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Pharyngeal cancer overview

The information on this page was reviewed and approved by
Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was updated on October 12, 2021.

Pharyngeal cancer occurs when cells in the throat start to grow and spread abnormally, destroying healthy tissue. It’s also called throat cancer and is considered a type of head and neck cancer.

Pharynx is the scientific name for the throat—the body’s air and food passageway that extends from the nose to the voice box, called the larynx. The pharynx ends when the tube diverges into the esophagus, which sends food to the stomach, while the trachea sends air to the lungs.

The pharynx has several parts:

  • Nasopharynx, the portion of the throat behind the nose
  • Oropharynx, behind the mouth
  • Laryngopharynx, also known as the hypopharynx, the lower portion of the throat

So, within the pharyngeal cancer family, there are nasopharyngeal, oropharyngeal and laryngopharyngeal cancers, depending on where the disease originates.

Though most pharyngeal cancers are squamous cell carcinomas—which begin in the thin, flat cells lining the throat—each of the three types has slightly different characteristics, including differing causes and survival rates.

Risk factors and causes of pharyngeal cancer

In general, the risk factors for pharyngeal cancer include:

  • Excessive drinking
  • Use of tobacco products
  • Older age
  • Male gender
  • Family history of head and neck cancers

Having several of these risk factors—for example, smoking and drinking heavily—further increases the risk of developing pharyngeal cancer.

Nasopharyngeal cancer risk factors

While there’s no one certain cause of nasopharyngeal cancer, research has linked a few factors to an increased risk of developing this type of tumor.

One of the links is exposure to the very common Epstein-Barr virus (EBV), which causes mononucleosis. Many samples of nasopharyngeal tumors have incorporated pieces of this virus in their cellular genome. Many people who develop nasopharyngeal cancers also have evidence of an active EBV infection in their blood. There are still many mysteries about how this virus is related to the development of nasopharyngeal cancer.

Nasopharyngeal cancer is more common in South Asia, the Middle East, North Africa and Greenland. In the United States, these cancers occur more frequently among those of Asian and Pacific Islander descent. It’s also more prevalent among the indigenous people in Alaska and Canada.

Oropharyngeal cancer risk factors

According to a 2019 study in the journal Cancer Epidemiology, Biomarkers & Prevention, most oropharyngeal cancers are linked to infections with the human papillomavirus (HPV), which may be prevented with a vaccine. HPV is the most common sexually transmitted disease in the United States, and several strains have a high risk of leading to cancer.

Laryngopharyngeal cancer risk factors

The biggest risk factor for laryngeal cancer is smoking tobacco. Smoking has been associated as a risk factor with most cases of laryngeal cancer, between 70 percent and 95 percent, according to a 2021 review in StatPearls Publishing.

In addition, laryngeal cancer is generally more common among male patients and African Americans.

Pharyngeal cancer symptoms

General symptoms of pharyngeal cancer are typically mild and can often be explained away as being caused by other conditions. These symptoms include:

  • Sore throat without other cold or flu symptoms, especially if it persists
  • Neck lump
  • Ringing or new pain in the ears
  • Difficulty or pain during swallowing

Other symptoms to watch out for with nasopharyngeal cancer specifically include:

  • Feeling of fullness in the ear (especially on one side) or repeated ear infections
  • Nasal blockages or persistent stuffiness
  • Nosebleeds
  • Facial numbness or pain
  • Headaches
  • Blurry or double vision

Symptoms of oropharyngeal cancer may include issues with opening the mouth or moving the tongue.

Laryngopharyngeal cancer symptoms may include high-pitched sounds when breathing or a hoarse voice.

Some patients have no symptoms and don’t discover the pharyngeal cancer until it’s advanced. Patients at higher risk for pharyngeal cancer who experience any of these symptoms should inform their doctor.

Diagnosis of pharyngeal cancer

To diagnose pharyngeal cancer, doctors typically request a detailed history and conduct an examination, noting down risk factors and symptoms. If the exam raises red flags, the patient may be referred to a specialist. That doctor may order imaging tests and take a sample of the possible tumor, called a biopsy.

Depending on the location of the throat cancer, doctors will likely also have the sample tested for signs of an active EBV or HPV infection.

Pharyngeal cancer treatment

For those diagnosed with pharyngeal cancer, treatments vary based on how advanced the cancer is, what may have caused it, and where it’s located.

A treatment plan may include:

  • Surgery to cut out the tumor and surrounding lymph nodes
  • Radiation therapy to kill cancer cells with high-energy rays
  • Chemotherapy to work synergistically with radiation therapy to kill rapidly growing cancer cells
  • Targeted therapy to attack the cancer cells based on their specific characteristics
  • Immunotherapy to promote the body’s immune system to fight cancer

Recommended treatment plans for specific types and cancer stages are continually updated, and clinical trials testing out new treatment options are always ongoing.

Survival rates for pharyngeal cancer

Cancer survival rates are tracked by the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program database. Data in the SEER database is broken down into stages, based on how much the cancer grew and spread before it was diagnosed.

The three stages are:

  • Localized: The cancer hasn’t spread beyond the tissue in which it developed.
  • Regional: The cancer has spread to nearby tissues or lymph nodes.
  • Distant: The cancer has spread to farther reaches of the body.

Nasopharyngeal cancer survival rates

The overall five-year survival rate for nasopharyngeal cancer is 61 percent, according to the SEER Program.

  • Localized: 85 percent
  • Regional: 71 percent
  • Distant: 49 percent

Oropharyngeal cancer survival rates

Oropharyngeal cancer has an overall five-year survival rate of 49 percent, according to the SEER Program.

  • Localized: 62 percent
  • Regional: 57 percent
  • Distant: 29 percent

Laryngopharyngeal cancer survival rates

Survival rates for laryngopharyngeal cancer vary greatly by their location, according to the SEER Program.

For cancers that develop in the supraglottis, the portion of the larynx above the vocal cords, the overall five-year survival rate is 46 percent.

  • Localized: 61 percent
  • Regional: 47 percent
  • Distant: 31 percent

For the glottis, the portion of the larynx that includes the vocal cords, the overall five-year survival rate is 76 percent.

  • Localized: 83 percent
  • Regional: 49 percent
  • Distant: 43 percent

For the subglottis, the portion of the larynx below the vocal cords, the overall five-year survival rate is 52 percent.

  • Localized: 63 percent
  • Regional: 35 percent
  • Distant: 43 percent

For cancer of the hypopharynx, the back of the throat by the voice box, the overall five-year survival rate is 32 percent.

  • Localized: 52 percent
  • Regional: 34 percent
  • Distant: 23 percent

Survival rates for laryngeal cancers seem to be better in patients who smoked for less than 10 years. One way to reduce the risk of developing pharyngeal cancers is to quit smoking and reduce excessive drinking. For some of these cancers, getting the HPV vaccine may greatly help to reduce risk, too.

 

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