Hypopharyngeal cancer is a rare type of head and neck cancer that affects the lower part of the throat. Due to its rarity and the similarity of its symptoms to more common throat conditions, such as sore throats or colds, it is often difficult to diagnose. This article discusses the symptoms, risk factors, diagnosis, and treatment methods for this type of cancer.
What is hypopharyngeal cancer? Hypopharyngeal cancer is a type of cancer that starts in the squamous cells located in the lower part of the throat. These cells are responsible for the inner lining of the throat and serve a protective role. When these cells grow and divide uncontrollably, hypopharyngeal cancer develops. This type of cancer is rare, accounting for only about 4.5% of all head and neck cancers. Smoking and excessive alcohol consumption are the main risk factors for this type of cancer.
Symptoms of Throat Cancer (Hypopharynx)
Throat cancer can occur in different parts of the throat, and as a result, it has various types. The throat, which is about 15 centimeters long, extends from the back of the throat to the beginning of the esophagus and consists of three main parts: the nasopharynx (the back of the nasal cavity), the oropharynx (the back of the mouth), and the larynx (which leads to the esophagus). These areas can become affected by cancer.
Types of Throat Cancer
- Nasopharyngeal Cancer: This type of cancer begins in the nasopharynx, which is located just behind the nose.
- Oropharyngeal Cancer: This type of cancer starts in the part of the throat located behind the mouth, including the tonsils.
- Laryngeal Cancer: This type is also called hypopharyngeal cancer and affects the lower part of the throat.
- Supraglottic Cancer: This type originates in the upper part of the voice box and includes cancer affecting the epiglottis.
- Subglottic Cancer: In this type, cancer begins in the lower part of the voice box, beneath the vocal cords.
Symptoms of Throat Cancer
The symptoms and signs of hypopharyngeal cancer can vary depending on the type of cancer and the affected area. However, common symptoms of throat cancers may include:
- Persistent coughing with blood
- Changes in voice, such as hoarseness or unclear speech
- Pain or difficulty swallowing
- Chronic ear pain that doesn’t improve
- A lump or sore that doesn’t heal
- Persistent sore throat or pharyngitis that continues
- Unexplained weight loss
- Difficulty opening the mouth or moving the tongue
- A lump in the back of the throat or mouth
- A lump in the neck
- White patches on the tongue or oral mucosa that don’t go away
Throat cancer can start in any of the parts of the throat, but the most common area is the oropharynx. Hypopharyngeal and nasopharyngeal cancers are rarer.
Throat, Pharyngeal, and Laryngeal Cancer Differences
The throat is divided into two main parts: the pharynx and the larynx, each of which can develop cancer separately. Each of these parts is made up of three main sections, which may be affected by cancer. As a result, each of these sections can lead to various types of throat cancer.
Throat Cancer
Throat cancer may be accompanied by the following symptoms:
- Difficulty swallowing
- Difficulty speaking
- Throat inflammation
- Shortness of breath
- Headache
Pharyngeal Cancer
Symptoms of pharyngeal cancer include:
- Changes in the color and texture of the throat
- Discharge and bleeding from ulcers
Laryngeal Cancer
Laryngeal cancer is typically identified by the following symptoms:
- Changes in voice
- Difficulty swallowing
- Throat inflammation
- Difficulty speaking
Comparison of Throat, Pharyngeal, and Laryngeal Cancer
These types of cancers have similar symptoms, but there are differences in how they affect various parts of the throat. If you notice symptoms such as changes in your voice, difficulty swallowing, or speaking, it’s best to consult a doctor as soon as possible.
Causes of Pharyngeal Cancer
The exact cause of pharyngeal cancer is not entirely clear, but research suggests that the HPV (Human Papillomavirus) virus is one of the main factors contributing to this cancer. The virus produces proteins that interfere with the genes regulating the growth of throat cells. When these genes lose their normal function, the cells begin to divide uncontrollably, leading to tumor formation.
Smoking, such as smoking cigarettes and using chewing tobacco, can also be another contributing factor that damages the throat cells. This damage causes cells to divide more rapidly in an attempt to repair the damage, increasing the risk of genetic mutations and cancer. Excessive alcohol consumption can also damage throat cells and reduce their ability to repair DNA, increasing the risk of pharyngeal cancer.
