General Information About Hypopharyngeal Cancer
Stages of Hypopharyngeal Cancer
Recurrent Hypopharyngeal Cancer
Treatment Option Overview
Treatment Options by Stage

Stage I Hypopharyngeal Cancer Stage II Hypopharyngeal Cancer Stage III Hypopharyngeal Cancer Stage IV Hypopharyngeal Cancer

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

Key Points for This Section

Hypopharyngeal cancer is a disease in which malignant (cancer) cells form in the tissues of the hypopharynx. Use of tobacco products and heavy drinking can affect the risk of developing hypopharyngeal cancer. Possible signs of hypopharyngeal cancer include a sore throat and ear pain. Tests that examine the throat and neck are used to help detect (find) and diagnose hypopharyngeal cancer. Certain factors affect prognosis (chance of recovery) and treatment options.

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:

• Smoking tobacco.
• Chewing tobacco.
• Heavy alcohol use.
• Eating a diet without enough nutrients.
• Having Plummer-Vinson syndrome.

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.

Stages of Hypopharyngeal Cancer

Key Points for This Section

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. There are three ways that cancer spreads in the body. The following stages are used for hypopharyngeal cancer: Stage 0 (Carcinoma in Situ) Stage I Stage II Stage III Stage IV

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 ¹ 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.

Enlarge

Pea, peanut, walnut, and lime show tumor sizes.

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:
  • has spread to nearby soft tissue, connective tissue, blood vessels, the thyroid, or the esophagus, and may have spread to lymph nodes of any size; or
  • is any size and has spread to lymph nodes that are larger than 6 centimeters.
• In stage IVC, cancer has spread beyond the hypopharynx to other parts of the body.

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.

Treatment Option Overview

Key Points for This Section

There are different types of treatment for patients with hypopharyngeal cancer. Three types of standard treatment are used: Surgery Radiation therapy Chemotherapy New types of treatment are being tested in clinical trials. Patients may want to think about taking part in a clinical trial. Patients can enter clinical trials before, during, or after starting their cancer treatment. Follow-up tests may be needed.

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 ².

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.

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.

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 ³. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site ⁴.

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 ⁵. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site ⁴.

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 ⁶. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site ⁴.

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 ⁷. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site ⁴.

Treatment Options for Recurrent Hypopharyngeal Cancer

Treatment of recurrent hypopharyngeal cancer may include the following:

• Surgery.
• Radiation therapy.
• Chemotherapy.
• A clinical trial of chemotherapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with recurrent hypopharyngeal cancer ⁸. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site ⁴.

To Learn More About Hypopharyngeal Cancer

For more information from the National Cancer Institute about hypopharyngeal cancer, see the following:

• Throat (Laryngeal and Pharyngeal) Cancer Home Page ⁹
• Smoking and Cancer Home Page ¹⁰ (Includes help with quitting)
• Head and Neck Cancer: Questions and Answers ¹¹

For general cancer information and other resources from the National Cancer Institute, see the following:

• What You Need to Know About™ Cancer - An Overview ¹²
• Understanding Cancer Series: Cancer ¹³
• Staging: Questions and Answers ¹⁴
• Chemotherapy and You: Support for People With Cancer ¹⁵
• Radiation Therapy and You: Support for People With Cancer ¹⁶
• Coping with Cancer ¹⁷
• Support and Resources ¹⁸
• Cancer Library ¹⁹
• Information For Survivors/Caregivers/Advocates ²⁰

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® ²¹ 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 ²² 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 ²³. 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.

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 ²⁴ section.
• Information about patients taking part in clinical trials and about follow-up tests was added to the Treatment Option Overview ²⁵ section.
• Links to ongoing clinical trials listed in NCI’s PDQ Cancer Clinical Trials Registry were added to the Treatment Options ²⁶ section.
• A new section called “ To Learn More ²⁷ ” 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.

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 ²². 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 ²⁸. 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.

Glossary Terms

The area of the body that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs.

Not normal. An abnormal lesion or growth may be cancerous, premalignant (likely to become cancer), or benign.

Treatment given after the primary treatment to increase the chances of a cure. Adjuvant therapy may include chemotherapy, radiation therapy, hormone therapy, or biological therapy.

