Hypopharyngeal cancera disease where abnormal cells split without control and spread to other nearby body tissue and/or organs is a rare form throat cancer that forms in the hypopharynx in the bottom portion of the throat (pharynx). The hypopharynx functions as a guide for food into the oesophagus and not into the larynx and lungs.
Hypopharyngeal cancers develop as carcinomas, which are cancers arising from cellsthe basic structural and functional unit of all living things in the skin or tissues that line organs. Most commonly, this disease presents as a squamous cell carcinomacancer arising from tissues that line organs, which develop in the squamous cells lining the skin. However, they can also develop as basaloid squamous carcinomas, spindle cell carcinomas and minor salivary gland carcinomas.
Hypopharyngeal cancer is more common in men, and is generally diagnosed in people between the ages of 55-70. However, anyone can develop this disease.
Treatment
If hypopharyngeal cancer is detected, it will be staged and graded based on size, metastasiswhen the cancer has spread to other parts of the body, also known as mets, and how the cancer cells look under the microscope. Stagingthe process of determining how big the cancer is, where it started and if it has spread to other areas and grading helps your doctors determine the best treatment for you.
Cancers can be staged using the TNM staging system:
- T (tumoura tissue mass that forms from groups of unhealthy cells) indicates the size and depth of the tumour.
- N (nodea small lump or mass of tissue in your body) indicates whether the cancer has spread to nearby lymph nodessmall bean-shaped structures that filters harmful substances from lymph fluid.
- M (metastasis) indicates whether the cancer has spread to other parts of the body.
This system can also be used in combination with a numerical value, from stage 0-IV:
- Stage 0: this stage describes cancer cells in the place of origin (or ‘in situ’) that have not spread to nearby tissuea group of cells that work together to perform a function.
- Stage I: cancer cells have begun to spread to nearby tissue. It is not deeply embedded into nearby tissue and had not spread to lymph nodes. This stage is also known as early-stage cancer.
- Stage II: cancer cells have grown deeper into nearby tissue. Lymph nodes may or may not be affected. This is also known as localisedaffecting only one area of body cancer.
- Stage III: the cancer has become larger and has grown deeper into nearby tissue. Lymph nodes are generally affected at this stage. This is also known as localised cancer.
- Stage IV: the cancer has spread to other tissues and organs in the body. This is also known as advancedat a late stage, far along or metastatic cancer.
Cancers can also be graded based on the rate of growth and how likely they are to spread:
- Gradea description of how abnormal cancer cells and tissue look under a microscope when compared to healthy cells I: cancer cells present as slightly abnormal and are usually slow growing. This is also known as a low-grade tumour.
- Grade II: cancer cells present as abnormal and grow faster than grade-I tumours. This is also known as an intermediate-grade tumour.
- Grade III: cancer cells present as very abnormal and grow quickly. This is also known as a high-grade tumour.
Once your tumour has been staged and graded, your doctor may recommend genetic testinga procedure that analyses DNA to identify changes in genes, chromosomes and proteins, which can be used to analyse tumour DNA to help determine which treatment has the greatest chance of success, which analyses your tumour DNA and can help determine which treatment has the greatest chance of success. They will then discuss the most appropriate treatment option for you.
Treatment is dependent on several factors, including location, stage of disease and overall health.
Treatment options for patients with hypopharyngeal cancer may include:
- Surgerytreatment involving removal of cancerous tissue and/or tumours and a margin of healthy tissue around it to reduce recurrence, potentially including:
- Larynpharyngectomycomplete or partial removal of the larynx and pharynx.
- Lymphadenectomysurgical removal of lymph node(s).
- Chemotherapya cancer treatment that uses drugs to kill or slow the growth of cancer cells, while minimising damage to healthy cells.
- Radiation therapya treatment that uses controlled doses of radiation to damage or kill cancer cells.
- Clinical trialsresearch studies performed to test new treatments, tests or procedures and evaluate their effectiveness on various diseases.
- Palliative carea variety of practices and exercises used to provide pain relief and improve quality of life without curing the disease.
Some of the information regarding treatment was obtained from the Hypopharyngeal Cancer Treatment (Adult) (PDQ) page published by the National Cancer Institute.
Risk factors
The riskthe possibility that something bad will happen factors for hypopharyngeal cancer include:
- Smoking/tobacco use.
- Heavy alcohol use.
- A diet lacking in nutrients.
- Having Plummer Vinson syndrome (a triad of dysphagia, glossitis, and iron deficiency anaemiaa condition where there aren't enough red blood cells in the blood, causing fatigue, weakness and pale skin and affecting how the body responds to infection).
Other potential risk factors for this disease include:
- Vitamin C deficiencies.
- Gastric reflux.
- Exposure to substances, such as:
- Asbestos.
- Steel/coal dusts.
- Iron compound fumes.
- Indoor air pollution from solid fuels (e.g., wood, crop residue, coal etc.)
Not everyone with these risk factors will develop the disease, and some people who have the disease may have none of these risk factors. See your general practitioner (GP) if you are concerned.
Some of the information regarding risk factors was obtained from the Hypopharyngeal Cancer Treatment (Adult) (PDQ) page published by the National Cancer Institute.
Symptoms
Symptoms of hypopharyngeal cancer include:
- Difficulties swallowing.
- Dyspneadifficulty breathing, shortness of breath.
- Persistent sore throat.
- Pain when swallowing.
- Ear pain.
- Persistent cough.
- A lump in the neck.
- Neck pain.
- Coughing up bloody mucus.
- Voice changes (such as hoarseness).
- Unexplainable weight loss.
- Bloodthe red bodily fluid that transports oxygen and other nutrients around the body in your saliva.
- Unexplainable bad breath.
Not everyone with the symptoms above will have cancer, but see your GP if you are concerned.
Diagnosis
If your doctor suspects you have hypopharyngeal cancer, they may order the following tests to confirm the diagnosisthe process of identifying a disease based on signs and symptoms, patient history and medical test results and refer you to a specialist for treatment:
- Physical examinationan examination of your current symptoms, affected area(s) and overall medical history.
- Neurological examinationan assessment of sensory and motor functions, such as vision, balance and coordination.
- Imagingtests that create detailed images of areas inside the body tests, potentially including:
- MRI (magnetic resonance imaging)a type of medical imaging that uses radiowaves, a strong magnet and computer technology to create detailed images of the body.
- CT (computed tomography) scana type of medical imaging that uses x-rays and computer technology to create detailed images of the body.
- PET (positron emission tomography) scana type of medical imaging that uses radioactive tracers to create detailed images of the body.
- X-raya type of medical imaging that uses x-ray beams to create detailed images of the body .
- Bone scana type of medical imaging that uses a radioactive tracer to detect bone conditions or abnormalities.
- Barium studiesa type of x-ray where barium powder is either swallowed (barium swallow) or introduced via the colon (barium enema) to coat the organs of the digestive tract and provide clearer x-ray images.
- Blood teststesting done to measure the levels of certain substances in the blood.
- Endoscopya procedure that involves inserting a long, flexible tube with a light and small camera (endoscope) into the body to view internal organs, potentially including:
- Laryngoscopy/microlaryngoscopyexamination of the larynx with a small, flexible instrument known as a laryngoscope.
- Oesophagoscopyexamination of the oesophagus with a small, flexible instrument called a oesophagoscope.
- Bronchoscopyan examination of the trachea and lungs with a small, flexible instrument known as a bronchoscope.
- Biopsyremoval of a section of tissue to analyse for cancer cells.
