Treatments for stage 1 and stage 2 hypopharyngeal cancer

The following are treatment options for stages 1 and 2 hypopharyngeal cancer. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.

Stage 1 and stage 2 hypopharyngeal cancers are not common. Most hypopharyngeal cancers are found at a later stage.

Chemoradiation

Chemoradiation is a main treatment for stages 1 and 2 hypopharyngeal cancer. In chemoradiation, chemotherapy is given during the same time period as radiation therapy. The chemotherapy makes the radiation more effective.

Cisplatin is the chemotherapy drug given along with radiation to the tumour and lymph nodes on both sides of the neck.

Surgery

Surgery is a main treatment for stages 1 and 2 hypopharyngeal cancer. It is used to remove the tumour along with a margin of healthy tissue around it. You may have surgery to remove part or all of the hypopharynx and larynx (voice box). Most people have a neck dissection along with the removal of the primary tumour. A neck dissection removes the lymph nodes in the neck (cervical lymph nodes).

Surgery is usually followed by radiation therapy to the site of the tumour and both sides of the neck.

Other procedures may be done to help with breathing and nutrition. These include:

placement of a feeding tube (usually with a gastrostomy) to make sure you get enough nutrients
placement of a breathing tube (called a tracheostomy) to help you breathe

Surgery for hypopharyngeal cancer may affect your ability to speak and swallow. It may also affect your appearance. Reconstructive surgery may be done to improve the look and function of the mouth and neck as much as possible. It is usually done at the same time as the surgery to remove the hypopharyngeal tumour.

Radiation therapy

You may be offered radiation therapy as the main treatment for stages 1 and 2 hypopharyngeal cancer. External radiation therapy may be given for certain small tumours in the hypopharynx and to lymph nodes on both sides of the neck.

If radiation therapy is used as a main treatment, you will need to have surgery if the cancer comes back. This is called salvage surgery.

Clinical trials

Talk to your doctor about clinical trials open to people with hypopharyngeal cancer in Canada. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.

American Cancer Society. Treating Laryngeal and Hypopharyngeal Cancer. 2021.
PDQ® Adult Treatment Editorial Board. Hypopharyngeal Cancer Treatment (Adult) (PDQ®) – Health Professional. Bethesda, MD: National Cancer Institute; 2019. https://www.cancer.gov/.
National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Head and Neck Cancer Version 2.2023. 2023. https://www.nccn.org/guidelines/category_1.
Machiels JP, Leemans CR, & Golusinski W. Squamous cell carcinoma of the oral cavity, larynx, oropharynx and hypopharynx: EHNS-ESMO-ESTRO clinical practices guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 2020: 31(11): 146201475.
Mendenhall WM, Dziegielewski PT, Dunn LA. Cancer of the larynx and hypopharynx. DeVita VT Jr, Lawrence TS, Rosenberg S. eds. DeVita Hellman and Rosenberg's Cancer: Principles and Practice of Oncology. 12th ed. Philadelphia, PA: Wolters Kluwer; 2023: Kindle version, chapter 25, https://read.amazon.ca/?asin=B0BG3DPT4Q&language=en-CA.

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