• Clinical science

Pharyngeal cancer

Abstract

Pharyngeal cancers include all malignant tumors arising in the nasopharynx, oropharynx, or hypopharynx. These cancers are most commonly squamous cell carcinomas. Alcohol and tobacco use are the two most important risk factors and are responsible for majority of the cases. Other risk factors include certain viral infections, poor oral hygiene, and workplace-related exposures, such as radiation. The clinical presentation depends on the location of the tumor. Symptoms may include a growing cervical lump, persistent sore throat, dysphagia, or a change in the voice. Diagnosis is confirmed based on tissue biopsy, whereas the extent of spread is determined via imaging modalities like CT or MRI. Treatment usually requires a combination of surgery, radiation therapy, and chemotherapy.

Epidemiology

References:[1][2][3][4][5]

Epidemiological data refers to the US, unless otherwise specified.

Etiology

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Clinical features

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Diagnostics

  • Panendoscopy with biopsy: visualization of the tumor and surrounding anatomy
  • Histopathological examination (confirmatory test): determines type, grade, and extent of the tumor
  • CT or MRI imaging: assesses tumor infiltration depth and invasion of surrounding structures

Treatment

  • Early or localized pharyngeal cancers
    • Complete surgical resection of the tumor (preferred) or
    • Radiation therapy
  • Locally advanced pharyngeal cancers
    • Induction chemotherapy , concurrent chemoradiation or radiation therapy
    • Surgical resection only carried out if there is response to induction therapies, or if tumor has well-defined margins
    • Additionally, excision of the cervical lymph nodes (neck dissection) may be indicated.
  • If inoperable, or if the patient rejects surgery: primary radiotherapy or radio- and chemotherapy

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Prognosis

  • Poor prognosis since tumors are commonly discovered in late stages
  • 5-year survival rate 64%

References:[3]