Understanding Hypopharyngeal Cancer

Overview

Hypopharyngeal cancer, also known as head and neck cancer, is an atypical type of throat cancer. Most hypopharyngeal cancers are classified as squamous cell carcinoma, which affects the cells that compose the lining of the throat. These types of cancers are smoking-associated. However, other rarer types of cancer in this region can also occur and usually are not smoking-related.

Hypopharyngeal Cancer Causes

Tobacco & alcohol

Tobacco and alcohol consumption increases the likelihood of developing hypopharyngeal or laryngeal cancer. The usage of tobacco items, including cigarettes, chewing tobacco, cigars, and snuff, is the root cause of all head and neck cancers. 

The extent of smoking directly correlates with the magnitude of the individual’s risk. Additionally, smoking marijuana and exposure to secondhand smoke can also heighten the risk. 

Poor Diet

Individuals who consume a diet lacking essential nutrients and fail to obtain sufficient amounts of vitamins A and E from fresh produce may potentially face a higher vulnerability to hypopharyngeal cancer.

Dysphagia

Individuals who experience dysphagia or difficulty swallowing may face an elevated vulnerability to the growth of hypopharyngeal cancer.

Plummer Vinson Syndrome (PVS)

Plummer-Vinson syndrome (PVS) is characterized by swallowing difficulties and the frequent occurrence of iron-deficiency anaemia, cheilosis, glossitis, and oesophagal webs. Individuals affected by this syndrome face an elevated vulnerability to different forms of throat cancers, like hypopharyngeal cancer.

Race

Studies have shared that African Americans and Caucasians have a higher incidence of laryngeal and hypopharyngeal cancers in comparison with other racial groups.

Gender

Research highlights that the probability of men developing hypopharyngeal cancer is four times higher compared to women. This disparity can be ascribed to historical patterns where men were more prone to immoderate smoking and alcohol consumption than women.

Anemia 

Anaemia is a condition that frequently leads to blood-related issues in individuals from a young age. People diagnosed with anaemia are particularly susceptible to developing hypopharyngeal, laryngeal, and oropharyngeal cancers.

Biological factors and genetic deficiencies

Biological factors and genetic deficiencies play a significant role in this increased risk. Individuals with specific genetic diseases, defects, or syndromes are more likely to develop hypopharyngeal cancer.

Age Factor

Individuals who are middle-aged or older may face a higher risk because this particular form of cancer typically needs a considerable amount of time to develop. In reality, more than half of those diagnosed with hypopharyngeal or laryngeal cancer are 65 years old or above.

Exposure To Certain Chemicals

Workers in industries like metalworking, construction, textile, and petroleum may face a heightened risk of developing hypopharyngeal cancer due to regular exposure to specific chemicals, paint fumes, wood dust, or asbestos.

Risk Factors

Dyskeratosis congenita is a genetic disorder that creates a considerable risk of head and neck cancer, particularly among the younger population. This condition can result in aplastic anaemia and issues with the skin and nails.

Fanconi anaemia, a hereditary genetic disorder characterized by an exceptionally heightened susceptibility to oral and pharyngeal malignancies, can also result in the development of leukaemia or myelodysplastic syndrome.

Plummer-Vinson syndrome is characterized by dysphagia and anaemia, which is created by an iron deficiency.

Human papillomavirus (HPV) can be transmitted via unprotected sexual activity and is associated with rare cases of hypopharyngeal and laryngeal cancers. 

Certain strains of this prevalent virus are known to be associated with cancers of the cervix, genitals, anus, and throat, particularly the oropharynx, which is the middle or back part of the throat situated just above the hypopharynx. 

Gastroesophageal reflux disease (GERD) is a condition marked by the regular flow of stomach acid into the oesophagus, elevates the risk of oesophagal cancer and may contribute to the development of hypopharyngeal cancer.

Symptoms of Hypopharyngeal cancer

Symptoms of hypopharyngeal cancer may vary among patients and can frequently go unnoticed for a considerable period. Common symptoms encompass:

• Difficulty breathing
• Difficulty and pain with swallowing
• Unexplained ear discomfort
• Coughing blood
• Hoarse voice
• Painless lump or mass on the neck

Hypopharyngeal Cancer Diagnosis and Detection

During an annual physical, individuals who engage in smoking or alcohol consumption may go through a comprehensive examination of their mouth, throat, and neck by a doctor to identify any unusual bumps or lesions. 

Multiple investigative methods can be employed if potential signs of cancer are detected.

First, the doctor may perform a more elaborate physical examination, potentially using a mirror to examine the patient’s throat. Moreover, the doctor may test the patient’s blood or urine for cancer indications.

A flexible, lighted scope is inserted via the patient’s nose or mouth to examine the throat thoroughly. Before inserting the scope, an anaesthetic spray may be used to numb the pathway.

For a more extensive examination that involves collecting a tissue sample, known as a biopsy, the patient may require to be sedated or given a general anaesthetic. 

A biopsy is essential as it helps confirm the diagnosis, and analyzing the tumour sample can give valuable information to guide the treatment. This comprehensive procedure called a triple endoscopy, allows for the examination of the hypopharynx, larynx, nose, ear, and windpipe sections.

