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.

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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.

Glossary Terms

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

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 term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also 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 place where they first formed. They have not spread. These abnormal cells may become cancer and spread into nearby normal tissue. Also called stage 0 disease.

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.

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

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

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

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.

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).

The original tumor.

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

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.

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.

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 cancer), or malignant (cancer). Also called neoplasm.

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