Pharyngeal Cancer - Types, Symptoms, and Treatment

What Is Pharyngeal Cancer?

Pharyngeal cancer, also called throat cancer, is a subtype of head and neck cancer that occurs when the cells in the pharynx grow abnormally and destroy healthy tissues. The pharynx is a funnel-shaped passage that connects the mouth and nose to the larynx and esophagus. It has three parts: the nasopharynx, oropharynx, and laryngopharynx. The functions of the pharynx include:

• Delivering liquids and foods to the digestive system.

• Carrying air to the respiratory system.

• Pushing food into the esophagus.

• Draining fluid and equalizing pressure in the ears.

Cancer in the pharynx can affect its normal functions and lead to severe complications such as difficulty swallowing, sore throat, and feeling of fullness in the ears. It can also metastasize to other body parts, especially the lymph nodes causing more severe symptoms. Treatment for pharyngeal cancer depends on the tumor's underlying cause, site, and severity.

What Are the Different Types of Pharyngeal Cancer?

Pharyngeal cancer is of three types that are named depending on where the disease originates. The pharyngeal cancer family includes the following cancers;

• Nasopharyngeal Cancer: Nasopharyngeal cancer forms in the upper part of the pharynx, called the nasopharynx, which connects the nose to the pharynx. In this disease, the cancer cells develop in the tissues of the nasopharynx, invade the surrounding structures, and eventually metastasize (cancer spread) to other body parts. It can develop at any age, and most cases are diagnosed in people younger than 55. Early detection and treatment can help cure this condition. However, treatment options usually depend on the stage and severity of cancer.

• Oropharyngeal Cancer: Oropharyngeal cancer develops in the middle portion of the pharynx, which includes the base of the tongue, tonsils, soft palate, and the walls and sides of the throat. It is mostly seen in people under 55 years of age and rare in children. The average age of oropharyngeal cancer diagnosis is 62. Men are more commonly affected than women. Nearly 90 percent of oropharyngeal cancers are squamous cell carcinoma, cancer that develops in the squamous cells that line the mouth and throat. It can also metastasize and involve nearby organs, especially the lungs.

• Hypopharyngeal Cancer: Hypopharyngeal cancer is characterized by the growth of malignant cells in the lower part of the pharynx. It is a rare form of pharyngeal cancer. It most commonly develops in people older than 50, and men are most commonly affected. It is often diagnosed at a later stage and has a poor prognosis.

What Are the Causes of Pharyngeal Cancer?

The exact cause of pharyngeal cancer is not unknown. However, genetic mutation is considered one of the main causes, but the underlying cause of the mutation is not clear. In general, some risk factors contribute to the development of pharyngeal cancer. It includes;

• Family history of head and neck cancers.

• Tobacco consumption.

• Exposure to toxic substances.

• Older age.

• Excessive alcohol consumption.

• The Epstein-Barr virus is a major risk factor for nasopharyngeal cancer.

• Human papillomavirus (HPV) is a major risk factor for oropharyngeal cancer.

• Gastroesophageal reflux disease (GERD) is a digestive disorder in which stomach acid persistently flows back into the esophagus and causes irritates the lining of the esophagus.

• Excess consumption of meat and meat products.

What Are the Symptoms of Pharyngeal Cancer?

In general, the symptoms of pharyngeal cancer are mild and non-specific. Some patients do not experience symptoms until the disease progresses to an advanced stage. A painless lump in the neck is the most common clinical feature of pharyngeal cancer. The other common symptoms of pharyngeal cancer include;

• Swelling in the neck.

• Sore throat.

• Difficulty in swallowing.

• Ear pain.

• Hoarseness.

• Changes in hearing.

The most common and specific symptoms of nasopharyngeal cancer include;

• Nasal congestion.

• Facial pain or numbness.

• Headaches.

• A feeling of fullness in the ear.

• Ear infections.

• Blurred vision.

