Hypopharyngeal cancer

How is hypopharyngeal cancer diagnosed? 

It is important that your doctor establishes the diagnosis of hypopharyngeal cancer, assesses the size of the cancer and whether it has spread to the lymph nodes in the neck or elsewhere in the body.

To answer these questions your doctor will need to do the following things:

  • talk with you about your medical history. This includes signs you may have noticed, any health conditions, medications that you are taking, and whether you smoke or drink alcohol

  • perform a physical examination by feeling and looking inside your throat and neck 

  • order diagnostic tests, which may include scans.

Not everyone will need to have every test for hypopharyngeal cancer. Your doctor will recommend tests that are right for you.

The most common tests include: 

Nasoendoscopy

Your doctor will use a very thin flexible tube with a tiny light and camera on it to look at your throat and voice box (larynx). 

   

Biopsy

This involves taking a small piece (sample) from the cancer. The sample is then examined under a microscope to check for cancer cells. This is often the only sure way to tell if you have cancer.
Your doctor may recommend biopsy of the hypopharynx or needle biopsy. 
  • Biopsy of the hypopharynx: This is commonly referred to as microlaryngoscopy and will need to be performed under a general anaesthetic, so that you don't feel any pain. During this procedure which is performed through the open mouth, your doctor will be able to accurately map the cancer and take a small sample for assessment. There may be some bleeding after the biopsy. If you take blood thinners (e.g. warfarin), you may need to stop these before the biopsy. 

  • Needle biopsy (Fine Needle Aspiration or FNA): This is used when there is a lump (enlarged lymph node) in the neck that could have cancer cells in it. During the procedure, your doctor will take some cells from the lump using a needle. Usually this is done with guidance from an ultrasound to make sure the needle is in the right spot. You may feel a bit uncomfortable during the biopsy. 

PET (POSITRON EMISSION TOMOGRAPHY) SCAN

This is a whole body scan that uses a radioactive form of sugar, which can show if hypopharyngeal cancer has spread to the lymph nodes or elsewhere in the body.

 

CT (COMPUTED TOMOGRAPHY) SCAN

This uses X-rays to take pictures of the inside of the body. If the person has cancer, a CT scan can help the doctor to see where it is, measure how big it is, and if it has spread into nearby organs or other parts of the body.

 

MRI (MAGNETIC RESONANCE IMAGING) SCAN

This uses magnetic fields to take pictures of the inside of the body. This helps the doctor see how far a cancer has grown into the tissue around it. Not all people with hypopharyngeal cancer need a MRI scan. 

 

ULTRASOUND SCAN 

This is to produce pictures of lymph nodes in the neck.

 

BLOOD TESTS 

This is to check general wellbeing, kidney and liver function, and make sure you are not suffering from anaemia (iron-deficiency).