Risk Factors for Pharyngeal Cancer
The most significant risk factor for pharyngeal cancer is infection with the HPV virus, particularly type 16. Other risk factors include:
- A history of smoking and tobacco use
- Excessive alcohol consumption
- A history of head and neck cancer
- Previous radiation therapy to the head and neck area
- Viral infections such as Epstein-Barr virus
- A diet lacking fruits and vegetables
- Gastroesophageal reflux disease (GERD)
- Exposure to toxic substances in work environments
Throat Cancer: Genetic Mutations and Uncontrolled Cell Growth
Throat cancer occurs when the cells in the throat undergo genetic mutations. These mutations cause the cells to grow uncontrollably and continue to live after the normal cells die. The accumulation of these cells can lead to the formation of malignant tumors.
Diagnosis of Pharyngeal Cancer
To diagnose oropharyngeal cancer, the doctor will first ask the patient about their symptoms and medical history. These questions include whether the patient has had head and neck cancer before or if they have received radiation therapy in the head and neck area. The doctor will also inquire about lifestyle factors and tobacco use.
After this stage, the doctor will examine the patient’s mouth, throat, and neck, carefully looking for any lumps or signs of abnormality in the neck area. In some cases, a fiber optic camera may be used to inspect the inside of the mouth and throat for a more detailed examination.
Endoscopic Biopsy
One of the primary methods for diagnosing pharyngeal cancer (hypopharynx) is endoscopic biopsy. In this procedure, a thin, flexible tube called an endoscope is used to collect a sample of throat tissue. The endoscope has a camera and cutting tools to help the doctor obtain a small tissue sample for examination by a pathologist. The pathologist examines the sample under a microscope to detect signs of cancer or HPV infection.
Imaging Scans
Various imaging methods are used to assess the size and spread of tumors:
- CT Scan: This scan helps the doctor assess the size of the tumors and determine if they have spread.
- PET Scan: This method is sometimes combined with CT to provide more detailed information about the tumor.
- MRI: This imaging technique provides detailed images of soft tissues, such as the tonsils and base of the tongue, which are very useful in diagnosing throat cancer. MRI also helps the doctor assess the size of tumors.
Stages of Throat Cancer
Throat cancer is typically categorized into four stages (I to IV), each indicating the extent and severity of the disease. These stages help doctors determine the appropriate treatment plan and make predictions about potential treatment outcomes.
The different stages of throat cancer may vary depending on the type of cancer, the presence of HPV, and the size and spread of the tumors. For example, in stage IV throat cancer, the cancerous tumors have spread to nearby lymph nodes or distant areas of the body.
Treatment of Throat Cancer
The treatment of throat cancer depends on the patient’s condition, the stage of the cancer, and factors such as the patient’s age, treatment history, and the extent of the disease. The goal of treatment is to eliminate cancer cells without compromising the patient’s ability to speak and swallow.
- Surgery
Surgery is one of the most effective treatment methods for throat cancer, especially in cases where the cancer has not yet spread. Transoral robotic surgery is used to remove tumors, particularly in small cancers that are difficult to access. This minimally invasive procedure is performed through the mouth.
- Chemotherapy
Chemotherapy in Gorgan is often used alone or in combination with radiation therapy to treat throat cancer. This method is employed when surgery is not possible or the tumors are too large. Chemotherapy can also be useful for:
- Treating cancers that have spread to other parts of the body.
- Shrinking tumors before surgery.
- Eliminating remaining cancer cells after surgery.
- Targeted Therapy
This method uses monoclonal antibodies, which are proteins of the immune system, to treat various types of cancer, including throat cancer. Targeted therapy works by blocking a protein that cancer cells rely on for division, growth, and spread.
- Immunotherapy
Immunotherapy is a first-line treatment for oropharyngeal cancer that has recurred or spread. This treatment helps the patient’s immune system identify and destroy cancer cells. Notable drugs in this method include Pembrolizumab (Keytruda®) and Nivolumab (Opdivo®).
