What is Pharyngeal Cancer? The pharynx, often called the throat, is a hollow tube about 5 inches long that starts behind the nose and goes down to the neck to become part of the esophagus (tube that goes to the stomach). Air and food pass through the pharynx on the way to the windpipe (trachea) or the esophagus. Cancer of the pharynx is often categorized as follows:
- The nasopharynx is behind the nose and is the upper part of the throat. The nares, the holes in the nose through which people breathe, lead into the nasopharynx. Two openings on the side of the nasopharynx lead into the ear. Cancer of the nasopharynx most commonly starts in the cells that line the oropharynx.
- The oropharynx is the middle part of the throat. The oropharynx includes the soft palate (the back of the mouth), the base of the tongue, and the tonsils. Cancer of the oropharynx most commonly starts in the cells that line the oropharynx.
- The hypopharynx is the bottom part of the throat. Cancer of the hypopharynx most commonly starts in the cells that line the hypopharynx, called squamous cells.
SymptomsSymptoms that are common to several head and neck cancer sites include a lump or sore that does not heal, a sore throat that does not go away, difficulty swallowing, and a change or hoarseness in the voice.
Other pharyngeal cancer symptoms may include the following: -
- Oropharynx and hypopharynx cancer symptoms—Ear pain.
- Nasopharynx cancer symptoms—Trouble breathing or speaking, frequent headaches, pain or ringing in the ears, or trouble hearing.
DiagnosisTo find the cause of pharyngeal cancer symptoms, a doctor evaluates a person’s medical history, performs a physical examination, and orders diagnostic tests. The exams and tests conducted may vary depending on the pharyngeal cancer symptoms. Some exams and tests that may be useful are described below:
- Physical examination may include visual inspection of the oral and nasal cavities, neck, throat, and tongue using a small mirror and/or lights. The doctor may also feel for lumps on the neck, lips, gums, and cheeks.
- Endoscopy is the use of a thin, lighted tube called an endoscope to examine areas inside the body. The type of endoscope the doctor uses depends on the area being examined. For example, a laryngoscope is inserted through the mouth to view the larynx; an esophagoscope is inserted through the mouth to examine the esophagus; and a nasopharyngoscope is inserted through the nose so the doctor can see the nasal cavity and nasopharynx to help with pharyngeal cancer diagnosis.
- Laboratory tests examine samples of blood, urine, or other substances from the body.
- X-rays create images of areas inside the head and neck on film.
- CT (or CAT) scan is a series of detailed pictures of areas inside the head and neck created by a computer linked to an x-ray machine.
- Magnetic resonance imaging (or MRI) uses a powerful magnet linked to a computer to create detailed pictures of areas inside the head and neck.
- Biopsy is the removal of tissue for examination under a microscope. A pathologist studies the tissue to make a diagnosis of pharyngeal cancer. A biopsy is the only sure way to tell whether a person has pharyngeal cancer.
TreatmentTreatment for pharyngeal cancer depends on the location of the tumor, as well as the stage of the cancer, and the person's age and overall health. Treatment options aim to minimize damage to a person's ability to eat, breathe and talk.
Surgeryis a common treatment of cancer of the oropharynx. A doctor may remove the cancer and some of the healthy tissue around the cancer. If cancer has spread to lymph nodes, the lymph nodes will be removed (lymph node dissection). A new type of surgery called micrographic surgery is being tested in clinical trials for early cancers of the oropharynx. Micrographic surgery removes the cancer and as little normal tissue as possible. During this surgery, the doctor removes the cancer and then uses a microscope to look at the cancerous area to make sure there are no oropharynx cancer cells remaining.
Radiation therapyuses high-energy x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external radiation therapy) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes in the area where the cancer cells are found (internal radiation therapy). External radiation to the thyroid or the pituitary gland may change the way the thyroid gland works. The doctor may wish to test the thyroid gland before and after therapy to make sure it is working properly. Giving drugs with the radiation therapy to make the oropharynx cancer cells more sensitive to radiation (radiosensitization) is being tested in clinical trials. If smoking is stopped before radiation therapy is started, there is a better chance of surviving longer.
Chemotherapyuses drugs to kill oropharynx cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by a needle in the vein or muscle. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and can kill cancer cells throughout the body.
People with oropharyngeal cancer have a higher risk of getting other cancers in the head and neck area. Clinical trials of oropharynx chemoprevention therapy are testing whether certain drugs can prevent second cancers from developing in the mouth, throat, windpipe, nose, or esophagus (the tube that connects the throat to the stomach).
Hyperthermiauses a special machine to heat the body for a certain period of time to kill cancer cells. Because cancer cells are often more sensitive to heat than normal cells, the oropharynx cancer cells die and the cancer shrinks.
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