Hypopharyngeal Cancer


General Information

What is cancer of the hypopharynx?
Cancer of the hypopharynx is a disease in which cancer (malignant) cells are found in the tissues of the hypopharynx. The hypopharynx is the bottom part of the throat (also called the pharynx). The pharynx is a hollow tube about 5 inches long that starts behind the nose and goes down to the neck to become part of the esophagus, the tube that goes to the stomach. Air and food pass through the pharynx on the way to the windpipe (trachea) or the esophagus.

Cancer of the hypopharynx most commonly starts in the cells that line the hypopharynx, called squamous cells. (Refer to the PDQ summaries on Adult Non- Hodgkin's Lymphoma Treatment and Childhood Non-Hodgkin's Lymphoma Treatment for more information on cancer that started in the lymph cells of the hypopharynx.)

A doctor should be seen if a person has a sore throat that does not go away, trouble swallowing, a lump in the neck, a change in voice, or ear pain.

If there are symptoms, a doctor will examine the throat using a mirror and lights. A thin lighted tube called an endoscope may be put down the throat so the doctor can see if there is tissue that is not normal. The doctor will also feel the throat for lumps. If tissue that is not normal is found, the doctor will need to cut out a small piece and look at it under the microscope to see if there are any cancer cells. This is called a biopsy.

The chance of recovery (prognosis) depends on where the cancer is in the throat, whether the cancer is just in the throat or has spread to other tissues (the stage), and the patient's general state of health.

Stage Information

Stages of cancer of the hypopharynx:

Once cancer of the hypopharynx is found, more tests will be done to find out if cancer cells have spread to other parts of the body. This is called staging. A doctor needs to know the stage of the disease to plan treatment. The following stages are used for cancer of the hypopharynx:

Stage I
The cancer is in only one part of the hypopharynx and has not spread to lymph nodes in the area (lymph nodes are small bean-shaped structures that are found throughout the body; they produce and store infection-fighting cells).

Stage II
The cancer is in more than one part of the hypopharynx or has spread to tissue next to the hypopharynx, but has not grown into the voice box (larynx). The cancer has not spread to lymph nodes in the area.

Stage III
Either of the following may be true:

The cancer is in more than one part of the hypopharynx or has spread to tissue next to the hypopharynx. The cancer has grown into the larynx.

The cancer is in the hypopharynx or has spread to the tissue around the hypopharynx. The cancer has spread to only one lymph node on the same side of the neck as the cancer. The lymph node that contains cancer measures no more than 3 centimeters (just over one inch).

Stage IV
Any of the following may be true:

The cancer has spread to the connecting tissue or soft tissues of the neck. The lymph nodes in the area may or may not contain cancer.
The cancer is in the hypopharynx or has spread to the tissues around the hypopharynx. The cancer has spread to more than one lymph node on the same side of the neck as the cancer, to lymph nodes on one or both sides of the neck, or to any lymph node that measures more than 6 centimeters (over 2 inches).
The cancer has spread to other parts of the body.

Recurrent
Recurrent disease means that the cancer has come back (recurred) after it has been treated. It may come back in the hypopharynx or in another part of the body.

Treatment Option Overview

How cancer of the hypopharynx is treated:

There are treatments for all patients with cancer of the hypopharynx. Two kinds of treatment are used:

-surgery (taking out the cancer)
-radiation therapy (using high-dose x-rays or other high-energy rays to kill cancer cells)
-chemotherapy (using drugs to kill cancer cells) is being tested in clinical trials.

Surgery is a common treatment of cancer of the hypopharynx. A doctor may remove the larynx and part of the throat in an operation called a laryngopharyngectomy. If the cancer is in the lymph nodes, the lymph nodes may be removed (lymph node dissection).

Radiation therapy uses high-energy x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external radiation therapy) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes in the area where the cancer cells are found (internal radiation therapy). Giving drugs with the radiation therapy to make the cancer cells more sensitive to radiation (radiosensitization) is being tested in clinical trials. If smoking is stopped before radiation therapy is started, a patient has a better chance of surviving longer. External radiation to the thyroid or the pituitary gland may change the way the thyroid gland works. The doctor may wish to test the thyroid gland before and after therapy to make sure it is working properly.

Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by a needle in the vein or muscle. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and can kill cancer cells throughout the body.

Because the hypopharynx helps people with breathing, eating, and talking, a patient may need special help adjusting to the side effects of the cancer and its treatment. The patient's doctor will consult with several kinds of doctors who can help determine the best treatment. Trained medical staff can also help the patient recover from treatment. The patient may need plastic surgery or help learning to eat and speak if all or part of the hypopharynx is taken out.

Treatment By Stage

Treatment of cancer of the hypopharynx depends on where the cancer is in the hypopharynx, the stage of the disease, and the patient's age and overall health.

Standard treatment may be considered because of its effectiveness in patients in past studies, or participation in a clinical trial may be considered. Not all patients are cured with standard therapy and some standard treatments may have more side effects than are desired. For these reasons, clinical trials are designed to find better ways to treat cancer patients and are based on the most up-to-date information. Clinical trials are ongoing in many parts of the country for patients with cancer of the hypopharynx.

Stage I Hypopharyngeal Cancer
Treatment may be one of the following:

1. Surgery to remove the larynx and the pharynx (laryngopharyngectomy).
2. Surgery followed by radiation therapy.
3. Radiation therapy alone.

Stage II Hypopharyngeal Cancer
Treatment may be one of the following:

1. Surgery to remove the larynx and the pharynx (laryngopharyngectomy) and
lymph nodes in the neck, followed by radiation therapy.
2. A clinical trial of chemotherapy followed by radiation therapy or surgery.

Stage III Hypopharyngeal Cancer
Treatment may be one of the following:

1. Surgery plus radiation therapy.
2. A clinical trial of chemotherapy followed by surgery or radiation therapy.
3. A clinical trial of chemotherapy combined with radiation therapy.

Stage IV Hypopharyngeal Cancer
If the cancer can be removed by surgery, treatment may be one of the following:

1. Surgery plus radiation therapy.
2. A clinical trial of chemotherapy followed by surgery or radiation therapy.
3. A clinical trial of chemotherapy combined with radiation therapy.
4. Radiation therapy with or without chemotherapy. Clinical trials are
testing new ways of giving radiation therapy in smaller doses
(hyperfractionated radiation therapy).

Recurrent Hypopharyngeal Cancer
Treatment may be one of the following:

1. Surgery to remove the cancer.
2. Radiation therapy.
3. A clinical trial of chemotherapy.






The information on this page was obtained from the National Cancer Institute. The National Cancer Institute provides accurate, up-to-date information on many types of cancer, information on clinical trials, resources for people dealing with cancer, and information for researchers and health professionals.

The National Cancer Institute is in no way affiliated with the Mary Stolfa Cancer Foundation.

The information on this web site is provided for general information only. It is not intended as medical advice, and should not be relied upon as a substitute for consultations with qualified health professionals who are familiar with your individual medical needs. The MSCF disclaims all obligations and liabilities for damages arising from the use or attempted use of the information, including but not limited to direct, indirect, special, and consequential damages, attorneys' and experts' fees and court costs. Any use of the information will be at the risk of the user.





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