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Table of Contents General Information About Hypopharyngeal Cancer
Stages of Hypopharyngeal Cancer
Recurrent Hypopharyngeal Cancer
Treatment Option Overview
Treatment Options by Stage
Treatment Options for Recurrent Hypopharyngeal Cancer
To Learn More About Hypopharyngeal Cancer
Get More Information From NCI
Changes to This Summary (04/28/2008)
About PDQ
General Information About Hypopharyngeal Cancer
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Hypopharyngeal cancer is a disease in which malignant (cancer)
cells form in the tissues of the hypopharynx.
The hypopharynx is the
bottom part of the pharynx (throat).
The pharynx is a hollow tube about 5 inches long that starts behind the nose, goes down the neck,
and ends at the top of the trachea (windpipe) and esophagus (the tube
that goes from the throat to the stomach). Air and food pass through the pharynx on
the way to the trachea or the esophagus.
Most hypopharyngeal cancers form in squamous cells,
the thin, flat cells lining the inside of the
hypopharynx. The hypopharynx has 3 different areas. Cancer may be found in 1 or more of these areas.
Use of tobacco products and heavy drinking can affect the risk
of developing hypopharyngeal cancer.
Risk factors include the following:
Possible signs of hypopharyngeal cancer include a sore throat
and ear pain.
These and other symptoms may be caused by hypopharyngeal cancer. Other conditions may cause the same symptoms. A doctor should be consulted if any of the following
problems occur:
- A sore throat that does not go away.
- Ear pain.
- A lump in the neck.
- Painful or difficult swallowing.
- A change in voice.
Tests that examine the throat and neck are used to help detect
(find) and diagnose hypopharyngeal cancer.
The following tests and procedures may be used:
- Physical exam of the throat: An exam in which
the doctor feels for swollen lymph
nodes in the neck and looks down the throat with a small,
long-handled mirror to check for abnormal areas.
- Endoscopy: A
procedure used to look at areas in the throat that cannot be seen
with a mirror during the physical exam of the throat. An endoscope (a thin, lighted tube) is inserted through the
nose or mouth to check the throat for anything that seems unusual. Tissue samples may be taken for biopsy.
- CT scan (CAT
scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
- MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
- Head, neck, and chest x-rays: An x-ray of the head, neck, and organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
- Barium esophagogram: An x-ray of the esophagus. The patient drinks a liquid that contains barium (a silver-white metallic compound). The liquid coats the esophagus and x-rays are taken.
- Esophagoscopy: A procedure to look inside the esophagus to check for abnormal areas. An esophagoscope (a thin, lighted tube) is inserted through the mouth or nose and down the throat into the esophagus. Tissue samples may be taken for biopsy.
- Bronchoscopy: A procedure to look inside the trachea and large airways in the lung for abnormal areas. A bronchoscope (a thin, lighted tube) is inserted through the nose or mouth into the trachea and lungs. Tissue samples may be taken for biopsy.
- Biopsy: The removal of cells or tissues so they can be viewed under a microscope to check for signs of cancer.
Certain factors affect prognosis (chance
of recovery) and treatment options.
Prognosis (chance of recovery) depends on the
following:
- The stage of the cancer (whether it
affects part of the hypopharynx, involves the whole hypopharynx, or has spread
to other places in the body). Hypopharyngeal cancer is usually detected in later stages because early symptoms rarely occur.
- The patient's age, gender, and general health.
- The location of the cancer.
- Whether the patient smokes during radiation therapy.
Treatment options depend on the following:
- The stage of the cancer.
- Keeping the patient's ability to talk, eat, and breathe as normal as possible.
- The patient's general health.
Patients who have had hypopharyngeal cancer are at an increased risk of developing a second
cancer in the head or neck. Frequent and
careful follow-up is important.
Back to Top Stages of Hypopharyngeal Cancer
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After hypopharyngeal cancer has been diagnosed, tests are done
to find out if cancer cells have spread within the hypopharynx or to other
parts of the body.
