Diagnosis and Treatment of Pharyngeal Cancers
The pharynx, medically called pharynx or pharynx, is an important part of the digestive tract located at the back of the oral and nasal cavity. The pharynx acts as a passageway for food to pass into the oesophagus and also contributes to the respiratory system. The pharynx is an approximately 50 cm long, tubular organ made up of muscle and mucosa.
The pharynx begins at the base of the skull and its lower end is at the 6th cervical vertebra. This long structure is connected to the nasal cavity at its upper end and continues with the oesophagus at its lower end. The pharynx is divided into three main parts.
Pharyngeal cancer refers to a condition in which a cancerous tumour of the pharynx develops. This cancer is usually caused by flat cells (squamous cells) lining the inner surface of the pharyngeal mucosa. In Western countries, types of pharyngeal cancer are often associated with smoking and alcohol consumption. This type of cancer is usually more common in men and the risk increases with age.
Types and Symptoms of Pharyngeal Cancer
1. Nasopharyngeal (nasal) cancer: It usually develops behind the nose and this part belongs to the respiratory system. Nasopharyngeal cancers are more common in Asian countries, especially in people aged 40-50 years. Symptoms may include nasal congestion, nosebleeds, nasal bleeding, nasal speech, unilateral or bilateral hearing loss, buzzing in the ear, swelling in the neck, numbness and tingling in the face, olfactory disturbances and regurgitation of liquids through the nose.
2. Oropharyngeal Cancer: It affects the middle part of the throat located at the back of the oral cavity. This area includes the back third of the tongue, soft palate, tonsils, side and back walls. Most oropharyngeal cancers are squamous cell carcinomas and symptoms include difficulty swallowing, sore throat and ear pain, cough, sputum containing blood, pain when swallowing, pain in the ear, a feeling of a mass in the throat or enlarged lymph nodes in the neck.
3. Hypopharynx (Lower Pharynx) Cancer: The hypopharynx is a region located at the back of the larynx, just above the oesophagus. Although this type of cancer is rare, treatment is difficult because it is usually diagnosed at an advanced stage. Diagnosis is made by endoscopic biopsy. In the initial stages, hypopharynx cancer may cause complaints such as difficulty swallowing, hoarseness, painful swallowing, pain in the ear, cough, coughing sputum containing blood, loss of appetite and weight loss.
Factors Causing Pharyngeal Cancers
Smoking stands out among the factors that cause the development of pharyngeal cancers. The risk of pharyngeal cancer is higher in smokers than in non-smokers. In addition, alcohol use can also increase the risk of pharyngeal cancer and the risk increases even more when combined with smoking. In addition, viruses such as Human Papillomavirus (HPV) can lead to pharyngeal cancers. Other risk factors include Wilson's disease, chronic nasal infections, consumption of smoked foods, poor diet, genetic predisposition and consumption of canned foods.
General Symptoms of Pharyngeal Cancer
Symptoms of pharyngeal cancer may vary depending on the location and extent of spread of the cancer, but the following general symptoms are common:
– Sore throat and foreign body sensation in the throat
– Difficulty in swallowing
– Swelling in the throat or neck
– Difficulty in swallowing and pain when swallowing
– Weight loss
– Cough
– Earache and/ or hearing loss
– Voice change
– Smell impairment
– Eye problems due to double vision and nerve involvement
– Backflow of ingested fluids through the nose
– Mass in the neck
– Numbness in the face symptoms
As these symptoms can be seen in pharyngeal cancer as well as in other diseases of the throat, larynx, respiratory tract and digestive system, it is important that people experiencing these symptoms consult a health professional. If symptoms last longer than a few weeks or worsen, the possibility of cancer should be considered.
Diagnosis of pharyngeal (pharyngeal) cancer
For the diagnosis of pharyngeal cancers, it is important to initially consult an ENT surgeon or head and neck surgeon. A careful examination of the pharynx and neck is necessary during the doctor's physical examination. During the examination, the inside of the pharynx can be visualised with the help of an oral mirror or endoscopic examinations. The lymph nodes affected by cancer of the pharynx are also checked during a neck examination.
Imaging modalities such as computed tomography (CT) and magnetic resonance imaging (MRI) are used to assess the spread and size of the cancer in the neck. Methods such as barium X-rays and ultrasonography can also be used to determine the final stages of cancer of the pharynx. In addition, a biopsy is taken to make a definitive diagnosis of the cancer and this tissue sample is subjected to pathological examination. In addition to cancer diagnosis, blood tests may also be ordered to determine the presence of viruses.
Pharynx (Swallow) Cancer Treatment
Many factors are taken into account in the treatment of cancer of the pharynx. The treatment plan depends on the location, size and spread of the cancer, the age and general health of the patient. Methods such as chemotherapy, radiotherapy and surgery are generally used in the treatment of cancer of the pharynx.
Nasopharyngeal cancers are often treated with radiotherapy and chemotherapy. Surgical treatment options may be limited due to the location of these cancers. Oropharyngeal cancers can be treated with surgical intervention, radiotherapy and/or chemotherapy according to the treatment plan. Although hypopharyngeal cancers are rare, treatment is difficult because they are usually diagnosed at advanced stages. Treatment is planned after diagnosis by endoscopic biopsy.