Oropharyngeal cancer often causes issues with tongue movements and mouth opening. The symptoms of hypopharyngeal cancer may include high-pitched sounds while breathing and a hoarse voice.

How Is Pharyngeal Cancer Diagnosed?

To diagnose pharyngeal cancer, the healthcare providers primarily enquire about the medical and family history of the patient. They also conduct an oral and physical examination to look for signs and symptoms of the condition. The doctor might recommend specific tests for a more precise diagnosis of the condition. It includes;

1. Imaging Tests: Imaging tests help diagnose pharyngeal cancer by providing detailed images of the pharynx. It helps determine the size, location, and extent of the tumor. The standard imaging tests used for pharyngeal cancer diagnosis include;

• Computed Tomography (CT) Scan: It provides cross-sectional images of the pharynx that helps determine the tumor size and invasion into nearby tissues. It also determines whether cancer has spread to the other body organs or not.

• Magnetic Resonance Imaging (MRI): MRI uses a magnetic field and radio waves to provide detailed images of the internal body structures. It helps detect the size, location, and extent of the tumor.

• Chest X-Ray: Chest X-ray help determines pharyngeal cancer metastasis to the lungs.

• Pharyngoscopy: Pharyngoscopy is a diagnostic test that helps visualize the pharynx (throat above the voice box). In addition, it helps detect any abnormality in the pharynx. The procedure is performed under general anesthesia and takes approximately 10 to 20 minutes.

• Laryngoscopy: Laryngoscopy helps determine any abnormality in the larynx (voice box). In this test, the doctors use a flexible instrument called the laryngoscope to detect any tumor in the larynx.

2. Biopsy: Doctors recommend a biopsy to have a definitive diagnosis. In a biopsy, a small tumor tissue sample is removed from the affected area and sent to the laboratory for pathological examination. The doctors use a biopsy to differentiate pharyngeal cancer from other noncancerous conditions that develop in the throat.

Besides these tests, doctors might recommend for human papillomavirus test (HPV test) to detect human papillomavirus association with nasopharyngeal cancer.

How Is Pharyngeal Cancer Treated?

The treatment for pharyngeal carcinoma depends on the following factors;

• Type of pharyngeal cancer.

• Site of the tumor.

• Stage and severity of cancer.

• Cancer metastasis.

The standard treatment options for pharyngeal cancer include;

• Surgery: Surgery is an effective treatment option for small-sized pharyngeal tumors. The main aim of surgery is to remove cancer as much as possible without causing damage to the healthy tissues. Surgeries indicated in pharyngeal cancer include endoscopic surgery, partial or complete pharyngectomy, and laryngectomy.

• Radiation Therapy: Radiation therapy uses high-energy X-rays to destroy cancer cells. It can be used as a mainstay treatment for early-stage pharyngeal cancer. It can be used alone or combined with other cancer treatments.

• Chemotherapy: Chemotherapy uses drugs to kill cancer cells. For example, it can be used with radiation therapy to treat pharyngeal cancers. This treatment is known as chemoradiation.

• Targeted Therapy: Targeted therapy uses specialized drugs to target and kill cancer cells. It is preferred over chemotherapy since it has fewer side effects.

• Immunotherapy: Immunotherapy utilizes and stimulates one's immune system to kill cancer cells.

Can Pharyngeal Cancer Be Prevented?

No, there are no proven ways to prevent pharyngeal cancer. However, following certain measures can reduce the risk of developing it. It includes;

• Quit tobacco smoking.

• Avoid excess alcohol consumption.

• Eat healthy fruits and vegetables.

• Taking the human papillomavirus (HPV) vaccine.

Conclusion

Pharyngeal cancer can be cured if diagnosed at early stages. However, the success rate of cure declines as the disease progress to advanced stages. The prognosis of pharyngeal cancer differs with the type and severity of cancer. The overall five-year survival rate for nasopharyngeal cancer is 61 percent and for oro-pharyngeal cancer is 70 percent.