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Pharyngeal

Pharyngeal cancer starts in the pharynx. The pharynx is the tube that connects your nose to your larynx (voicebox) and the back of your mouth to your esophagus (swallowing tube).
This information should not be used to diagnose yourself or in place of a doctor's care.
Diagnosis & Staging

The pharynx has three parts:

  • Nasopharynx is the upper part of your pharynx. It is the part of your airway behind your nose and above your soft palate. The Eustachian tube from your middle ear enters the side wall of your nasopharynx.
  • Oropharynx is the middle part of your pharynx. It is the part at the back of your mouth. It includes the soft palate, the tonsils, the uvula, the base of the tongue and the back wall of your throat.
  • Hypopharynx, or laryngopharynx, is the lower part of your pharynx. It lies on either side of and behind the larynx. It connects to the esophagus.

Pharyngeal cancer may also be called throat cancer, pharyngeal tumour, nasopharyngeal cancer or carcinoma, NPC, or oropharyngeal cancer.

Pharyngeal cancers are rare in Canada.

What are the signs and symptoms of pharyngeal cancer?

Some cancers may not have any symptoms. These cancers may be found during a routine exam by a doctor or nurse practitioner.

A common symptom is a lump in the neck. This lump is usually painless.

Symptoms of nasopharyngeal cancer

  • Frequent nosebleeds.
  • Deafness in one ear.
  • Feeling that one of your ears will not "pop" (blocked Eustachian tube).
  • Headache that does not go away.
  • Double vision (cancer involves the nerves just above the nasopharynx).
  • Numbness or change in feeling on your face.

Symptoms of oropharyngeal cancer

  • Sore throat that does not go away.
  • Painful or difficulty swallowing.
  • Earache.
  • Coughing up blood.
  • Change in voice or hoarseness (raspy voice).

Symptoms of hypopharyngeal cancer

  • Sore throat that does not go away.
  • Painful or difficulty swallowing.
  • Hoarseness.

Many common symptoms of pharyngeal cancer are also symptoms of other conditions.  If you have any of the above symptoms for more than two weeks, see your doctor or nurse practitioner.

If you have any signs or symptoms that you are worried about, please talk to your family doctor or nurse practitioner.

How is pharyngral cancer diagnosed?

Tests that may help diagnose pharyngeal cancer include:

  • Exam of nose, mouth, throat, neck:  Doctor or nurse practitioner will often use a light and a mirror during the exam.
  • In-depth exam by head and neck specialist (otolaryngologist): Specialist will use an endoscope (thin tube with a light and camera at the end).
  • Biopsy: This is when a doctor takes a sample of your tissue. A specialty doctor (pathologist) then examines the tissue for cancer. 
  • Imaging: to see tumour and check if cancer has spread to other organs or tissues
    • CT (Computed Tomography) scan.
    • MRI (Magnetic Resonance Imaging).
    • PET (Positron Emission Tomography) scan.
    • X-ray.
    • Ultrasound.
    • Bone scan.
For more information on tests used to diagnose cancer, see BC Cancer Library screening and diagnosis pathfinder.


What are the types of pharyngeal cancer?

Nearly all pharyngeal cancers start in the cells that line the pharynx. These cancers are called squamous cell carcinomas.

What are the stages of pharyngeal cancer?

Staging describes the cancer. Staging is based on how much cancer is in the body, where it was first diagnosed, if the cancer has spread and where it has spread to.

The stage of the cancer can help your health care team plan your treatment. It can also tell them how your cancer might respond to treatment and the chance that your cancer may come back (recur). 

Pharyngeal cancer staging

  • Stage 1: The tumour is small and only in one area.
  • Stage 2: The tumour is more than 2 cm (0.75 inches) but less than 4 cm (1.5 inches). The tumour may have grown into the soft tissue of the throat.
  • Stage 3: The tumour is more than 4 cm and may have spread into nearby bone or sinuses.
  • Stage 4:  The tumour has spread into nearby structures such as the neck, larynx, esophagus, jaw and base of the skull. 
For more information about staging, see About Cancer.

What are the grades of pharyngeal cancer?

The grade of the cancer describes how different the cancer cells look from normal cells and how fast the cancer cells are growing. 

A pathologist will give the cancer a grade after looking at the cells under a microscope. Pharyngeal cancer can be grade 1, 2, or 3. The lower the number, the lower the grade. 