The process used to find out if cancer has spread within the hypopharynx or to other parts of the
body is called staging. The
information gathered from the staging process determines the stage of the disease. It is
important to know the stage of the disease in order to plan treatment.
The results of some of the tests used to diagnose hypopharyngeal cancer are often also used to stage the disease.
There are three ways that cancer spreads in the body.
The three ways that cancer spreads in the body are:
- Through tissue. Cancer invades the surrounding normal tissue.
- Through the lymph system. Cancer invades the lymph system and travels through the lymph vessels to other places in the body.
- Through the blood. Cancer invades the veins and capillaries and travels through the blood to other places in the body.
When cancer cells break away from the primary (original) tumor and travel through the lymph or blood to other places in the body, another (secondary) tumor may form. This process is called metastasis. The secondary (metastatic) tumor is the same type of cancer as the primary tumor. For example, if breast cancer spreads to the bones, the cancer cells in the bones are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer.
The following stages are used for hypopharyngeal
cancer:
Stage 0 (Carcinoma in Situ)
In stage 0, abnormal cells are found in the lining of the hypopharynx. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.
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Stage I
In stage I, cancer has formed in one area of the hypopharynx only and the tumor is 2 centimeters or smaller.
Stage II
In stage II, the tumor is either:
- larger than 2 centimeters but not larger than 4 centimeters and has not spread to the larynx (voice box); or
- found in more than one area of the hypopharynx or in nearby tissues.
Stage III
In stage III, one of the following is found:
- The tumor is in only one area of the hypopharynx and is 2 centimeters or smaller; cancer has also spread to a single lymph node on the same side of the
neck and the lymph node is 3 centimeters or smaller.
- Cancer is in more than one area of the hypopharynx, is in nearby tissues, or is larger than 2 centimeters but not larger than 4 centimeters and is not in the larynx; cancer has also spread to a single lymph node on the same side of the neck and the lymph node is 3 centimeters or smaller.
- The tumor is larger than 4 centimeters or has spread to the larynx; cancer may have spread to a single lymph node on the same side of the neck and the lymph node is 3 centimeters or smaller.
Stage IV
Stage IV is divided
into stage IVA, IVB, and IVC as follows:
- In stage IVA, the tumor:
- can be any size and has spread to nearby soft tissue, connective tissue, the thyroid, or the esophagus; cancer may be found either in one lymph node on the same side of the neck (the lymph node is 3 centimeters or smaller) or in one or more lymph nodes anywhere in the neck (all of these lymph nodes are 6 centimeters or smaller); or
- is in only one area of the hypopharynx, is 2 centimeters or smaller, and has also spread to one or more lymph nodes anywhere in the neck (all of these lymph nodes are 6 centimeters or smaller); or
- is in more than one area of the hypopharynx, is in nearby tissues, or is larger than 2 centimeters but not larger than 4 centimeters and has not spread to the larynx; cancer has spread to one or more lymph nodes anywhere in the neck (all of these lymph nodes are 6 centimeters or smaller); or
- is larger than 4 centimeters or has spread to the larynx; cancer has also spread to one or more lymph nodes anywhere in the neck (all of these lymph nodes are 6 centimeters or smaller).
- In stage IVB, the tumor either:
- In stage IVC, cancer has spread beyond the hypopharynx to
other parts of the body.
Back to Top Recurrent Hypopharyngeal Cancer
Recurrent hypopharyngeal cancer is cancer that has recurred
(come back) after it has been treated. The cancer may come
back in the hypopharynx or in other
parts of the body.
Back to Top Treatment Option Overview
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There are different types of treatment for patients with
hypopharyngeal cancer.
Different types of treatment are available for patients with
hypopharyngeal cancer. Some treatments
are standard (the currently used treatment), and some are being tested in clinical trials. A
treatment clinical trial is a research study meant to help improve current
treatments or obtain information on new treatments for patients with cancer.
