Pharynx is the curve area of the back of the mouth, located between esophagus and trachea connecting the nasal and oral cavities to the larynx. Its functions is to provide a passageway for respiratory and digestive tracts. In the United States in 2010 alone, according to National cancer Institute, there were 12,660 new cases of pharyngeal cancer, resulting in deaths of 2,410 patients
Pharynx Cancer or pharyngeal cancer
Pharynx Cancer is originated in tissue of the pharynx and classified
1. The nasopharynx (the upper part of the throat behind the nose)
Cancer of the pharyngeal most commonly begins with malignant cells that line the nasopharynx, including nasal passages and auditory tubes join the remainder of the upper respiratory tract.
2. The oropharynx (the middle part of the pharynx)
Cancer of the oropharynx also begins with the malignant cells that line the oropharynx, including the base of the tongue, the tonsils, the soft palate.
3. The hypopharynx (the bottom part of the pharynx)
Cancer of the hypopharynx most commonly begins with the malignant squamous cell that line the hypopharynx where the area of the larynx and esophagus meet. 90% of oropharyngeal neoplasms are squamous cell carcinoma.
Symptoms
Symptoms are similar to larynx cancer, including
1. Hoarseness or other voice changes
Due to malignant cells have invaded the vocal cords.
2. A cough that doesn't go away
Due to blocking of the airway
3. Breathing difficulties
Tumor has grown large enough to block off the air way
4. Ear pain
Tumor has pressed onto the nerve
5. A lump or mass in the neck or throat
Cancer gas invaded the nearby lymph nodes in the neck and throat.
6. Coughing up of blood
Breaking off of some malignant cells
7. Weight loss
Unintentional weight loss of over 10%
8. Difficulty swallowing
May be blockage of the tumors or affect the tumor to the swallowing muscles.
9. Etc.
Causes of risk factors
Although the real causes of pharynx cancer are unknown, but the followings are considered have been contributing to the causes.
1. Smoking
The risk of larynx cancer is 30 time higher in smoker compared to never smoke people. it may be due to high levels of carcinogens accumulated in the surface of the larynx lining for the
prolonged period of time. Secondhand smoke is also considered as a cause of non smoker.
2. Alcohol
Risk of larynx cancer is twice in heavy drinking compared to non or moderate drinking. In a controlled case of study of Combined effect of tobacco and alcohol on laryngeal cancer risk, researchers found that both cigarette smoking and alcohol drinking are independent risk factors for laryngeal cancer. Heavy consumption of alcohol and cigarettes determined a multiplicative risk increase, possibly suggesting biological synergy.
3. Aging
The risk of larynx cancer increases with age. Most cases of the cancer are detected usually detected in people between 50 and 75 years.
3. Gastroesophageal reflux disease (GERD)
In GERD, the stomach acid backs up into the esophagus, causing a burning pain. It any be caused by prolonged period of acid damaging to the larynx. In some studies, researchers found that irritation from longstanding GERD increases the risk of larynx cancer.
4. Poor nutrition
Poor nutrition induces the risk of all kinds of diseases due to weakened immune system, including larynx cancer. Some researchers suggested that not getting enough vitamins might be a risk factor.
5. Human papillomavirus (HPV)
HPV infection of the larynx may increase the risk of laryngeal cancer. Although, infectious theory may be required further study, but prolonged period of larynx infection increases the risk of cancer found in some patients.
6. Race
Larynx cancer is developed twice as often among people of African descent than among Caucasians.
7. Gender
Men are at risk of larynx cancer than women. It may be due higher percentage of men are smokers and heavy drinkers.
9. Weakened immune system
People with weaken immune systems due to diseases or poor nutrition are at risk to develop laryngeal cancer.
10. Toxic exposure
Inhaling or exposed to wood dust, asbestos, or many types of chemicals that can increase the risk of larynx cancer.
11. Voice overused
Occupation required to use their voice most of the time can damage the vocal cord, leading to cancerous polyp.