- Herbal Treatment
In addition to medical treatments, some people turn to herbal remedies to combat throat cancer. Examples of effective herbal treatments include:
- Turmeric: Has antiseptic and antibiotic properties that can help reduce inflammation and fight cancer cells.
- Mint: The chemicals in mint prevent blood supply to cancerous tumors.
- Coriander and Thyme: Other herbal options for combating throat cancer.
- Traditional Medicine for Throat Cancer
Traditional medicine also recommends treatments for throat cancer. Some of these treatments include:
- Clove: Drinking clove tea can aid in cancer treatment.
- Jujube, dark leafy greens, and fruits like cherries and grapes: These are also recommended in traditional medicine as natural remedies for throat cancer.
Necessary Care in Throat Cancer Treatment
After undergoing primary treatments for throat cancer, post-treatment care is crucial. These care measures help reduce the side effects of treatments and improve the patient’s quality of life. Since issues such as difficulty swallowing and speaking may arise after treatment, rehabilitation therapies like speech therapy and swallowing exercises are essential.
1. Diet
A healthy and balanced diet plays a vital role in the recovery process. Patients undergoing treatment for throat (hypopharyngeal) cancer should follow a diet rich in fresh fruits and vegetables. Consuming soft and easy-to-swallow foods can facilitate the eating process. Additionally, ensuring adequate nutrient intake can help strengthen the immune system and reduce treatment side effects.
2. Healthy Lifestyle
Individuals who have undergone throat cancer treatment should make lifestyle changes to prevent cancer recurrence and other complications. These changes include:
- Quitting smoking and avoiding tobacco use.
- Eliminating alcohol consumption.
- Maintaining hygiene, especially sexual hygiene, to prevent viral infections such as HPV.
These adjustments can reduce the risk of related cancers.
3. Post-Chemotherapy Care
After chemotherapy, specific care is necessary to minimize the side effects of treatment. This care may include:
- Managing nausea and vomiting.
- Oral and dental care to prevent infections.
- Skin care for affected areas.
- Using pain-relieving medications.
Complications of Throat Cancer
Complications arising from throat (hypopharyngeal) cancer can result from both the disease itself and its treatments. Some of the most common complications include:
- Dry mouth: May occur due to radiation therapy or chemotherapy.
- Severe headaches: Caused by treatments or tumor pressure.
- Difficulty swallowing and eating: Especially after surgery or radiation therapy.
- Speech problems: Including hoarseness or inability to speak.
- Ear pain: Resulting from tumor spread to nearby areas.
- Nausea and vomiting: Side effects of chemotherapy.
- Skin rashes: May develop due to radiation therapy or treatment side effects.
- Chronic fatigue: Common during treatment periods.
- Loss of appetite: Particularly during chemotherapy or radiation therapy.
- Abnormal bleeding: Another possible complication.
Prevention of Throat Cancer (Hypopharynx)
Although it may not be possible to completely prevent throat cancer, certain measures can significantly reduce the risk of developing it:
1. Avoiding HPV Infection
- Refraining from oral sex and having multiple sexual partners can reduce the risk of HPV infection.
- Receiving the HPV vaccination can lower the risk of throat cancer.
2. Quitting Smoking and Avoiding Tobacco
- Smoking is one of the biggest risk factors for throat cancer. Quitting smoking can significantly reduce the risk of developing this disease.
3. Reducing Alcohol Consumption
- Excessive alcohol consumption increases the risk of throat cancer. Avoiding the combination of alcohol and tobacco can further reduce the risk.
4. Healthy Diet and Regular Exercise
- A diet rich in fruits, vegetables, and anti-cancer foods can help lower the risk of throat cancer.
- Regular exercise and maintaining a healthy weight are also crucial.
5. Regular Medical Checkups
- Regular visits to a doctor and dentist for oral and throat examinations, especially for high-risk individuals, can help detect early changes and prevent disease progression.
Final Thoughts
Hypopharyngeal cancer is a rare and serious type of cancer that develops in the lower part of the throat, near the trachea and esophagus. This type of cancer is often asymptomatic in its early stages, but as it progresses, it can cause symptoms such as difficulty swallowing, voice changes, and pain in the neck or ears. Early detection of hypopharyngeal cancer is crucial because treatment is more effective in the initial stages.
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