Pharyngeal cancer actually does not really exist: taking into account the location and the cells most often affected by cancer in this area, doctors and scientists distinguish three types of cancer. So you may suffer from a cancer of the nasopharynx, oropharynx or hypopharynx. They are part of ENT cancers (mouth cancer, throat cancer, etc.).
The vast majority of cancers located in different parts of the pharynx are squamous cell carcinomas, meaning they appear in the squamous cells that line the mucosa. However, each type of pharyngeal cancer presents specificities, particularly in terms of the risk factors playing a role in their occurrence.
1. Definition: where is the pharynx located?
To fully understand the different types of pharyngeal cancers and their specificities, it is important to focus on the anatomy of this area of the human body. The pharynx simply characterizes, under a medical term, the throat. It is a funnel-shaped muscular tube in the middle of the neck that connects the mouth and nose to the esophagus (which sends food to the stomach) and larynx. (which conducts air towards the trachea then towards the lungs). The pharynx plays several roles in the human body. It allows the passage of air between the nasal cavity and the respiratory system. It is also the passageway for food and drinks, which are then transported to the digestive system – with a sorting function, to avoid wrong routes. It also has a role in regulating pressure in the ears, which is why you have to pinch your nose to regain your hearing after a plane trip or at altitude. The pharynx is divided into several parts, which are, from top to bottom:
- the nasopharynx, the area of the throat located behind the nose;
- the oropharynx, which is located behind the mouth;
- the laryngopharynx, better known as the hypopharynx, which is located in the lower area of the throat.
2. Nasopharyngeal cancer: what are we talking about?
Most of the time, nasopharyngeal cancer appears in epithelial cells: the cells that cover the surface of the nasopharynx. According to the National Cancer Institute, the 5-year survival rate for people with nasopharyngeal cancer is 66%.
3. Hoarseness, tinnitus, metastases… What are the first symptoms of nasopharyngeal cancer?
People affected by nasopharyngeal cancer usually have one or more lumps at the back of the neck. In most cases, these masses are not painful. The problem is that these masses become visible when the cancer cells have spread to the lymph nodes in the neck. Certain warning symptoms of nasopharyngeal cancer can sometimes be detected by the sick person:
The symptoms of nasopharyngeal cancer are very similar to those of other upper airway diseases. This is why it is rarely diagnosed at an early stage. Make an appointment with your doctor if you notice one or more of these symptoms, so that he or she can quickly make a diagnosis.
4. What are the risk factors for nasopharyngeal cancer?
Certain risk factors seem to favor the appearance of nasopharyngeal cancer, in particular:
- An infection with the Epstein-Barr virus (EBV). This is the virus that also causes mononucleosis. The Epstein-Barr virus is very often present in people who have been diagnosed with nasopharyngeal cancer. However, rest assured: not everyone who has been infected with EBV has nasopharyngeal cancer.
- A diet rich in salted meat and fish and foods preserved with nitrites.
5. Oropharyngeal cancer: what is it?
Oropharyngeal cancer appears in most cases in the squamous cells (also called squamous cells) which cover the walls of the oropharynx. The oropharynx includes the base of the tongue, the tonsils, the soft palate, and the central portion of the pharyngeal wall. The National Cancer Institute reports that the 5-year survival rate for people who develop oropharyngeal cancer is 41% for men and 53% for women.
6. Oropharyngeal cancer: what are the symptoms of throat cancer?
What complicates the diagnosis and therefore the treatment of oropharyngeal cancer is the fact that its symptoms often pass for those of benign conditions. People who suffer from it do not necessarily consult their doctor, believing that they will pass, without suspecting that it is in reality a serious illness. Indeed, the most common symptoms of oropharyngeal cancer are:
7. Papillomavirus, alcohol, tobacco… What are the risk factors for oropharyngeal cancer?
The most common cause of oropharyngeal cancer is infection with the human papillomavirus, or HPV. This virus produces proteins that change the genes of the cells lining the mouth and throat, particularly the rate at which these cells multiply. Oropharyngeal cancer therefore appears when cells with mutated genes grow uncontrollably and clump together to form tumors. Other risk factors have been established:
- Tobacco consumption in its different forms: smoking cigarettes and cigars or using chewing tobacco. Tobacco products damage the cells that cover the oropharynx. In response, they begin to multiply and divide more than usual. The more they divide to compensate for damaged cells, the more likely they are to create cells with mutations in their DNA, which increases the risk of cancer cells appearing.
- Alcohol abuse: the effect of alcohol on the cells of the throat is identical to that of tobacco.
8. Hypopharyngeal cancer: what is it?
Hypopharyngeal cancer most often occurs in squamous cells lining the walls of the hypopharynx. Pharyngeal cancer has the worst prognosis: 5-year survival is only 26%.
9. What are the signs of hypopharyngeal cancer?
The low survival rate of hypopharyngeal cancer is explained by the fact that it has mild symptoms. In the early stages of the disease, people often don’t notice any signs, or they think it’s just a minor illness. Hypopharyngeal cancer can cause:
- a change in the voice, which seems to become hoarser;
- the appearance of a mass, palpable along the neck;
- a sore throat that persists for several weeks;
- difficulty swallowing, which causes loss of appetite;
- pain, ringing, or a feeling of a lump inside one or both ears.
10. What are the risk factors for hypopharyngeal cancer?
As with many head and neck cancers, smoking and alcohol abuse play a significant role in the development of hypopharyngeal cancer. Alcohol and chemicals in smoking or chewing tobacco damage the cells of the hypopharynx over time. The more a person drinks alcohol or uses tobacco products, and the longer it lasts, the higher their risk of developing hypopharyngeal cancer.
11. Treatments and operations: how to treat the different types of pharyngeal cancer?
Treatment for pharyngeal cancer (whether nasopharyngeal, oropharyngeal, or hypopharyngeal cancer) is different for each sick person. The personalized care protocol is established by the multidisciplinary team based on the stage of the cancer, its primary cause, its location, and whether it has metastasized elsewhere in the body or not. The treatments implemented for these cancers generally include:
- surgery to remove the tumor and sentinel lymph nodes;
- radiotherapy to eliminate cancer cells;
- chemotherapy, in combination with radiotherapy, to destroy rapidly multiplying cancer cells;
- targeted therapies to eliminate cancer cells by targeting their specificities;
- immunotherapy to teach the patient’s immune system to better destroy cancer cells.
Clinical trials can also be offered to people with pharyngeal cancer, in order to improve their chances of survival.
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