A liquid containing barium sulfate that is used in x-rays to highlight parts of the digestive system.

The removal of cells or tissues for examination by a pathologist. The pathologist may study the tissue under a microscope or perform other tests on the cells or tissue. There are many different types of biopsy procedures. The most common types include: (1) incisional biopsy, in which only a sample of tissue is removed; (2) excisional biopsy, in which an entire lump or suspicious area is removed; and (3) needle biopsy, in which a sample of tissue or fluid is removed with a needle. When a wide needle is used, the procedure is called a core biopsy. When a thin needle is used, the procedure is called a fine-needle aspiration biopsy.

A tissue with red blood cells, white blood cells, platelets, and other substances suspended in fluid called plasma. Blood takes oxygen and nutrients to the tissues, and carries away wastes.

A tube through which the blood circulates in the body. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins.

Primary bone cancer is cancer that forms in cells of the bone. Some types of primary bone cancer are osteosarcoma, Ewing sarcoma, malignant fibrous histiocytoma, and chondrosarcoma. Secondary bone cancer is cancer that spreads to the bone from another part of the body (such as the prostate, breast, or lung).

Cancer that forms in tissues of the breast, usually the ducts (tubes that carry milk to the nipple) and lobules (glands that make milk). It occurs in both men and women, although male breast cancer is rare.

A thin, tube-like instrument used to examine the inside of the trachea, bronchi (air passages that lead to the lungs), and lungs. A bronchoscope has a light and a lens for viewing, and may have a tool to remove tissue.

A procedure that uses a bronchoscope to examine the inside of the trachea, bronchi (air passages that lead to the lungs), and lungs. A bronchoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue to be checked under a microscope for signs of disease. The bronchoscope is inserted through the nose or mouth. Bronchoscopy may be used to detect cancer or to perform some treatment procedures.

A term for diseases in which abnormal cells divide without control. Cancer cells can invade nearby tissues and can spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord.

The smallest type of blood vessel. A capillary connects an arteriole (small artery) to a venule (small vein) to form a network of blood vessels in almost all parts of the body. The wall of a capillary is thin and leaky, and capillaries are involved in the exchange of fluids and gases between tissues and the blood.

A group of abnormal cells that remain in the tissue in which they first formed. These abnormal cells may become cancer and spread into nearby normal tissue.

A flexible tube used to deliver fluids into or withdraw fluids from the body.

The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.

A measure of length in the metric system. There are 100 centimeters in a meter and 2½ centimeters in an inch.

Treatment with drugs that kill cancer cells.

An x-ray of the structures inside the chest. An x-ray is a type of high-energy radiation that can go through the body and onto film, making pictures of areas inside the chest, which can be used to diagnose disease.

A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease. Also called clinical study.

Supporting tissue that surrounds other tissues and organs. Specialized connective tissue includes bone, cartilage, blood, and fat.

A dye or other substance that helps show abnormal areas inside the body. It is given by injection into a vein, by enema, or by mouth. Contrast material may be used with x-rays, CT scans, MRI, or other imaging tests.

A series of detailed pictures of areas inside the body taken from different angles. The pictures are created by a computer linked to an x-ray machine. Also called CAT scan, computed tomography scan, computerized axial tomography scan, and computerized tomography.

The process of identifying a disease, such as cancer, from its signs and symptoms.

The amount of medicine taken, or radiation given, at one time.

Any substance, other than food, that is used to prevent, diagnose, treat or relieve symptoms of a disease or abnormal condition. Also refers to a substance that alters mood or body function, or that can be habit-forming or addictive, especially a narcotic.

A thin, tube-like instrument used to look at tissues inside the body. An endoscope has a light and a lens for viewing and may have a tool to remove tissue.

A procedure that uses an endoscope to examine the inside of the body. An endoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue to be checked under a microscope for signs of disease.

Examination of the esophagus using an esophagoscope. An esophagoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue to be checked under a microscope for signs of disease.

The muscular tube through which food passes from the throat to the stomach.

A type of radiation therapy that uses a machine to aim high-energy rays at the cancer from outside of the body. Also called external-beam radiation therapy.

