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Questions to Ask Your Doctor About Your Cancer
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Hypopharynx Tumors

The hypopharynx is located behind and below the oropharynx. It is not visible by routine office examination. The area consists of three subsites: the pyriform sinuses; the posterior pharyngeal wall, and the postcricoid area.

About 70% of all hypopharyngeal lesions are found in the pyriform sinuses, followed by the posterior pharyngeal wall (about 25%) and the postcricoid area (about 5%). Overall, approximately 3,000 new cases are diagnosed each year, with the majority occurring in men.

Pathologically, the majority of these cancers are squamous cell carcinomas. They generally behave in an aggressive fashion, with diffuse local spread, early metastasis to lymph nodes and a relatively high rate of distant spread (metastasis).

Staging
Unfortunately, the staging system for the hypopharyngeal cancers is not adequate and has several limitations in its use. Therefore, unlike most other cancers discussed in this site, no tumor, node, metastasis (TNM) staging system will be presented here. It is advisable for anyone confronting hypopharyngeal cancer to discuss his or her condition thoroughly and carefully with a physician regarding stage and prognosis.

Treatment
The appropriate therapy for tumors of the hypopharynx depends upon several factors:

• the patient's health (performance status);
• the extent of disease,
• the presence of absence of laryngeal involvement; and
• the presence or absence of either local (lymph node) or distant metastasis.

In general, for early stage disease (T1 or T2 lesions) surgery or radiation may be considered equally. More advanced disease typically calls for combined therapy with surgery and radiation. In recent years, surgeons have tried to utilize chemotherapy prior to a definitive surgical procedure, in order to achieve organ preservation.

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