Treatments for hypopharyngeal cancer

Hypopharyngeal cancer starts in the hypopharynx, which is the lower part of the pharynx.

If you have hypopharyngeal cancer, your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan. The plan is based on your health and specific information about the cancer. What you want or prefer is also important when planning treatment. When deciding which treatments to offer for hypopharyngeal cancer, your healthcare team will consider:

• the stage
• where the tumour is found in the hypopharynx
• if the tumour can be removed with surgery
• the best way to preserve your breathing, swallowing and speech
• your age
• your overall health
• any medical conditions you may have
• your lifestyle
• which treatments youʼve already had
• if you would be a good candidate for a clinical trial

Hypopharyngeal tumours are usually at an advanced stage when they are diagnosed.

Surgery is the main treatment for stage 1 hypopharyngeal cancer. The type of surgery is a total or partial laryngopharyngectomy, which removes all or some of the larynx (voice box) and the pharynx. The lymph nodes on one or both sides of the neck may also be removed (a neck dissection).

After surgery, radiation therapy is given to the lymph nodes in the neck if they werenʼt removed with surgery.

Find out more about surgery for pharyngeal cancer and radiation therapy for pharyngeal cancer.

Surgery is the main treatment for stage 2 hypopharyngeal cancer. The type of surgery is a total or partial laryngopharyngectomy, which removes all or some of the voice box (larynx) and the pharynx. The lymph nodes on one or both sides of the neck are also removed (a neck dissection).

Radiation therapy may also be given to the lymph nodes of the neck before or after surgery.

You may be offered chemoradiation after surgery as a treatment for stage 2 hypopharyngeal cancer.

Find out more about surgery for pharyngeal cancer, radiation therapy for pharyngeal cancer and chemotherapy for pharyngeal cancer.

Treatment for stage 3 hypopharyngeal cancer depends on whether the cancer can be removed with surgery.

If the cancer can be removed, surgery may be the first option for treatment. The types of surgery are a total laryngopharyngectomy, which removes all of the voice box (larynx) and the pharynx, and a neck dissection to remove lymph nodes on one or both sides of the neck.

Chemoradiation is the main treatment for stage 3 hypopharyngeal cancer that can’t be removed with surgery. It may also be given after surgery.

Radiation therapy may be given to the tumour and lymph nodes before surgery to remove the tumour. It may also be given after surgery.

Chemotherapy may be given after radiation therapy is finished.

The targeted therapy drug cetuximab (Erbitux) may be given along with radiation therapy, instead of chemotherapy, to treat stage 3 hypopharyngeal cancer.

Find out more about surgery for pharyngeal cancer, radiation therapy for pharyngeal cancer, chemotherapy for pharyngeal cancer and targeted therapy for pharyngeal cancer.

Treatment for stage 4 hypopharyngeal cancer depends on whether the cancer can be removed with surgery.

If the cancer can be removed, surgery may be the first option for treatment. The types of surgery are a total removal of the voice box and throat, and removal of lymph nodes on one or both sides of the neck (a total laryngopharyngectomy and a neck dissection).

Chemoradiation is the main treatment for stage 4 hypopharyngeal cancer that canʼt be removed with surgery. It may also be given after surgery.

Radiation therapy may be given before surgery to remove the tumour. The radiation is given to the tumour and the lymph nodes in the neck. It may also be given after surgery.

Chemotherapy may be given after radiation therapy is finished.

The targeted therapy drug cetuximab (Erbitux) may be given along with radiation therapy, instead of chemotherapy, to treat stage 4 hypopharyngeal cancer.

Find out more about surgery for pharyngeal cancer, radiation therapy for pharyngeal cancer, chemotherapy for pharyngeal cancer and targeted therapy for pharyngeal cancer.

Recurrent hypopharyngeal cancer means that the cancer has come back after it has been treated.

Your healthcare team will suggest treatments based on the type of recurrence, and on your needs, and work with you to develop a treatment plan. You may be offered the following treatments for recurrent hypopharyngeal cancer.

For local recurrence of hypopharyngeal cancer, you may be offered the following treatment options.

If you had a partial laryngopharyngectomy done with the first surgery, you may be offered more surgery to remove the remaining pharynx and surrounding tissues.

Surgery may also be offered if you had radiation therapy to treat the cancer the first time.

Depending on the amount of radiation that was used when the cancer was first treated, you may be offered more radiation therapy.

You may be offered chemotherapy combined with the targeted therapy drug cetuximab.

For a distant recurrence of hypopharyngeal cancer, you may be offered the following treatment options:

• surgery, if there are only a few tumours found and they can be removed

• radiation therapy to treat tumours that have spread (metastasized)

• immunotherapy with either pembrolizumab (Keytruda) or nivolumab (Opdivo)
• chemotherapy on its own or combined with the targeted therapy drug cetuximab
• targeted therapy with cetuximab on its own

Find out more about radiation therapy for pharyngeal cancer, chemotherapy for pharyngeal cancer, surgery for pharyngeal cancer, immunotherapy for pharyngeal cancer, and targeted therapy for pharyngeal cancer.

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.

You may want to consider a type of care to make you feel better without treating the cancer itself. This may be because the cancer treatments donʼt work anymore, theyʼre not likely to improve your condition or they may cause side effects that are hard to cope with. There may also be other reasons why you canʼt have or donʼt want cancer treatment.

Talk to your healthcare team. They can help you choose care and treatment for advanced cancer.