Monitoring a person's health over time after treatment. This includes keeping track of the health of people who participate in a clinical study or clinical trial for a period of time, both during the study and after the study ends.

The bottom part of the throat. Cancer of the hypopharynx is also known as hypopharyngeal cancer.

Use of a syringe and needle to push fluids or drugs into the body; often called a "shot."

A type of radiation therapy in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near a tumor. Also called brachytherapy, implant radiation therapy, and radiation brachytherapy.

Cancer that has spread beyond the layer of tissue in which it developed and is growing into surrounding, healthy tissues. Also called infiltrating cancer.

The area of the throat containing the vocal cords and used for breathing, swallowing, and talking. Also called voice box.

One of a pair of organs in the chest that supplies the body with oxygen, and removes carbon dioxide from the body.

The clear fluid that travels through the lymphatic system and carries cells that help fight infections and other diseases. Also called lymphatic fluid.

A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Lymph nodes filter lymph (lymphatic fluid), and they store lymphocytes (white blood cells). They are located along lymphatic vessels. Also called lymph gland.

A thin tube that carries lymph (lymphatic fluid) and white blood cells through the lymphatic system. Also called lymphatic vessel.

The tissues and organs that produce, store, and carry white blood cells that fight infections and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes, and lymphatic vessels (a network of thin tubes that carry lymph and white blood cells). Lymphatic vessels branch, like blood vessels, into all the tissues of the body.

The spread of cancer from one part of the body to another. A tumor formed by cells that have spread is called a “metastatic tumor” or a “metastasis.” The metastatic tumor contains cells that are like those in the original (primary) tumor. The plural form of metastasis is metastases (meh-TAS-tuh-SEEZ).

A procedure in which radio waves and a powerful magnet linked to a computer are used to create detailed pictures of areas inside the body. These pictures can show the difference between normal and diseased tissue. MRI makes better images of organs and soft tissue than other scanning techniques, such as computed tomography (CT) or x-ray. MRI is especially useful for imaging the brain, the spine, the soft tissue of joints, and the inside of bones. Also called magnetic resonance imaging, NMRI, and nuclear magnetic resonance imaging.

The National Cancer Institute, part of the National Institutes of Health of the United States Department of Health and Human Services, is the Federal Government's principal agency for cancer research. The National Cancer Institute conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the National Cancer Institute Web site at http://www.cancer.gov. Also called NCI.

NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the Federal Government's principal agency for cancer research. It conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://www.cancer.gov. Also called National Cancer Institute.

Surgery to remove lymph nodes and other tissues in the neck.

Treatment given as a first step to shrink a tumor before the main treatment, which is usually surgery, is given. Examples of neoadjuvant therapy include chemotherapy, radiation therapy, and hormone therapy.

A chemical compound (such as protein, fat, carbohydrate, vitamin, or mineral) contained in foods. These compounds are used by the body to function and grow.

A part of the body that performs a specific function. For example, the heart is an organ.

PDQ is an online database developed and maintained by the National Cancer Institute. Designed to make the most current, credible, and accurate cancer information available to health professionals and the public, PDQ contains peer-reviewed summaries on cancer treatment, screening, prevention, genetics, complementary and alternative medicine, and supportive care; a registry of cancer clinical trials from around the world; and directories of physicians, professionals who provide genetics services, and organizations that provide cancer care. Most of this information, and more specific information about PDQ, can be found on the NCI's Web site at http://www.cancer.gov/cancertopics/pdq. Also called Physician Data Query.

The hollow tube inside the neck that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). The pharynx is about 5 inches long, depending on body size. Also called throat.

The main endocrine gland. It produces hormones that control other glands and many body functions, especially growth.

An operation that restores or improves the appearance of body structures.

A disorder marked by anemia caused by iron deficiency, and a web-like growth of membranes in the throat that makes swallowing difficult. Having Plummer-Vinson syndrome may increase the risk of developing esophageal cancer. Also called Paterson-Kelly syndrome and sideropenic dysphagia.

The original tumor.

The likely outcome or course of a disease; the chance of recovery or recurrence.

Energy released in the form of particle or electromagnetic waves. Common sources of radiation include radon gas, cosmic rays from outer space, medical x-rays, and energy given off by a radioisotope (unstable form of a chemical element that releases radiation as it breaks down and becomes more stable).

