What is the hypopharynx?

The hypopharynx is the bottom part of the pharynx (throat), which is a hollow tube that is about five inches long. The pharynx starts behind the nose, goes down the neck (behind the voice box), and ends at the esophagus (the tube that goes from the throat to the stomach). The pharynx acts as the passageway for air and food that are on the way to the voice box or the esophagus. The hypopharynx is a combination of three anatomical subsites (sections): the piriform sinus, the posterior hypopharyngeal wall, and the posterior cricoid region.

What is hypopharyngeal cancer?

Hypopharyngeal cancer is a disease that occurs when cancerous (malignant) cells develop in the tissues of the hypopharynx. These cells usually originate from the surface of the lining of the throat and form squamous cell carcinoma (cancer).

What are the risk factors for hypopharyngeal cancer?

Risk factors include:

  • Tobacco use (smoking or chewing)
  • Excessive use of alcohol
  • Lack of nutrients in the diet
  • Presence of Plummer-Vinson syndrome (a disorder linked to severe, long-term iron deficiency anemia)

What are the symptoms of hypopharyngeal cancer?

The following signs and symptoms might be caused by hypopharyngeal cancer or by other conditions. See your doctor if you have:

  • A lump in the neck
  • Difficulty/pain associated with swallowing
  • Voice changes
  • Ear pain

How is hypopharyngeal cancer diagnosed?

Tests and procedures that are used to diagnose hypopharyngeal cancer include:

  • Endoscopy: This procedure uses a thin, lighted tube that is inserted into the nose or mouth to check for anything unusual.
  • Physical exam: Doctors check for swollen lymph nodes in the neck and look down the throat with a small mirror to check for anything unusual.
  • CT scan (also called computed tomography or computerized tomography): This scan takes a series of detailed pictures of areas inside the body. The images are created by a computer that is linked to an X-ray machine.
  • MRI (also called magnetic resonance imaging): This procedure uses radio waves and a powerful magnet, linked to a computer, to create detailed pictures of areas inside the body.
  • PET scan (also called positron emission tomography): This procedure is an imaging test that helps reveal how metabolically active your body tissues are. The test checks all areas of the body for hypermetabolic tissues, which usually mean they are involved with cancer or infection.
  • Esophagoscopy: This procedure looks inside the esophagus to check for unusual areas. An esophagoscope (a thin, lighted tube) is inserted through the mouth and down the throat into the esophagus. Tissue samples might be taken for biopsy. This is usually done under general anesthesia or heavy sedation.
  • Biopsy: In this procedure, tissue samples are removed and viewed under a microscope to determine if cancer is present.

What are the stages of hypopharyngeal cancer?

The stages of hypopharyngeal cancer are numbered 0 through IV.

  • Stage 0
    Cancer is confined only in the lining of the hypopharynx. There is no spread to lymph nodes.
  • Stage I
    The tumor is in the hypopharynx and is 2 centimeters (about ½ inch) or smaller in size. There is no spread to lymph nodes.
  • Stage II
    The tumor is either larger than 2 centimeters, but not larger than 4 centimeters (between about ½ and 1½ inches), and has not spread to the larynx (voice box), OR it is found in more than one area of the hypopharynx or tissues nearby. There is no spread to lymph nodes.
  • Stage III
    The tumor can be any size but is confined to the throat, but the cancer has usually also spread to a single lymph node on the same side of the neck, and the lymph node is 3 centimeters (just over 1 inch) or smaller.
  • Stage IV
    This stage is divided into Stage IVA, IVB, and IVC.
    • Stages IVA and IVB
      This is an advanced stage in which local disease and/or lymph node disease has spread. The spreading may involve movement from the pharynx into nearby soft tissues, such as the voice box, the thyroid gland, or the carotid artery. Neck disease may have spread to several lymph nodes or very large lymph nodes (over 6 centimeters; between 2 and 2½ inches).
    • Stage IVC
      The cancer has spread beyond the hypopharynx to other parts of the body.

How is hypopharyngeal cancer treated at each stage?

  • Stage I
    Treatment might include pharyngectomy (removal of part of the pharynx) and surgery to remove lymph nodes or other tissues of the neck. Radiation therapy applied to the lymph nodes of the neck may follow the surgery in some patients. Another option could be to use radiation therapy alone.
  • Stage II
    Treatment of Stage II hypopharyngeal cancer might include partial or total laryngopharyngectomy (removal of the larynx and pharynx) and surgery to remove lymph nodes or other tissues of the neck. Radiation therapy applied to the lymph nodes of the neck may follow the surgery in some patients. Chemotherapy might also be given during this radiation therapy. Another option could be to use radiation therapy alone.
  • Stage III and Stage IV
    Treatment might include the following:
    • Radiation therapy before or after surgery, with or without chemotherapy.
    • Chemotherapy followed by surgery and/or radiation therapy
    • Chemotherapy given at the same time as radiation therapy
    • Surgery followed by chemotherapy given at the same time as radiation therapy
    • Reconstructive surgery to help with eating, breathing, or talking if all or part of the hypopharynx is removed

What is the prognosis (chance for recovery) for people with hypopharyngeal cancer?

The 5-year survival rate for all stages of pharyngeal cancer is less than 50%. However, keep in mind that this estimate is based on data from thousands of cases of this type of cancer in the United States and might not apply to an individual person.

References

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 2/2/2017...#12181