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Pharynx
General Information / Anatomy / Function / Statistics
The pharynx is made up of three general areas:
- The Nasopharynx which is the part of the airway that lies behind the nose and above the soft palate. The Eustachian tubes, which connect the middle ear to the throat, are found on the side walls of the nasopharynx
- The Oropharynx which lies at the back of the mouth and includes the soft palate, the tonsils (or the place where they used to lie if they have been removed), the posterior third of the tongue and the back or posterior wall of the throat
- The Hypopharynx which is the lower part of the throat that lies on either side of and behind the larynx and above the esophagus. It is consisted of three areas: postcricoid area (junction of pharynx and esophagus), pyriform sinus and posterior (back) pharyngeal wall
Symptoms / Signs
- Depends on the site. In all cases the first sign may not be from the primary tumour, but may be an enlarged, usually painless, lymph node in the neck. Some tumours may produce no symptoms and be found at a routine examination.
- Nasopharynx
- Nosebleeds, deafness or feeling that the ear won't "pop" (blocked Eustachian tube), persistent headache, double vision - due to involvement of the nerves that lie just above the nasopharynx, or change in sensation over the face
- Oropharynx
- Persistent sore throat, pain on swallowing, earache, coughing up blood, difficulty swallowing, change in voice or hoarseness
- Hypopharynx
- Persistent sore throat, pain or difficulty when swallowing, hoarseness
- Any of the above symptoms which persist for more than two weeks should be checked by a physician
Etiology / Carcinogens / Risks
- Cancer of the nasopharynx is more common in the Chinese population and is thought to be due to a combination of genetic predispositon, exposure to the Epstein Barr virus and diet as a child
- Some cancers of the nose are seen more frequently in furniture workers
- Tobacco and alcohol consumption increase the risk
- Most oropharyngeal cancers occur in men
Prevention
- Avoidance of tobacco products and excess alcohol consumption
Diagnosis / Staging / Grading / Types
- Complete physical examination
- Biopsy of abnormality
- X-rays and CT and MRI scans as appropriate
- The vast majority are squamous cell carcinomas (95%), they tend to be more aggressive than those arising in the mouth
- Greater tendency to spread more rapidly to lymph nodes in the neck and move to distant sites
Treatment
- The choice of treatment is determined by the anticipated functional and cosmetic results
- Radiation therapy is the treatment of choice for nasopharyngeal cancer
- Radiation therapy is the treatment of choice for small cancers of the oropharynx and
hypopharynx
- Surgery may also be used
- Radiation fields are usually planned to include the primary tumour and most of the lymph nodes in one or both sides of the neck
- Radiation treatment usually takes between 3 and 6.5 weeks
- More advanced cancers of the oropharynx and hypopharynx are often treated with combined radiation therapy and surgical excision, the sequence of the two treatments depends on the circumstances of each individual case
- Because of the low cure rate for patients with advanced tumours, studies of different radiation schedules - such as twice daily treatment - and the use of chemotherapy concurrently with radiation are in progress
Revised April 1998
March 2007 We are currently reviewing and updating these pages. If you have any questions about your cancer and its treatment, please discuss with your oncologist or physician. Thank you.
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