Low grade: cells are abnormal but look a lot like normal cells.  Low grade cancers usually grow slowly and are less likely to spread.

High grade: cells are abnormal and do not look like normal cells. High grade cancers usually grow more quickly and are more likely to spread.

The grade of the cancer can help your health care team plan your treatment.

Treatment

What is the treatment for pharyngeal cancer?

Cancer treatment may be different for each person. It depends on your particular cancer. Your treatment may be different from what is listed here.

Treatment for pharyngeal cancer depends on the type of cancer, the size and stage of the cancer, how old you are, and if you have any other medical conditions.

Surgery 

  • Sometimes used to remove lymph nodes the cancer has spread to.
  • More advanced cancers (stage 3 or 4) are often treated with surgery and radiation therapy.

Radiation Therapy (high energy x-rays that kill or shrink cancer cells)

  • Used for most early stage pharyngeal cancers.
  • Planning for pharyngeal radiation therapy is complex.  We will make you a custom mask to wear so that you do not move during treatment. Planning this radiation can take 7 to 10 days
  • BC Cancer radiation therapy information

Systemic Therapy

  • Systemic therapy alone will not cure pharyngeal cancers. It may be used with radiation therapy.
  • Nasopharyngeal cancers are more sensitive to systemic therapy than other cancers of the head and neck.

What is the follow-up after treatment?

  • Follow-up testing and appointments are based on the type and stage of your cancer.
  • Follow-up after treatment for pharyngeal cancer
  • These are guidelines written for your doctor, nurse practitioner or specialist. You can look at them to see what appointments and tests you might need after treatment.
  • It is very important that you are followed carefully by an oncologist or otolaryngologist for two years after your treatment.
  • Most cancer recurrences (when the cancer comes back) are found in the first two years after treatment. Nasopharyngeal cancers are more likely to come back.
  • After treatment, you will likely need to see a dietitian, a physiotherapist and a speech language pathologist. They will help you with side effects from treatment.
  • It is important you take care of your mouth and teeth.  Please read our Dry Mouth and Mouth Pain handout for tips on how to care for your mouth and teeth.
  • Life after Cancer has information on issues that cancer survivors may face.
More Information

What causes pharyngeal cancer and who gets it?

These are some of the risk factors for this cancer. Not all of these risk factors may cause this cancer, but they may help the cancer start growing.

  • Using tobacco, in any form. The longer you use it, the greater your risk of getting mouth cancer.
  • Drinking a lot of alcohol. 
  • Drinking a lot of alcohol and using tobacco at the same time.
  • Breathing in second-hand smoke.
  • Cancer of the nasopharynx is more common in people from Hong Kong and the nearby provinces of southern China, people from the Middle East and Mediterranean basin, and Inuit peoples. The higher occurrence in people from these areas is not linked to smoking or alcohol.
  • Men are 2 to 3 times more likely to get nasopharyngeal cancer than women [See note below, Statistics].
  • Being older. In B.C. most people diagnosed with this type of cancer are 40 years old or older.
  • Having a Human Papillomavirus (HPV) infection.
  • Having an Epstein-Barr virus infection.
  • Eating lots of salt-cured meats and fish.

Statistics on pharyngeal cancer

Note:  Available statistics do not have information about the inclusion of transgender and gender diverse participants. It is unknown how these statistics apply to transgender and gender diverse people.  Patients are advised to speak with their primary care provider or specialists about their individual considerations and recommendations.


Can I help prevent pharyngeal cancer?

Using tobacco and drinking too much alcohol are the major risk factors for getting this cancer.

Here are some things you can do to lower your risk of pharyngeal cancer:

  • Do not smoke: If you smoke, stop.  Also, try to avoid breathing in cigarette smoke. Even if you have been using tobacco for many years, quitting will lower your cancer risk. Support is available to help you successfully quit. 
  • Do not drink too much alcohol:  Not drinking alcohol at all will lower your cancer risk the most.
  • If you have been cured of pharyngeal cancer, you should still stop using tobacco and alcohol. Using tobacco and drinking alcohol will increase your risk of getting another cancer.
  • Eat healthy, nutritious foods:

Is there screening for pharyngeal cancer?

There is no screening program for this cancer.

See your doctor or nurse practitioner regularly.  An exam of your head and neck is an effective way of diagnosing pharyngeal cancers. If you use tobacco or alcohol regularly, you should see your doctor or nurse practitioner at least once a year.

Where can I find more information?
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