If cancer is detected, various imaging techniques may be used to collect more information about it, including its spread or metastasis. Some of these imaging tests include:

• X-ray
• Ultrasound
• Barium swallow
• Magnetic resonance imaging (MRI) scan
• Computed tomography (CT) scan
• Positron emission tomography (PET) scan
• Bone scan
• Hypo

Hypopharyngeal Cancer Staging

The results obtained from various scans and tests are to determine the stage of the cancer. The staging methods may vary, but generally, the size and location of the original tumour, the presence of cancer in lymph nodes or other tissues, and whether it is a recurrent early-stage cancer are considered into account. 

The cancer is allocated a score ranging from 0 to 4, with a higher number implying a more advanced stage. These numbers can be categorized into groups using letters for more specific stage information.

Hypopharyngeal cancer can potentially extend to neighbouring tissues in the neck, such as the larynx, oesophagus, trachea, hyoid bone, lymph nodes, and carotid arteries. It can also metastasize to distant areas in the spinal column, chest, and other body parts.

Treatment For Patients With Hypopharyngeal Cancer

Surgery

Surgery is a regular treatment for hypopharyngeal cancer at all stages. Several surgical procedures may be employed:

1. Laryngopharyngectomy: This surgery involves the removal of the larynx (voice box) and a portion of the pharynx (throat).

2. Partial laryngopharyngectomy: In this procedure, a part of the larynx and a portion of the pharynx are removed. It is performed to prevent the loss of the patient’s voice.

3. Neck dissection: This surgery removes lymph nodes and other tissues in the neck.

Following the surgical removal of visible cancer, some patients may get chemotherapy or radiation therapy to eliminate any remaining cancer cells. This additional treatment, administered after surgery to reduce the risk of cancer recurrence, is known as adjuvant therapy.

Radiation therapy

Radiation therapy is a medical procedure employed to combat cancer by using high-energy X-rays or different forms of radiation to eliminate cancer cells or impede their growth. 

In external radiation therapy, a device positioned outside the body emits radiation towards the particular region affected by cancer.

Patients who have stopped smoking before commencing treatment may experience enhanced effectiveness of radiation therapy. It is worth noting that external radiation therapy targeting the thyroid or pituitary gland can potentially change the functioning of the thyroid gland. 

To ensure the correct functionality of the thyroid gland, a blood test may be conducted both before and after therapy to assess the levels of thyroid hormone in the body.

Chemotherapy

Chemotherapy is a form of cancer treatment that employs medication to halt the proliferation of cancer cells. It achieves this by either eliminating the cells or hindering their division. 

When administered orally or through injection into a vein or muscle, the drugs enter the bloodstream and can successfully target cancer cells throughout the entire body (known as systemic chemotherapy).

Neoadjuvant chemotherapy, on the other hand, is designed to reduce the size of the tumour before surgery or radiation therapy.

Prevention of Hypopharyngeal Cancer

Quit smoking

Refrain from indulging in any form of tobacco, as it is a highly effective measure to prevent hypopharyngeal cancer. This encompasses abstaining from cigarettes, pipes, cigars, chewing tobacco, and betel quid-containing tobacco.

Avoid initiating the use of tobacco in any form. If you are presently a tobacco user, seek assistance to quit. By quitting, you considerably reduce your chances of developing hypopharyngeal cancer. 

Former tobacco users have a lesser risk compared to current users. The risk of cancer declines with each passing year since you quit.

Quit Alcohol

Alcohol consumption is a well-known factor that increases the likelihood of developing hypopharyngeal cancer. However, the risk becomes even more significant when alcohol is combined with tobacco smoking, increasing the chances of developing not only hypopharyngeal cancer but also other head and neck cancers. 

It is recommended to abstain from consuming alcohol altogether to reduce your risk of cancer. If you do choose to consume alcohol, it is essential to keep your cancer risk at a minimum by limiting yourself to no more than two standard drinks per week. Remember, the less alcohol you consume, the lower your risk of developing cancer.

Avoid Human Papillomavirus Infection (HPV)

It is crucial to refrain from engaging in any form of genital contact with another person to minimize the risk of acquiring an HPV infection. You can significantly reduce the chances of contracting the virus by altogether avoiding such contact.

Eat Fruits & Vegetables

Consuming a diet rich in vegetables and fruits has been found to potentially provide a degree of defence against hypopharyngeal cancer, as highlighted by specific studies. These nutritious foods are essential components of a well-balanced diet, so it is advisable to incorporate a diverse range of vegetables and fruits into your daily meals.

Adhere To Safety Protocols In The Workplace

It is essential to adhere to safety protocols in the workplace. Exposure to cement dust, coal dust, or formaldehyde can considerably increase the chances of developing hypopharyngeal cancer. To minimize the risk, it is essential to strictly follow all safety instructions provided and avoid inhaling these hazardous substances.

Conclusion

The hypopharynx, situated at the throat’s base, is the junction between the trachea (windpipe) and the oesophagus. The onset of cancer occurs when cells undergo uncontrolled growth, leading to the formation of tumours or lesions.

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