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Localized synchronous squamous cell carcinomas of the esophagus and hypopharynx treated with definitive concurrent chemoradiotherapy with a unified .
Table of contents

During surgery, a surgical oncologist removes the cancerous tumor and some healthy tissue around it, called a margin. A surgical oncologist is a doctor who specializes in treating cancer using surgery. The goal of surgery is to remove the entire tumor and leave negative margins. Having negative margins mean that there is no trace of cancer in the healthy tissue that was removed during the operation.

Sometimes it is not possible to completely remove the cancer. In these cases, other treatments will be recommended. Before surgery, talk with your health care team about the possible side effects from the specific surgery you will have. Partial laryngectomy. The following are some of the different types of partial laryngectomies:. Supraglottic laryngectomy.

During this procedure, the surgeon removes the area above the vocal folds. If part of the hypopharynx is removed along with the cancer, this procedure is called a partial pharyngectomy. Supracricoid partial laryngectomy. The removal of the vocal folds and the area surrounding them. Total laryngectomy.

Hypopharyngeal Cancer

This procedure removes the entire larynx. During the operation, a hole called a stoma is made in the front of the neck through the windpipe, so the person can breathe. This is called a tracheostomy see below. Because the vocal folds have been removed, people can no longer speak using their vocal folds after a total laryngectomy.

However, a speech pathologist can teach people to speak in a different way after surgery. A laryngopharyngectomy is the removal of the entire larynx, including the vocal folds and part or all of the pharynx.

Disease & Drug Info

After this surgery, doctors must reconstruct the pharynx using flaps of skin from the forearm, other parts of the body, or a segment of the intestine. Like a total laryngectomy, people can no longer speak using the vocal folds after laryngopharyngectomy. They may also have difficulty swallowing. However, a speech pathologist can help people learn to speak and swallow afterward. Neck dissection. If the cancer has spread to the lymph nodes in the neck, some of these lymph nodes may need to be surgically removed.

Hypopharyngeal cancer

This is called a neck dissection. There are several types of neck dissections, such as a partial neck dissection, modified neck dissection, or selective neck dissection. Depending on the stage and location of the cancer, some or all the lymph nodes in the neck may have to be removed. Patients with laryngeal cancer who receive radiation therapy or chemoradiotherapy usually do not need a neck dissection. A patient may have varying degrees of stiffness in the shoulder and the neck and loss of sensation in the neck after this type of surgery. Laser surgery. Laser surgery uses a beam of light to remove a small tumor in the larynx or perform a partial laryngectomy.

This tool is a relatively new treatment approach that should only be performed by an experienced doctor. Other types of surgery that may be used during treatment for laryngeal or hypopharyngeal cancer include:. As part of both a partial and total laryngectomy, the surgeon makes a hole called a stoma in the front of the neck into the windpipe or trachea. This surgical procedure may also be called a tracheotomy. A tube is often inserted to keep the hole open. Air enters and leaves the windpipe, called the trachea, and lungs through the stoma, so the person can breathe.

For people who have a partial laryngectomy, the stoma is usually temporary. After recovery from the partial laryngectomy, the tube is removed, the hole heals shut, and the person can then breathe and talk in the same way as before the surgery. In some cases, the voice may be hoarse or weak, but it usually gets better as the person recovers from surgery. For people who have a total laryngectomy, the stoma is permanent.

The tube is removed but the person will continue to breathe through the stoma and must learn to speak in a new way. For example, if the surgery requires major tissue removal, reconstructive or plastic surgery may be done to replace the missing tissue. In general, surgery often causes swelling of the mouth and throat, making it difficult to breathe. After the operation, the lungs and windpipe produce a great deal of mucus. The mucus is removed with a small suction tube until the person learns to cough through the stoma. Similarly, saliva may need to be suctioned from the mouth because swelling in the throat can prevent swallowing.

Talk with your doctor about what you can expect after surgery. In addition, surgery may cause permanent loss of voice or impaired speech, difficulty swallowing or talking, lymphedema, facial disfigurement, numbness in parts of the neck and throat, and less mobility in the shoulder and neck area.

Surgery can also decrease thyroid gland function, especially after a total laryngectomy. Rehabilitation of lost or altered physical functions and emotional support services are important parts of care after surgery. This may take time and require the expertise of different members of the treatment team. Patients are encouraged to talk with their health care team about what to expect before having any type of surgery. Systemic therapy is the use of medication to destroy cancer cells.

