Loading
Below, week by week, is what OnCo's record of Hypopharyngeal cancer says about the first two months: the order is typical, the timing is yours to ask about. Cancer of the hypopharynx, the funnel behind the voice box, is the head and neck cancer with the worst outlook because it grows silently and spreads to the neck early. Treatment is chemoradiation to keep the larynx where possible, or removal of the larynx and pharynx with reconstruction for the most extensive tumours. Sections appear only where the record has something to say. Orientation, not medical advice.
Staging tests establish exactly what and where the cancer is. Everything else follows from the answers.
Panendoscopy with biopsy, CT of the neck and chest, PET-CT for stage III to IV, and assessment of swallowing and nutrition before treatment.
Ask which of these were tested and what the results were; see the report reader for what each value means.
These specialties appear in the standard of care for this cancer. In most centres they meet weekly as a tumour board to agree each plan; you can ask when yours was discussed and what was decided.
A second opinion from a centre that treats many similar cases is normal, not rude; the standard of care tells you what to compare it against.
Each row is a setting from the standard of care, in the order it usually arises. Not all will apply to you; your stage and biomarkers decide which do. The guideline grade, where recorded, says how strong the evidence is.
Smoking cessation and alcohol reduction; no screening programme exists.
Radiotherapy alone, or transoral or open partial pharyngectomy in selected small tumours, with treatment of both sides of the neck.
Concurrent cisplatin chemoradiation to 70 Gy; induction cisplatin-fluorouracil (EORTC 24891) or docetaxel-cisplatin-fluorouracil followed by radiotherapy in some centres.
Cetuximab with radiotherapy (Bonner), or carboplatin-based chemoradiation.
Total laryngopharyngectomy with neck dissection and free-flap or gastric pull-up reconstruction, then postoperative radiotherapy or cisplatin chemoradiation by pathology.
Pembrolizumab alone or with platinum-fluorouracil (KEYNOTE-048).
Generated from this cancer's standard of care, biomarkers and open problems. Take the group that matches where you are. To tick, add your own and print, open the one-page appointment sheet.
Much of what helps in the first weeks is free if you know to ask: testing, helplines, rides and lodging, second opinions, trial travel.
Every term links to the glossary.