Diagnosis & staging
The pharynx has three parts:
- Nasopharynx is the upper part of your pharynx. It is the part of your airway behind your nose and above your soft palate. The Eustachian tube from your middle ear enters the side wall of your nasopharynx.
- Oropharynx is the middle part of your pharynx. It is the part at the back of your mouth. It includes the soft palate, the tonsils, the uvula, the base of the tongue and the back wall of your throat.
- Hypopharynx, or laryngopharynx, is the lower part of your pharynx. It lies on either side of and behind the larynx. It connects to the esophagus.
Pharyngeal cancer may also be called throat cancer, pharyngeal tumour, nasopharyngeal cancer or carcinoma, NPC, or oropharyngeal cancer.
Pharyngeal cancers are rare in Canada.
Some cancers may not have any symptoms. These cancers may be found during a routine exam by a doctor or nurse practitioner.
A common symptom is a lump in the neck. This lump is usually painless.
- Frequent nosebleeds.
- Deafness in one ear.
- Feeling that one of your ears will not "pop" (blocked Eustachian tube).
- Headache that does not go away.
- Double vision (cancer involves the nerves just above the nasopharynx).
- Numbness or change in feeling on your face.
- Sore throat that does not go away.
- Painful or difficulty swallowing.
- Earache.
- Coughing up blood.
- Change in voice or hoarseness (raspy voice).
- Sore throat that does not go away.
- Painful or difficulty swallowing.
- Hoarseness.
Many common symptoms of pharyngeal cancer are also symptoms of other conditions. If you have any of the above symptoms for more than two weeks, see your doctor or nurse practitioner.
If you have any signs or symptoms that you are worried about, please talk to your family doctor or nurse practitioner.
Tests that may help diagnose pharyngeal cancer include:
- Exam of nose, mouth, throat, neck: Doctor or nurse practitioner will often use a light and a mirror during the exam.
- In-depth exam by head and neck specialist (otolaryngologist): Specialist will use an endoscope (thin tube with a light and camera at the end).
- Biopsy: This is when a doctor takes a sample of your tissue. A specialty doctor (pathologist) then examines the tissue for cancer.
- Imaging: to see tumour and check if cancer has spread to other organs or tissues
- CT (Computed Tomography) scan.
- MRI (Magnetic Resonance Imaging).
- PET (Positron Emission Tomography) scan.
- X-ray.
- Ultrasound.
- Bone scan.
Nearly all pharyngeal cancers start in the cells that line the pharynx. These cancers are called squamous cell carcinomas.
Staging describes the cancer. Staging is based on how much cancer is in the body, where it was first diagnosed, if the cancer has spread and where it has spread to.
The stage of the cancer can help your health care team plan your treatment. It can also tell them how your cancer might respond to treatment and the chance that your cancer may come back (recur).
- Stage 1: The tumour is small and only in one area.
- Stage 2: The tumour is more than 2 cm (0.75 inches) but less than 4 cm (1.5 inches). The tumour may have grown into the soft tissue of the throat.
- Stage 3: The tumour is more than 4 cm and may have spread into nearby bone or sinuses.
- Stage 4: The tumour has spread into nearby structures such as the neck, larynx, esophagus, jaw and base of the skull.
The grade of the cancer describes how different the cancer cells look from normal cells and how fast the cancer cells are growing.
A pathologist will give the cancer a grade after looking at the cells under a microscope. Pharyngeal cancer can be grade 1, 2, or 3. The lower the number, the lower the grade.
Low grade: cells are abnormal but look a lot like normal cells. Low grade cancers usually grow slowly and are less likely to spread.
High grade: cells are abnormal and do not look like normal cells. High grade cancers usually grow more quickly and are more likely to spread.
The grade of the cancer can help your health care team plan your treatment.
