What is hypopharyngeal cancer?
Hypopharyngeal cancer, also called hypopharynx cancer, is one of the rarest head and neck cancers. Due to the hypopharynx's location in the throat, hypopharyngeal cancer is often associated with other throat cancers, including:
- Laryngeal cancer, disease of the larynx (voice box)
- Cervical esophageal cancer, affecting the cervical esophagus (top portion of the food tube)
What is hypopharyngeal cancer?
Hypopharyngeal cancer develops when cells inside the hypopharynx change, grow uncontrollably, and accumulate to form a tumor. People who consume too much tobacco or alcohol, especially together, have a greater risk of developing the disease.
Hypopharyngeal Cancer Symptoms
Hypopharyngeal cancer symptoms can be the same as those of other conditions. Talk with your doctor if you have:
- Sore throat that does not go away
- Difficult or painful swallowing
- Ear pain
- Lump in the neck
- Noisy or difficult breathing
- Voice change
Hypopharyngeal Cancer Risk Factors
Some factors may increase your risk of getting hypopharyngeal cancer. Having risk factors does not mean you will get cancer, and some people with no risk factors develop the disease.
Hypopharyngeal cancer appears more often in older adults, non-Hispanic white people, and African Americans. Your risk for hypopharyngeal cancer also increases with:
- Tobacco use, particularly with alcohol use
- Heavy alcohol use, particularly with tobacco use
- Genetic (inherited) conditions such as Fanconi anemia and dyskeratosis congenita
- Past exposure to radiation
- Poor nutrition
- Plummer-Vinson syndrome, linked to poor nutrition
- Prolonged exposure to wood dust, paint fumes and some chemicals used in metalworking, petroleum, construction, and textile industries
Types of Hypopharyngeal Cancer
The most common type of hypopharyngeal cancer is squamous cell carcinoma (squamous cell cancer). This type of cancer starts in the thin, flat squamous cells lining the inside of the hypopharynx.
Other types of cancers that can start in the hypopharynx include:
- Minor salivary gland cancer: Starts in the hypopharynx's minor salivary glands
- Sarcoma: Begins in the hypopharynx's connective tissues
Hypopharyngeal Cancer Stages
Staging is the process of determining whether cancer has spread and, if so, how far. This information helps doctors understand your prognosis (probable outcome based on others' experiences) and develop your treatment plan.
To determine a cancer's stage, doctors consider many variables, including:
- The main tumor's size and how far it has grown into the hypopharynx and nearby structures
- Whether cancer has spread to nearby lymph nodes, and if so, which ones
- Whether cancer has spread to other parts of the body or distant organs
In general, the lower the stage number, the less cancer has spread. Hypopharyngeal cancer staging involves many factors and can be complicated, so talk with your doctor for details about your situation.
Stage 0: Abnormal cells are in the hypopharynx lining. They could become cancerous and spread into nearby tissue. Another name for Stage 0 is carcinoma in situ, which means "in its original place."
Stage 1: A cancerous tumor is in only one area of the hypopharynx and is no larger than 2 cm. Cancer has not spread to lymph nodes or elsewhere in the body.
Stage 2: The tumor has extended into more areas of the hypopharynx or nearby areas and is between 2 cm and 4 cm. Cancer is not in the vocal cords, lymph nodes or distant body parts.
Stage 3: The tumor may be larger than 4 cm or affect one or both vocal cords. Or cancer may have spread to nearby tissues or one lymph node but not to distant parts of the body.
Stage 4: This stage is divided into several substages, each describing how hypopharyngeal cancer has extended elsewhere in the body.
Recurrent hypopharyngeal cancer
Recurrent hypopharyngeal cancer is cancer that has come back after being treated. Cancer may appear in the hypopharynx or other areas of the body.
Diagnostic Tests for Hypopharyngeal Cancer
We conduct a comprehensive evaluation to diagnose hypopharyngeal cancer, starting with your medical history. After completing a physical exam, including a thorough check of your throat, your doctor may recommend specific tests, including:
With an endoscopy, your doctor inserts an endoscope (a thin, lighted tube) through the nose or mouth to check the throat for abnormal cells. During an endoscopy, your doctor may also take tissue samples for a biopsy. Types of endoscopy procedures that check for hypopharyngeal cancer include:
- Laryngoscopy to evaluate the larynx
- Esophagoscopy to examine the esophagus
- Bronchoscopy to view the bronchi (main airways of the lungs)
- Panendoscopy, a procedure combining laryngoscopy, esophagoscopy, and bronchoscopy
A neurological exam includes questions and tests to check brain, spinal cord, and nerve function. The exam evaluates mental status, coordination, walking ability, and function of the muscles, senses, and reflexes.
Specialized images from inside your throat can help doctors learn about your tumor's size and location. Doctors can also use these detailed pictures to determine if cancer has expanded into lymph nodes or other body parts. Your care team may recommend one or more imaging tests, including:
- Barium swallow/upper gastrointestinal (GI) series: A drinkable fluid called barium coats your digestive system's organs, helping the organs show up when we perform an X-ray.
- Head and chest X-ray: A technician aims an energy beam at the area of your body that doctors need to study. A plate behind you captures images as the energy beam changes while passing through your skin, bone, muscle and other tissue.
- Computed tomography scan (CT scan): A specialized X-ray beam moves around your body while capturing pictures of bones, muscles, tissues, and organs.
- Magnetic resonance imaging scan (MRI): A large magnet, radio waves, and computer work together to take clear, detailed pictures.
- Positron emission tomography (PET) scan: This type of imaging measures your body's cell activity. You receive a small amount of a tracer (radioactive substance) that travels through your body. The tracer collects in areas of increased cell activity (typically indicating cancer) and appears brighter on the scan.
- PET/CT scan: PET and CT technology combine to show areas of increased cell activity and highly detailed images of nearby organs and tissues.
- PET/MRI scan: This PET and MRI combination shows cell differences and detailed images of the brain, internal organs and soft tissues. It uses less radiation than a CT scan.
If imaging tests indicate that you might have hypopharyngeal cancer, your doctor may request a biopsy. This procedure takes a tiny sample of cells from abnormal areas for doctors to evaluate for cancer.
In addition to an endoscopic biopsy, our doctors use several types of biopsies, including:
- Needle biopsy: Your doctor inserts a thin needle (fine needle aspiration) or a wider needle (core biopsy) into a tumor.
- Image-guided biopsy: A radiologist uses an imaging technique such as ultrasound or MRI to guide the needle for the biopsy.
- Surgical (excisional) biopsy: Your surgeon may remove all or part of a tumor to be tested.
Before and during treatment, we test small samples of your blood in our lab. Blood tests provide valuable health information and help us monitor for cancer treatment side effects.
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Hypopharyngeal Cancer
Hypopharyngeal cancer is a type of throat cancer. Our expert team treats all types and stages of hypopharynx cancer and other head and neck cancers.
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