Pharyngeal cancer

Last updated: October 21, 2021

Summarytoggle arrow icon

Pharyngeal cancers include all malignant tumors arising in the nasopharynx, oropharynx, hypopharynx, and tonsils.These cancers are most commonly squamous cell carcinomas. Alcohol and tobacco use are the two most important risk factors and are responsible for the majority of 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 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.

Epidemiological data refers to the US, unless otherwise specified.

Pharyngeal cancer is usually asymptomatic for a long time. . Often, the first manifestations are swollen cervical lymph nodes.

Oropharyngeal cancer and hypopharyngeal cancer

Nasopharyngeal cancer [2]

Tonsillar cancer

Metastatic disease

References: [5]

Approach

Treatment depends on the type of pharyngeal cancer, cancer stage, and individual patient factors (e.g., comorbidities). There is not a clear superior regimen for most stages, so treatment options must be carefully evaluated on a case-by-case basis. Management options include radiation therapy, chemotherapy, different surgical approaches, or a combination of measures.

Treatment options of pharyngeal cancer
Stage Oropharyngeal cancer [1] Nasopharyngeal cancer [2] Hypopharyngeal cancer [4]
Early or localized Stage I
  • Radiation therapy (standard fractionation)
  • OR surgery: preferably minimally invasive techniques such as transoral robotic surgery (TORS) or transoral laser microsurgery (TLM)
Stage II
Advanced Stage III
Stage IV
  • Poor prognosis since tumors are commonly discovered in late stages
  • 5-year survival rate 64%

References:[6]

  1. Oropharyngeal Cancer Treatment (Adult) (PDQ®)–Health Professional Version. https://www.cancer.gov/types/head-and-neck/hp/adult/oropharyngeal-treatment-pdq. Updated: October 15, 2021. Accessed: October 19, 2021.
  2. Nasopharyngeal Cancer Treatment (Adult) (PDQ®)–Health Professional Version. https://www.cancer.gov/types/head-and-neck/hp/adult/nasopharyngeal-treatment-pdq#_50. Updated: August 30, 2019. Accessed: October 19, 2021.
  3. Chang ET, Ye W, Zeng Y-X, Adami H-O. The Evolving Epidemiology of Nasopharyngeal Carcinoma. Cancer Epidemiology Biomarkers & Prevention. 2021; 30 (6): p.1035-1047. doi: 10.1158/1055-9965.epi-20-1702 . | Open in Read by QxMD
  4. Hypopharyngeal Cancer Treatment (Adult) (PDQ®)–Health Professional Version. https://www.cancer.gov/types/head-and-neck/hp/adult/hypopharyngeal-treatment-pdq#_53. . Accessed: October 19, 2021.
  5. Pestana C. Dr. Pestana's Surgery Notes: Top 180 Vignettes for the Surgical Wards. Kaplan ; 2015
  6. Cancer Stat Facts: Oral Cavity and Pharynx Cancer. https://seer.cancer.gov/statfacts/html/oralcav.html. Updated: March 6, 2017. Accessed: March 6, 2017.
  7. Brunicardi F, Andersen D, Billiar T, et al.. Schwartz's Principles of Surgery. McGraw-Hill Education ; 2014
  8. What Are the Key Statistics About Oral Cavity and Oropharyngeal Cancers?. https://www.cancer.org/cancer/oral-cavity-and-oropharyngeal-cancer/about/key-statistics.html. Updated: January 6, 2017. Accessed: February 16, 2017.
  9. Treatment Options for Oral Cavity and Oropharyngeal Cancer by Stage. https://www.cancer.org/cancer/oral-cavity-and-oropharyngeal-cancer/treating/by-stage.html. Updated: March 2, 2017. Accessed: July 4, 2017.

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