Pharyngeal Cancer Treatment

The pharynx is like a tube with three sections:

  • Nasopharynx is the top section
  • Oropharynx is the middle section
  • Hypopharynx is the lowest section

The oropharynx is the space in the back of the mouth, sometimes called the back of the throat. The base of the tongue, parts of the tonsil, the back of the soft palate, and the uvula are all located in the oropharynx.

The oropharynx is often just called the pharynx.

Radiation Therapy

Radiation therapy, combined with chemotherapy (chemoradiation) is the most common treatment.

Intensity-Modulated Radiation Therapy (IMRT)

Radiation therapy can be prescribed before surgery, after surgery, or sometimes as the only treatment. Radiation uses high-energy X-rays, electron beams, or radioactive isotopes to destroy cancer cells.

IMRT uses a computer to deliver precise doses of radiation to a tumor or an area of a tumor. This minimizes radiation exposure to the surrounding normal tissue. IMRT allows the use of more effective radiation doses with fewer side effects than conventional radiotherapy techniques.

Radiation therapy, including IMRT, stops cancer cells from dividing. The growth of the tumor is slowed. Radiotherapy also destroys cancer cells and can shrink or eliminate tumors.

Radiation therapy involves 5-6 weeks of daily treatments.

Chemotherapy

Medical oncologists administer chemotherapy if the cancer has spread to lymph nodes or other organs. The medicine circulates in the blood and disrupts the growth of the cancer cells. Chemotherapy medications are taken by mouth or given through a vein for several months.

Chemotherapy is prescribed for different reasons:

  • Together with radiotherapy as an alternative to surgery (called chemoradiation)
  • After surgery to decrease the risk of the cancer returning
  • To slow the growth of a tumor and control symptoms when the cancer cannot be cured (palliative treatment).

Surgery

In most cases, surgery is only required if the tumor returns after chemoradiation therapy.

If the tumor is small, the surgeon can perform transoral laser microsurgery. The laser is on a small metal scope (tube). The patient is given anesthesia before the surgery begins. The laser is inserted into the mouth and the beam from the laser is used to excise the tumor, and one centimeter (2.5 inches) of tissue around it.

After the surgery, a small nasogastric feeding tube (NG tube) is inserted through a nostril and into the stomach because the patient cannot eat until the surgical area heals. Healing takes about two weeks. During this time, the patient will receive liquefied food through the NG tube. The patient can go home three to five days after surgery with the NG tube in the nostril.

Larger tumors require a traditional incision with a scalpel. Before the surgery begins the patient is given anesthesia. The surgeon makes an incision in the neck, under the chin, to locate and remove the tumor. The open area is then reconstructed and closed with a flap of skin or muscles from the arm or other part of the body.

If the lymph nodes in the neck are affected, a neck dissection may be needed to remove the nodes.