12. Mouthwash used
A review of 200 patients with oral cancer researcher found that 10 of the 11 patients who did not smoke or drink alcohol frequently used mouthwash high in alcohol content, but further study showed that there is no link of mouth wash with high alcohol content and larynx cancer.
13. Etc.
Diagnosis and tests
Physical exam is performed at your doctor office if you are having some of above symptoms to check any abnormality of the neck, thyroid, larynx, and lymph nodes, including swellings and lumps.
In fact, not all abnormalities are cancerous.
1. Chest X ray
Chest X ray is a form of electromagnetic radiation to take image and check for any abnormality of the lung
2. Bone scan
With a small amount of radioactive substance, called a tracer injected into a vein, as it travels through the bloodstream it allows a special camera takes pictures of the tracer in your bones. If there is any abnormality in the bone, it will show up in the pictures.
3. Biopsy
Biopsy is a procedure of taking sample from susceptible area or tumor found by other tests by a small needle with local or general anesthesia. The sample will be examined by a pathologist under microscope to review the stage of the tumor.
4. CT scan (computerized tomography)
A CT scan generates a large series of two-dimensional X-ray images taken around a single axis of rotation, to create a three-dimensional picture of the inside of the body in details.The pictures are viewed by your doctor to see the extent of the tumors abnormalities, such as spreading of cancer to the nearby structure and lymph nodes. This test is helped to determine whether the abnormality is a cyst or a tumor. In some doctors, X ray may be also ordered together with the CT scan.
5. MRI (magnetic resonance imaging)
MRI (magnetic resonance imaging is one of many advanced technology used to visualize internal structures cross sectional imaging of your body used effectively in providing the better details of the metastasis of cancer in the larynx and surrounding areas.
6. Etc.
Also depending to the location of the tumor, further diagnosis may be required
1. Nasopharyngeal (the upper part of the throat behind the nose) cancer
a. Nasoscopy
With the use of a nasoscopy, which is a thin, tube-like instrument with a light on its end inserted into your nose, your doctor can visualize and check for any abnormal cell growth mass in your nose and remove a sample which will be viewed under microscopy to determine the stage of the tumors.
b. Epstein-Barr virus (EBV) test
Epstein-Barr virus (EBV) test is to check for EBV in a blood or from a sample to rule out the Epstein-Barr virus (EBV) cause of symptoms.
2. Hypopharyngeal ((the bottom part of the pharynx) cancer
a. Barium X ray
Barium X ray is a type of X ray that the patient require to drinks a solution that contains barium, which is a dense liquid that will show up white under x-rays, allowing the tumor to be seen. This test is to check for abnormal areas in the esophagus.
b. Esophagoscopy: A procedure to look inside the esophagus to check for abnormal areas. An Esophagoscope which is a thin, tube like instrument with lighted on the end) is inserted through the mouth or nose and down the throat into the esophagus to check for abnormal cell mass. If there is any abnormality is found, sample may be taken as well.
c. Bronchoscopy:
Boronchoscopy which another thin, tube-like instrument is inserted through you mouth or nose into the trachea and lung to check for any abnormality cells mass in the trachea and lung. If any abnormality is found, sample may be taken for view under microscopy to determine the stage of the tumor.
3. Oropharynx (the middle part of the pharynx) cancer
Exam is performed by your doctor to check for any abnormality in the middle part of the pharynx with light and mirror.
Stages and grade of larynx cancer
A. Grading of the tumor is depended on the nature of non invasive or invasive. Tumor which spread slowly is given a lower grade, while fast spreading tumor is given a highest grade.
B. Stage of the larynx cancer
1. Stage 0
Larynx cancer is classified as
Stage 0. if the cancerous cell have not penetrated in deeper tissue but remain in the surface of the lining.