When clinical trials show that a new treatment is better than the
standard treatment, the new
treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Three types of standard treatment are used:
Surgery
Surgery (removing the cancer in
an operation) is a common treatment for all stages of hypopharyngeal cancer. The following
surgical procedures may be used:
- Laryngopharyngectomy: Surgery to remove the larynx (voice box) and part of
the pharynx (throat).
- Partial laryngopharyngectomy: Surgery to remove part of the
larynx and part of the pharynx. A partial laryngopharyngectomy prevents loss of
the voice.
- Neck dissection:
Surgery to remove lymph nodes and
other tissues in the neck.
Even if the doctor removes all the cancer that can be seen at the
time of the surgery, some patients may be given chemotherapy or radiation
therapy after surgery to kill any cancer cells that are left. Treatment given
after the surgery, to increase the chances of a cure, is called adjuvant therapy.
Radiation therapy
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.
Radiation therapy may be more effective in patients who have
stopped smoking before beginning treatment. External radiation therapy to the thyroid or the pituitary gland may change the way
the thyroid gland works. The thyroid gland may be tested before
and after therapy to make sure it is working properly.
Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.
Chemotherapy may be used to shrink the tumor before surgery or radiation therapy. This is called neoadjuvant chemotherapy.
New types of treatment are being tested in clinical
trials.
Information about clinical trials is available from the
NCI Web site.
Patients may want to think about taking part in a clinical trial.
For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.
Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.
Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's clinical trials database.
Follow-up tests may be needed.
Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. This is sometimes called re-staging.
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.
For hypopharyngeal cancer, follow-up to check for recurrence should include careful head and neck exams once a month in the first year after treatment ends, every 2 months in the second year, every 3 months in the third year, and every 6 months thereafter.
Back to Top Treatment Options by Stage
A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.
Stage I Hypopharyngeal Cancer
Treatment of stage I hypopharyngeal
cancer may include the following:
- Laryngopharyngectomy and neck dissection with or without
high- dose radiation therapy to the lymph nodes of the neck.
- Partial laryngopharyngectomy with or without high-dose radiation
therapy to the lymph nodes on both sides of the neck.
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage I hypopharyngeal cancer.
Stage II Hypopharyngeal Cancer
Treatment of stage II hypopharyngeal
cancer may include the following:
- Laryngopharyngectomy and neck dissection. High- dose radiation therapy to the lymph nodes of the neck may be given before or after surgery.
- Partial laryngopharyngectomy. High-dose radiation therapy to the lymph nodes of the neck may be given before or after surgery.
- Chemotherapy given during or after radiation therapy or after surgery.
- A clinical trial of chemotherapy followed by
radiation therapy or surgery.
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage II hypopharyngeal cancer.
Stage III Hypopharyngeal Cancer
Treatment of stage III hypopharyngeal
cancer may include the following:
- Radiation therapy before or after surgery.
- Chemotherapy given during or after radiation therapy or after surgery.
- A clinical trial of chemotherapy followed by surgery and/or radiation
therapy.
- A clinical trial
of chemotherapy given at the same time as radiation therapy.
- A clinical trial of surgery followed by chemotherapy given at the same time as radiation therapy.
Treatment and follow-up of stage III hypopharyngeal cancer is complex and is ideally overseen by a team of specialists with experience and expertise in treating this type of cancer. If all or part of the hypopharynx is removed, the patient may need plastic surgery and other special help with breathing, eating, and talking.
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage III hypopharyngeal cancer.
Stage IV Hypopharyngeal Cancer
Treatment of stage IV hypopharyngeal
cancer that can be treated with surgery may include the
following:
- Radiation therapy before or after surgery.
- A clinical trial of chemotherapy followed by surgery and/or radiation
therapy.
- A clinical trial of surgery followed by chemotherapy given at the same time as radiation therapy.
Surgical treatment and follow-up of stage IV hypopharyngeal cancer is complex and is ideally overseen by a team of specialists with experience and expertise in treating this type of cancer. If all or part of the hypopharynx is removed, the patient may need plastic surgery and other special help with breathing, eating, and talking.
