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Hypopharyngeal Cancer

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Hypopharyngeal cancer occurs when malignant (cancerous) cells grow in the hypopharynx, the area where the larynx (voice box) and esophagus meet. This rare cancer requires aggressive treatment and management. 

Why Choose Sylvester Comprehensive Cancer Center?

Sylvester is an NCI-designated cancer center. The National Cancer Institute has recognized Sylvester for its outstanding work conducting research in its laboratories, treating patients in its clinics and hospitals, and reaching out to medically underserved communities with innovative prevention strategies.

The Department of Otolaryngology ranks No. 9 in the nation according to U.S. News & World Report. The team has one of the largest academic head-neck cancer groups in the country at South Florida’s only NCI-designated cancer center, Sylvester Comprehensive Cancer Center. Surgeons lead a well-established multidisciplinary oncology team, incorporating innovative techniques such as oral cancer screening, robotic technology, microvascular reconstruction, sentinel node identification, and a specialized postoperative care unit for these complex procedures.

The largest number of board-certified head and neck surgical specialists in South Florida. In the majority of cases requiring reconstruction, you have just one operation to remove the tumor and rebuild any facial and/or neck features needing reconstructive surgery. Sylvester is one of the best places in the country for simultaneous head and neck cancer surgery and microvascular reconstruction.    

Clinical trials that focus on robotic surgery, chemotherapy, reducing radiation toxicity and immunotherapy are often available for head and neck cancer patients.  We offer the most advanced treatment options available in the South Florida region.

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Treatments

Treatments might be used alone or in combination to offer you the best potential outcome.                                     

  • Surgery

    A surgeon will remove all or part of the tumor in the pharynx (throat) and the lymph nodes, which are on each side of the neck. Sometimes the larynx (voice box) will also be removed. Radiation or chemotherapy combined with radiation (chemoradiation) may be recommended after surgery to decrease the risk of cancer returning.

    Types of surgery

    • Laryngectomy: Includes the removal of the tumor from the larynx while leaving as much of the larynx intact as possible. Lymph nodes may need to be removed. Some patients will be given radiation with or without chemotherapy to decrease any chance of recurrence.

    • Reconstructive Surgery: Sometimes, head and neck surgeries can cause substantial cosmetic changes. Your Sylvester head and neck experts will plan before any treatment starts for both the cancer removal and any bone or tissue reconstruction.

      • Often, these reconstructive procedures can utilize small pieces of tissue, skin or bone from your own body for a more natural look and feel — such as from your lower leg, shoulder blade, chest, forearm, and other areas.

      • Another option is to develop a prosthesis or artificial replacement. Sylvester's head and neck cancer team members collaborate with our dentistry team members. Prosthodontists are dentists who specialize in making replacements for teeth and other facial structures.

      • Custom prosthetic facial parts also can be created for head and neck cancer patients when needed. These prosthetics are designed as closely as possible to a patient's natural features

  • Radiation Therapy 

    Radiation can be the primary treatment for some patients with small tumors. Another option is to be treated first with both radiation and the chemotherapy drug cisplatin (chemoradiation). Surgery may be performed if any cancer remains after treatment.                          
    Sylvester has one of the most experienced and most sophisticated head/neck cancer radiation teams in the nation. Highly targeted radiation beams kill cancer cells and decrease the size of tumors. Most often it is used together with chemotherapy or targeted therapy. Our techniques include: 

    • Oral Health Evaluation: Evaluation by our dentistry team before radiation treatment can identify problems such as infection, fractured teeth, restorations, or periodontal disease. These would be treated before any radiation therapy. Untreated, these issues could contribute to oral complications when cancer therapy begins.

    • IMRT (Intensity modulated radiation therapy): IMRT is an advanced form of external beam radiation therapy. Radiation specialists plan radiation doses for the exact 3D shape of your tumor. The precise control and flexibility can decrease amounts of radiation going to surrounding healthy tissue.

    • Radiosensitizing treatment: In some cases, such as in cancers of the larynx (voice box) and oropharynx (middle of the throat), we may use chemotherapy and radiation therapy together to kill all the cancer cells. This can help reduce the need for surgery and preserve your voice box and/or throat structures.


  • Chemotherapy

    Induction chemotherapy is when chemotherapy is used as the first line of treatment. Radiation therapy or chemoradiation might be recommended after initial chemotherapy. The decision is based on how much the tumor shrinks after the chemotherapy. Surgery is an option if the tumor does not shrink enough. Any enlarged lymph nodes remaining can be removed by lymph node dissection.                                                             

    The high level of experience of Sylvester's medical oncology team allows our physicians to choose and deliver the most advanced chemotherapy approaches, often before they become available in the community. Chemotherapy before or after surgery, or with radiation therapy, might be recommended to help avoid surgery. Hair loss is not typically a result of the drugs used in head and neck cancer chemotherapy.

    • Intravenous (infusion) chemotherapy is available at the Comprehensive Treatment Unit (CTU) at Sylvester's Miami location, a 12,000-square-foot unit that includes 33 recliners and 11 private rooms. If you prefer, you may have your infusion treatments at the Deerfield Beach, Plantation, Hollywood, Coral Springs, Coral Gables, and Kendall locations.

  • Targeted Therapy

    These therapies target specific parts of cancer cells. For example, a protein called EGFR may accelerate the growth of head and neck cancer cells. The most commonly used medicine that targets these cells is called cetuximab. It blocks EGFR so the cancer cell growth often slows or stops.

  • Supportive Care

    Clinical trials may be considered and discussed with you as either as a standalone treatment or as an addition to another therapy. Clinical trials are the newest research studies available, focused on creating the improved next-generation standard of care. 

Tests

After a complete medical history and physical exam, procedures for diagnosing head and neck cancers may include the following tests: 

  • Endoscopic Ultrasound

    This exam uses a long, thin, flexible tube called an endoscope with a light at the end. It is put in through the nose so the doctor can get a close look at the inside of your nasal cavity, the back of your nose, throat and voice box. A special tool on the endoscope may be used to remove samples of suspicious tissue.

  • Modified Barium Swallow

    This procedure involves taking X-rays while you swallow a safe, chalky substance called barium. A radiologist and a speech and swallowing therapist administer this test. Changes in swallowing and any obstructions are seen on the X-rays. 

  • CT (Computed Tomography, or CAT) Scan

    X-ray pictures are taken from many angles inside your body. A computer then creates a detailed 3D image. CT scans can be used to check the head and neck and are sometimes used to evaluate the chest. 

  • MRI (Magnetic Resonance Imaging) 

    Images are created by a machine that uses magnets and radio waves. Your doctor will look for cancer in the image details. 

  • Biopsy 

    A biopsy (a sample of the suspicious tissue) is the only sure way to know if you have cancer. The sample is checked by a pathologist who looks at the tissue under a microscope to check for cancer cells. The tissue is removed from the primary tumor site in the head/neck area. If the suspicious area is a lump or lymph node on your neck, your doctor uses a process called fine-needle aspiration to check for cancerous cells in your lymph nodes. 

  • Chest X-ray or Chest CT Scan 

  • This X-ray helps us see any cancer that has spread to your lungs. 

  • PET Scan (Positron Emission Tomography)

    This test measures metabolic activity in your body tissue. Radioactive material in small amounts is injected into a vein. The radioactive material is seen in the images as highlighted places where cancer cells could be growing. 

  • Staging Head and Neck Cancers

    Staging is the word used to describe how early or advanced a cancer is, and how fast it is growing. Stages range from I (low) to IV (advanced). Staging helps us to decide what treatment might be best for your cancer.   

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