2. Stage I
The cancerous are no longer in the surface but have invaded into deep the lining, but still completely inside the larynx.
a. Stage IA
The cancer is not ≤ 3 mm (1/8 inch) deep and ≤ 7 mm (1/4 inch) wide.
a.1. Stage IA1: The spreading is < 3mm(1/8 inch) deep and < 7mm (1/4 inch) wide.
a.2. Stage IA2: The invasion area is ≥ 3 mm but ≤ 5 mm (about 1/5 inch) deep and &less than 7 mm (about 1/4 inch) wide.
b. Stage IB: The cancer in this stage have invaded the connective tissue of the larynx, & less than 5mm (1/5 inch).
b.1. Stage IB1:
Cancer is 4 cm large (1 3/4 inches).
b.2. Stage IB2:
Cancer is ≥ 4 cm (1 3/4 inches) but & less than 5cm (1/5 inch)
3. Stage III
The cancer cells have spread to distant tissues, but is still within the larynx
4. Stage IV
The cancerous cells has spread to the tissues immediately surrounding the larynx
5. Stage V
Stage V is the most advance stage of renal cell carcinoma as cancer cells have spread to the distant parts of the body
Preventions
A. How to prevent
1. Quit smoking
Smokers are 5 time more at risk to develop larynx cancer than non smokers.
2. Alcohol
Heaving drinking non only damage the liver but also twice at risk than non or moderate drinkers3. Avoid asbestos. The inhalation of asbestos fibers can cause serious illnesses, including larynx cancer. Although asbestos now have been banned in some countries and precarious is taken in some others. People in the underdeveloped world still at risk of asbestos using.
3. Nutrients and immune system
Make sure you are eating healthy to prevent poor nutritional and weakened immune system causes of larynx cancer.
4. Protect your sound
If you are in occupation required a lot of talking and singing, please take time to stop.
5. Etc.
B. Diet
Your are directed to my previous article of 100+ most healthier foods at
http://healthy-foods-index.blogspot.com/
1. Fruits
In a study of nutrient-based dietary patterns and laryngeal cancer: evidence from an exploratory factor analysis, researchers suggested that diets rich in animal products and animal fats are directly related, and those rich in fruit and vegetables inversely related, to laryngeal cancer risk.
2. Freeze dried strawberry
In study of 36 participants consumed 60 grams of freeze dried strawberries daily for six months and completed a dietary diary chronicling their strawberry consumption. The results showed that 29 out of 36 participants experienced a decrease in histological grade of the precancerous lesions during the study.
3. Tomato
In study of Tomatoes, tomato-rich foods, lycopene and cancer of the upper aerodigestive tract, researchers stated that our study provides a strong protective evidence of tomatoes, tomato-rich foods and lycopene against cancer of the upper aerodigestive tract.
4. Soy
In study of Flavonoids, Proanthocyanidins, and Cancer Risk: A Network of Case-Control Studies From Italy, researchers found that intakes of flavonoids, flavanones, and flavonols were found to be inversely related to oral and laryngeal cancers.
5. Cruciferous vegetables
Research found that cruciferous vegetables such as broccoli, cabbage, cauliflower and brussel sprout contain high amount of phytochemicals, sulforaphanem, indole-3-carbinol and diindolylmethane have shown inhibition of certain cancerous cells.
6. Etc.
C. Nutritional supplements
1. Antioxidants
Antioxidants are one the proven to be effective in prevent cancer caused of oxidation stress. You are directed to my previous article for in depth discussion. Visit http://the-anti-aging-guide.blogspot.com/2011/03/anti-aging-guide.html
2. Antioxidants
In a case-control study of micro-nutrients and laryngeal cancer risk in Italy and Switzerland, researchers found that independently from smoking and alcohol consumption, the intake of several micro-nutrients, including selected antioxidants, is inversely related to laynx cancer risk.