Treatment of stage IV hypopharyngeal cancer that cannot be treated
with surgery may include the following:
- Radiation therapy.
- Chemotherapy given at the same time as radiation
therapy.
- A clinical trial of radiation therapy with chemotherapy.
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage IV hypopharyngeal cancer.
Back to Top Treatment Options for Recurrent Hypopharyngeal Cancer
Treatment of recurrent hypopharyngeal cancer may include the
following:
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with recurrent hypopharyngeal cancer.
Back to Top To Learn More About Hypopharyngeal Cancer
For more information from the National Cancer Institute about hypopharyngeal cancer, see the following:
For general cancer information and other resources from the National Cancer Institute, see the following:
Back to Top Get More Information From NCI
Call 1-800-4-CANCER
For more information, U.S. residents may call the National Cancer Institute's (NCI's) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 9:00 a.m. to 4:30 p.m. Deaf and hard-of-hearing callers with TTY equipment may call 1-800-332-8615. The call is free and a trained Cancer Information Specialist is available to answer your questions.
Chat online
The NCI's LiveHelp® online chat service provides Internet users with the ability to chat online with an Information Specialist. The service is available from 9:00 a.m. to 11:00 p.m. Eastern time, Monday through Friday. Information Specialists can help Internet users find information on NCI Web sites and answer questions about cancer.
Write to us
For more information from the NCI, please write to this address:
- NCI Public Inquiries Office
- Suite 3036A
- 6116 Executive Boulevard, MSC8322
- Bethesda, MD 20892-8322
Search the NCI Web site
The NCI Web site provides online access to information on cancer, clinical trials, and other Web sites and organizations that offer support and resources for cancer patients and their families. For a quick search, use our “Best Bets” search box in the upper right hand corner of each Web page. The results that are most closely related to your search term will be listed as Best Bets at the top of the list of search results.
There are also many other places to get materials and information about cancer treatment and services. Hospitals in your area may have information about local and regional agencies that have information on finances, getting to and from treatment, receiving care at home, and dealing with problems related to cancer treatment.
Find Publications
The NCI has booklets and other materials for patients, health professionals, and the public. These publications discuss types of cancer, methods of cancer treatment, coping with cancer, and clinical trials. Some publications provide information on tests for cancer, cancer causes and prevention, cancer statistics, and NCI research activities. NCI materials on these and other topics may be ordered online or printed directly from the NCI Publications Locator. These materials can also be ordered by telephone from the Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237), TTY at 1-800-332-8615.
Back to Top Changes to This Summary (04/28/2008)
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
Several enhancements have been made to this summary to better explain certain medical concepts and to help readers find information about clinical trials. The following changes were made:
- Text describing the way cancer spreads in the body was added to the Stages section.
- Information about patients taking part in clinical trials and about follow-up tests was added to the Treatment Option Overview section.
- Links to ongoing clinical trials listed in NCI’s PDQ Cancer Clinical Trials Registry were added to the Treatment Options section.
- A new section called “ To Learn More ” was added. It includes links to more information about this type of cancer and about cancer in general.
- The “Get More Information from NCI” section (originally called “To Learn More”) was revised.
Back to Top About PDQ
PDQ is a comprehensive cancer database available on NCI's Web site.
PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information database. Most of the information contained in PDQ is available online at NCI's Web site. PDQ is provided as a service of the NCI. The NCI is part of the National Institutes of Health, the federal government's focal point for biomedical research.
PDQ contains cancer information summaries.
The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries are available in two versions. The health professional versions provide detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions provide current and accurate cancer information.
The PDQ cancer information summaries are developed by cancer experts and reviewed regularly.
Editorial Boards made up of experts in oncology and related specialties are responsible for writing and maintaining the cancer information summaries. The summaries are reviewed regularly and changes are made as new information becomes available. The date on each summary ("Date Last Modified") indicates the time of the most recent change.
PDQ also contains information on clinical trials.
A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Listings of clinical trials are included in PDQ and are available online at NCI's Web site. Descriptions of the trials are available in health professional and patient versions. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.
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