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This type of medication is given through the bloodstream to reach cancer cells throughout the body. Systemic therapies are generally prescribed by a medical oncologist, a doctor who specializes in treating cancer with medication. Common ways to give systemic therapies include an intravenous IV tube placed into a vein using a needle or in a pill or capsule that is swallowed orally. Each of these types of therapies is discussed below in more detail. A person may receive 1 type of systemic therapy at a time or a combination of systemic therapies given at the same time. The medications used to treat cancer are continually being evaluated.

Talking with your doctor is often the best way to learn about the medications prescribed for you, their purpose, and their potential side effects or interactions with other medications. It is also important to let your doctor know if you are taking any other prescription or over-the-counter medications or supplements. Herbs, supplements, and other drugs can interact with cancer medications. Learn more about your prescriptions by using searchable drug databases. Chemotherapy is the use of drugs to destroy cancer cells, usually by keeping the cancer cells from growing, dividing, and making more cells.

What is Hypopharyngeal Cancer?

A chemotherapy regimen, or schedule, usually consists of a specific number of cycles given over a set period of time. A patient may receive 1 drug at a time or a combination of different drugs given at the same time. For laryngeal and hypopharyngeal cancer, chemotherapy may be used before surgery, radiation therapy, or both.

This is called neoadjuvant therapy. The side effects of chemotherapy depend on the individual and the dose used, but they can include fatigue, lowered blood counts, nausea and vomiting, hair loss, loss of appetite, diarrhea, dry mouth, hearing loss, and open sores in the mouth that can lead to infections. This type of treatment blocks the growth and spread of cancer cells while limiting damage to healthy cells.

Not all tumors have the same targets. To find the most effective treatment, your doctor may run tests to identify the genes, proteins, and other factors in your tumor.

This helps doctors better match each patient with the most effective treatment whenever possible. In addition, research studies continue to find out more about specific molecular targets and new treatments directed at them. Learn more about the basics of targeted treatments. Cetuximab Erbitux is a targeted treatment approved for use in combination with radiation therapy for head and neck cancer that has not spread.

It is also approved for use with chemotherapy to treat patients with metastatic cancer see below. Talk with your doctor about possible side effects for a specific medication and how they can be managed. Immunotherapy, also called biologic therapy, is designed to boost the body's natural defenses to fight the cancer.

It uses materials made either by the body or in a laboratory to improve, target, or restore immune system function. There are 2 immunotherapy drugs, nivolumab Opdivo and pembrolizumab Keytruda , that are approved for the treatment of patients with recurrent or metastatic squamous cell carcinoma after chemotherapy with a platinum-based drug has stopped working.

Immunotherapy in combination with chemotherapy and radiation therapy may also be used in clinical trials. Different types of immunotherapy can cause different side effects. Common side effects include skin reactions, flu-like symptoms, diarrhea, and weight changes. Talk with your doctor about possible side effects for the immunotherapy recommended for you.

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Learn more about the basics of immunotherapy. Cancer and its treatment cause physical symptoms and side effects, as well as emotional, social, and financial effects. Managing all of these effects is called palliative care or supportive care. It is an important part of your care that is included along with treatments intended to slow, stop, or eliminate the cancer. Palliative care focuses on improving how you feel during treatment by managing symptoms and supporting patients and their families with other, non-medical needs.

Any person, regardless of age or type and stage of cancer, may receive this type of care. And it often works best when it is started right after a cancer diagnosis. People who receive palliative care along with treatment for the cancer often have less severe symptoms, better quality of life, and report they are more satisfied with treatment. Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional and spiritual support, and other therapies. You may also receive palliative treatments similar to those meant to get rid of the cancer, such as chemotherapy, surgery, or radiation therapy.

Before treatment begins, talk with your doctor about the goals of each treatment in the treatment plan. You should also talk about the possible side effects of the specific treatment plan and palliative care options. During treatment, your health care team may ask you to answer questions about your symptoms and side effects and to describe each problem. Be sure to tell the health care team if you are experiencing a problem.

This helps the health care team treat any symptoms and side effects as quickly as possible. It can also help prevent more serious problems in the future. Learn more about the importance of tracking side effects in another part of this guide. Learn more about palliative care in a separate section of this website. If cancer spreads to another part in the body from where it started, doctors call it metastatic cancer.

