Hypopharyngeal cancer originates from the hypopharynx (commonly found in the laryngeal region), and when it spreads to the larynx, it is referred to as hypopharyngeal-laryngeal cancer. This type of cancer ranks second (after nasopharyngeal cancer) among cancers of the ear, nose, and throat. It is most commonly diagnosed in individuals aged 45-65, with a male-to-female ratio of 5:1.
Understanding Hypopharyngeal Cancer
Causes of Hypopharyngeal Cancer
The exact causes of hypopharyngeal cancer have not been clearly identified. However, several risk factors associated with hypopharyngeal cancer include:
- Smoking: The level of tobacco use is directly proportional to the incidence of hypopharyngeal cancer.
- Alcohol addiction: Prolonged alcohol consumption can cause local irritation in the pharyngeal mucosa. Smoking and alcohol addiction are the two main risk factors for hypopharyngeal cancer.
- Poor oral hygiene: Inadequate oral hygiene allows opportunistic bacteria to thrive, leading to chronic infections in the pharyngeal region, which can promote prolonged inflammation, a favorable condition for hypopharyngeal cancer.
- HPV Virus: Infection with HPV is a risk factor for nasopharyngeal cancer, including hypopharyngeal cancer.
- Chronic irritation in the pharyngeal area due to gastroesophageal reflux is also a risk factor for the disease.
- Plummer-Vinson syndrome: Characterized by difficulty swallowing, iron deficiency anemia, and esophageal webs. This condition is linked to an increased incidence of hypopharyngeal cancer in non-smoking women in Northern Europe.
- Environmental factors: Environmental pollution or exposure to asbestos and wood dust can increase the risk of hypopharyngeal cancer.
Hypopharyngeal cancer often remains silent for a long time.
Symptoms of Hypopharyngeal Cancer
Hypopharyngeal cancer typically remains asymptomatic for an extended period. Symptoms of hypopharyngeal cancer appear gradually and may include:
- Swallowing difficulties: Increasing difficulty swallowing, initially on one side, progressively affecting both sides of the throat.
- Persistent sore throat that worsens over time, potentially accompanied by ear pain.
- Swollen lymph nodes in the neck: hard, firm, limited mobility, and non-painful lymph nodes.
- In advanced stages, patients may experience weight loss, shortness of breath, and hoarseness due to tumor invasion into the larynx and nerves.
What are the stages of hypopharyngeal cancer? Hypopharyngeal cancer has four stages:
- Stage 1: The tumor is smaller than 2 cm, located in one area of the hypopharynx, without invasion into surrounding tissues or lymph node involvement.
- Stage 2: The tumor is larger than 2 cm but smaller than 4 cm, may invade other areas of the hypopharynx or spread locally but has not invaded the vocal cords, and the larynx is not fixed. The patient has no lymph node involvement and no distant metastasis.
- Stage 3: The tumor is larger than 4 cm or has affected the vocal cords or invaded the esophagus. The patient may have lymph nodes on one side of the neck that are smaller than 3 cm.
- Stage 4: The tumor has invaded cartilage, bone, and soft tissue. The patient may have lymph nodes on both sides of the neck, with distant metastases present.
At-Risk Populations for Hypopharyngeal Cancer
- Male patients with a history of alcohol addiction and long-term smoking
- Individuals infected with HPV types 16 and 18
- Individuals with a history of exposure to toxic chemicals such as asbestos
- Individuals with Plummer-Vinson syndrome
- Individuals with a long history of gastroesophageal reflux
Is hypopharyngeal cancer contagious? This is a non-communicable disease. There are several non-specific preventive measures:
- The most important measure is to quit alcohol and tobacco, as these are the two main risk factors.
- Use protective equipment in environments with toxic chemicals.
- Effectively treat any gastroesophageal reflux conditions.
- Maintain a balanced diet to prevent malnutrition and vitamin deficiencies. The American Cancer Society emphasizes healthy eating: plenty of fruits and vegetables, whole grains, while limiting red meat and processed foods.
- Prevent HPV infection through vaccination and practicing safe sex.
- Maintain good oral hygiene and thoroughly treat any nasal and throat conditions.
- If symptoms of hoarseness, shortness of breath, or difficulty swallowing appear (especially in patients over 40), it is essential to consult an ear, nose, and throat specialist for early detection of the disease.
Treatment Methods for Hypopharyngeal Cancer
Diagnostic tests to assist in diagnosing the disease include:
- Laryngoscopy-hypopharyngeal examination: rigid or flexible laryngoscopy allows for direct assessment of lesions: location, size, characteristics of the tumor, and aids in biopsy for diagnosis.
- Pathological examination: biopsy of the lesion provides the most definitive results. It may be combined with lymph node aspiration to determine tumor invasion of the lymph nodes.
- CT scan of the neck: assesses the extent of tumor spread to lymph nodes or surrounding tissues.
Can hypopharyngeal cancer be cured? As of now, hypopharyngeal cancer has not been completely cured. The primary treatment methods include: surgery, radiation therapy, chemotherapy, and immunotherapy.
- Surgery: Depending on the stage of the disease, appropriate surgical intervention is indicated (partial or total laryngectomy, with or without neck dissection).
- Radiation therapy: can be administered alone or as adjuvant therapy after surgery.
- Chemotherapy and immunotherapy: systemic treatment for advanced hypopharyngeal cancer.
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