The treatments used for each patient with hypopharyngeal cancer depend on the stage and the patient’s overall health condition. There are standard treatments as well as some being tested in clinical trials. Early hypopharyngeal cancer may be treated with surgery and usually radiation therapy. More advanced cancer may require additional treatments to be sure all cancer cells in the body are killed.
The recommended treatments may also change based on where the cancer is located to give the patient the best chance at keeping their ability to talk, eat, and breathe as normal as possible.
Most patients will have surgery to remove the tumor in the throat and/or lymph nodes or other tissue in the neck. One of the following surgical procedures may be used:
Laryngopharyngectomy: Surgery to remove the larynx (voice box) and part of the pharynx (throat).
Partial laryngopharyngectomy: Surgery to remove part of the larynx and part of the pharynx. A partial laryngopharyngectomy prevents loss of the voice.
Neck dissection: Surgery to remove lymph nodes and other tissues in the neck.
For patients whose cancer hasn’t spread outside of the hypopharynx, radiation therapy may be used after surgery to ensure any remaining cancer cells left behind are killed. High-energy radiation is used to kill cancer cells in the area where the surgery was performed. In some cases you may be given radiation therapy before surgery to shrink the cancer cells so that less tissue needs to be removed. These patients usually also have radiation therapy after surgery as well.
External beam radiation is the most common radiation therapy used to treat hypopharyngeal cancer. At RCOG, we typically use intensity modulated radiation therapy (IMRT) — an advanced form of external beam radiation treatment. IMRT allows precise targeting of tumor cells with high-energy beams of radiation that can be adjusted to different levels of intensity. This helps the radiation oncologist deliver a higher dose to the targeted area while limiting damage to surrounding healthy tissue. If you or someone you love has been diagnosed with hypopharyngeal cancer you have options for where to receive radiation therapy in the Atlanta area.
Not all patients need to continue with other therapies. If your oncologist feels there’s a chance that cancer cells moved to the lymph nodes, or the cancer isn’t completely removed through surgery and radiation, a combination of the following types of cancer treatments may be recommended as the next step.
Chemotherapy: the use of drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. Chemotherapy may be used to shrink the tumor before surgery or radiation therapy. This is called neoadjuvant chemotherapy.
Targeted therapy: a special type of systemic therapy, usually given in the same ways as chemotherapy. This type of therapy takes advantage of differences between normal cells and cancer cells, attacking only the cancerous cells, not the healthy ones.
Currently, there is one targeted treatment (Cetuximab) approved for use in combination with radiation therapy for head and neck cancer that has not spread. Others are being tested in clinical research trials.
Immunotherapy: the use of medicines that help a person’s own immune system find and destroy cancer cells more effectively. For hypopharyngeal cancer, immune checkpoint inhibitors can be used. Cancer cells are able to trick the immune system into thinking they are healthy cells so they’re not attacked as a foreign body. This is done by turning off the “checkpoints” that would normally identify the cancer cell as something to attack. Drugs that target these checkpoints, called checkpoint inhibitors, may be added to the treatment plan, allowing the patient’s immune system to fight the cancer cells.
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