaging (NMRI).
  • PET scan - During a positron emission tomography scan (PET), a small amount of radioactive glucose (sugar) is injected into a vein. The scanner makes computerized pictures of the areas inside the body. Cancer cells absorb more radioactive glucose than normal cells, so the tumor is highlighted on the pictures.

Treatment

Radiation therapy combined with chemotherapy (chemoradiation) is the most common treatment. In most cases, surgery is only required if the tumor returns after chemoradiation therapy.

Radiation Therapy

Radiation therapy, including intensity modulated radiation therapy, stops cancer cells from dividing and slows the growth of the tumor. Radiotherapy also destroys cancer cells and can shrink or eliminate tumors. Intensity modulated radiation therapy allows the use of more effective radiation doses with fewer side effects than conventional radiotherapy techniques.

Radiation therapy involves 5-6 weeks of daily treatments.

Chemotherapy

Chemotherapy is prescribed for different reasons:

• Together with radiotherapy as an alternative to surgery (called chemoradiation)
• After surgery to decrease the risk of the cancer returning
• To slow the growth of a tumor and control symptoms when the cancer cannot be cured (palliative treatment)

Surgery

In most cases, surgery is only required if the tumor returns after chemoradiation therapy. Surgery is also used on selective lesions.

If the lymph nodes in the neck are affected, a neck dissection may be needed to remove the nodes.

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