If this happens, it is a good idea to talk with doctors who have experience in treating it. Doctors can have different opinions about the best standard treatment plan. Clinical trials might also be an option. Learn more about getting a second opinion before starting treatment, so you are comfortable with your chosen treatment plan. Typically, the treatment recommendation includes systemic chemotherapy, either using standard drugs or drugs being studied as part of a clinical trial.

Your treatment plan may also include a combination of targeted therapy, immunotherapy, surgery, or radiation therapy. Some clinical trials focus on treating tumors with specific genetic changes, called mutations. To participate in these kinds of clinical trials, patients will need to have their tumor undergo molecular testing. These kinds of laboratory tests look for specific genes, proteins, or other factors unique to the tumor.

Palliative care will also be important to help relieve symptoms and side effects. For most people, a diagnosis of metastatic cancer is very stressful and, at times, difficult to bear. You and your family are encouraged to talk about how you feel with doctors, nurses, social workers, or other members of the health care team.

It may also be helpful to talk with other patients, including through a support group. A remission is when cancer cannot be detected in the body and there are no symptoms. A remission may be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. While many remissions are permanent, it is important to talk with your doctor about the possibility of the cancer returning. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the cancer does return.

Learn more about coping with the fear of recurrence.

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If the cancer returns after the original treatment, it is called recurrent cancer. It may come back in the same place called a local recurrence , nearby regional recurrence , or in another place distant recurrence. Most recurrences in the same place or in the neck happen in the first 18 to 24 months after the original treatment. Following are common risk factors for the disease:.

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The symptoms below may be caused by hypopharyngeal cancer. Other conditions may cause the same symptoms, and so it is important to talk to your doctor if you experience of the following:. Learn About Diagnosis of Hypopharyngeal Cancer. If hypophyaryngeal cancer is diagnosed, the doctor needs to know the stage, or extent, of the disease to plan the best treatment. Staging is a careful attempt to find out whether the cancer has spread, and if so, to what parts of the body. Stage 0 Carcinoma in Situ - In stage 0, abnormal cells are found in the lining of the hypopharynx.

These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ. Stage II - In stage II, the tumor is either larger than two centimeters but not larger than four centimeters and has not spread to the larynx voice box or found in more than one area of the hypopharynx or in nearby tissues. Cancer may have spread to one lymph node on the same side of the neck as the tumor and the lymph node is three centimeters or smaller.

Stage IVA - The cancer has spread to cartilage around the thyroid or trachea, the bone under the tongue, the thyroid, or nearby soft tissue. Cancer may have spread to one lymph node on the same side of the neck as the tumor and the lymph node is three centimeters or smaller or it has spread to one lymph node on the same side of the neck as the tumor the lymph node is larger than three centimeters but not larger than six centimeters or to lymph nodes anywhere in the neck affected lymph nodes are six centimeters or smaller.

Stage IVB - The tumor has spread to muscles around the upper part of the spinal column, the carotid artery, or the lining of the chest cavity and may have spread to lymph nodes which can be any size or may be any size and has spread to one or more lymph nodes that are larger than six centimeters. Stage IVC - The tumor may be any size and has spread beyond the hypopharynx to other parts of the body. Knowing the stage assists the doctor in determining a prognosis.

It also better helps you understand the care and treatment that will be required. Different types of treatment are available for patients with hypopharngeal cancer. Some treatments are standard the currently used treatment , and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer.

Your treatment options depend on the stage of cancer, your overall health and your preferences about treatment. In metastatic disease, the location and extent of the hypopharyngeal cancer is also an important consideration. In all cases, treatment should be individualized for you. Although cancers are classified into particular stages, each person is unique. You do not have to rush to make a decision, so consider the options carefully.

Research shows that cancer survivors of all educational levels and backgrounds can have a hard time communicating with their health care team. One of the best ways to improve communication with your health care team is to prepare your visits so that you can best make use of the time.

A treatment plan is a way to deal with both the short and long term goals of managing your hypopharyngeal cancer. Patients have time for second opinions and to talk through all of their options with their doctors and develop a treatment plan that best fits their needs. Standard Treatments. Providing professional programs of emotional support, education and hope for people impacted by cancer at no charge so that no one faces cancer alone.

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Hypopharyngeal Cancer Treatment (Adult) (PDQ®)–Patient Version - National Cancer Institute

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