The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called irradiation and radiotherapy.

Giving off radiation.

A small, radioactive pellet that is placed in or near a tumor. Cancer cells are killed by the energy given off as the radioactive material breaks down and becomes more stable.

To come back or to return.

Cancer that has recurred (come back), usually after a period of time during which the cancer could not be detected. The cancer may come back to the same place as the original (primary) tumor or to another place in the body. Also called recurrent cancer.

Cancer that has recurred (come back), usually after a period of time during which the cancer could not be detected. The cancer may come back to the same place as the original (primary) tumor or to another place in the body. Also called recurrence.

Treatment with anticancer drugs directed to a specific area of the body.

Something that may increase the chance of developing a disease. Some examples of risk factors for cancer include age, a family history of certain cancers, use of tobacco products, certain eating habits, obesity, lack of exercise, exposure to radiation or other cancer-causing agents, and certain genetic changes.

A problem that occurs when treatment affects healthy tissues or organs. Some common side effects of cancer treatment are fatigue, pain, nausea, vomiting, decreased blood cell counts, hair loss, and mouth sores.

Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body.

The bones, muscles, tendons, and other tissues that reach from the base of the skull to the tailbone. The spinal column encloses the spinal cord and the fluid surrounding the spinal cord. Also called backbone, spine, and vertebral column.

Flat cell that looks like a fish scale under a microscope. These cells cover inside and outside surfaces of the body. They are found in the tissues that form the surface of the skin, the lining of the hollow organs of the body (such as the bladder, kidney, and uterus), and the passages of the respiratory and digestive tracts.

The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.

Abnormal cells are found in the lining of the hypopharynx. These abnormal cells may become cancer and spread into nearby normal tissue.

The tumor is found only in one area of the hypopharynx and is 2 centimeters or smaller.

The tumor is either (1) larger than 2 centimeters but not larger than 4 centimeters and has not spread to the larynx (voice box); or (2) found in more than one area of the hypopharynx or in nearby tissues.

In stage III hypopharyngeal cancer the tumor is (1) found only in 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; or (2) 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; or (3) 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.

The tumor has spread to nearby tissues and lymph nodes of the neck and may have spread to other parts of the body.

Stage IV hypopharyngeal cancer is divided into stages IVA, IVB, and IVC. In stage IVA, the tumor is (1) 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 (2) 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 (3) 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 (4) 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).

Stage IV hypopharyngeal cancer is divided into stages IVA, IVB, and IVC. In stage IVB, the tumor either (1) has spread to nearby soft tissue, connective tissue, blood vessels, the thyroid, or the esophagus, and may have spread to lymph nodes of any size; or (2) is any size and has spread to lymph nodes that are larger than 6 centimeters.

Stage IV hypopharyngeal cancer is divided into stages IVA, IVB, and IVC. In stage IVC, cancer has spread beyond the hypopharynx to other parts of the body.

Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. It is important to know the stage of the disease in order to plan the best treatment.

In medicine, treatment that experts agree is appropriate, accepted, and widely used. Health care providers are obligated to provide patients with standard therapy. Also called best practice and standard of care.

An organ that is part of the digestive system. The stomach helps digest food by mixing it with digestive juices and churning it into a thin liquid.

A procedure to remove or repair a part of the body or to find out whether disease is present. An operation.

An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.

Treatment with anticancer drugs that travel through the blood to cells all over the body.

A gland located beneath the voice box (larynx) that makes thyroid hormone and calcitonin. The thyroid helps regulate growth and metabolism.

A gland located beneath the voice box (larynx) that produces thyroid hormone. The thyroid helps regulate growth and metabolism.

A group or layer of cells that work together to perform a specific function.

The airway that leads from the larynx (voice box) to the bronchi (large airways that lead to the lungs). Also called windpipe.

An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancerous), or malignant (cancerous). Also called neoplasm.

A blood vessel that carries blood to the heart from tissues and organs in the body.

A type of high-energy radiation. In low doses, x-rays are used to diagnose diseases by making pictures of the inside of the body. In high doses, x-rays are used to treat cancer.