3. Vitamin A, C and zinc
Association of vitamin A, vitamin C and zinc with laryngeal cancer to assess the levels of vitamin A, vitamin C and zinc in laryngeal cancer patients and healthy controls, researchers found that serum vitamin A, zinc and plasma vitamin C levels were significantly lower in laryngeal cancer patients as compared to the controls.
4. Selenium
In study of laryngeal cancer and blood selenium levels researchers found that lower blood selenium levels in this latter group of laryngeal cancer patients may be a consequence of their disease rather than its cause.
5. Quercetin
In study of effects of quercetin on human throat cancer Hep-2 cells, researchers found that Quercetin could effectively inhibit the proliferation of Hep-2 cells and its mechanism is probably related to the apoptosis.
6. Etc.
Treatments
A. Conventional Medicine
1. Surgery
Depending to the stage and grade of the tumor. In this surgery, a tracheostomy tube, is needed keeps the new airway open and a new airway called stoma (opening on the chest made during surgery by your surgeon) to allow air to enter and leaves the trachea and lungs.
a. Total laryngectomy
Completely remove the larynx.
b. Partial laryngectomy
In this surgery, only parts of rlarynx is removed.
b.1. Supraglottic laryngectomy
In this surgery, only the top part of larynx is removed.
b.2. Cordectomy:
In this surgery, one or both vocal cords are removed.
c. Side effects
Surgery and anesthesia risks and complication
2. Radio therapy By using high-energy x-rays or other types of radiation, radiation therapy kills breast cancer cells and keep them from growing or regrowing. If the cancer is small in size, cancer can be cured. If the cancer is large, radiation therapy can be used to control local bad symptoms. Treatments are usually given 5 days a week for 4 to 8 weeks.
a. In general, radiotherapy is used for small tumors or patients who cannot have surgery.
b. In other case, if surgery can not be performed due to the stage of the tumor, radiotherapy can be used to shrunk the tumor to make surgery possible
c. Side effects
c.1. Fatigue
c.2. Chest pain
c.3. Heart problem
c.4. Short of breath
c.5. Skin discoloration or pinkness, irritation
c.6. Etc.
3. Chemotherapy
a. Chemotherapy can be used conjunction with radio therapy and surgery, if cancer has spread to a distant parts of the body with drugs taken by mouth or injected into a vein or muscle of the patient to stop the growth of or to kill cancer cells. Chemotherapy is found to have a less primary role in treating throat cancer.
b. Side effects
b.1. Nausea
b.2. Vomiting
b.3. Hair loss
b.4. Fatigue
b.5. Anemia
b.6. Mouth sores taste and smell changes
b.7. Infection
b.8. Etc.
B. Traditional Chinese medicine
1. Chen Pi
Chen Pi is also known as Tangerine Peel. The acrid, bitter and warm herb has been used in TCM as antibiotic agent and to stimulate blood vessels, inhibits movements of digestive tract and movement of uterine muscles, improve digestion, etc. as it regulates stomach qi, invigorates spleen Qi, dry damp, transform phlegm and prevent stagnation, etc. by enhancing the functions of lung and spleen channels. In vitro study Researcher found that hesperidin in Chen pi inhibits anti oxidation effect in preventing oxidation cause of cell DNA alternation.
2. Niu Bang Zi
Niu Bang Zi is also known as great burdock fruit. The acrid, bitter and cold herb has been used in TCM as antibiotic, anti-pyretic, anti tumor agent and to lower blood sugar, get rid of toxins, etc. as it clears heat, disperses wind-heat, remove toxins, etc. by enhancing the functions of lung and stomach channels. In studies researchers found that have arctigenin, a chemical in Niu Bang Zi, does in fact slow tumor growth.
3. Jie Geng
Jie geng is also known as Platycodon Root. The acrid, bitter and neutral herb has been use in TCM as anti-inflammatory, anti ulcers agent and to inhibit cough, treat bronchitis, sore throat etc., as it stimulates the lung in dispersing and descending functions, transforms phlegm, etc., by enhancing the functions of the lung channels.
The Researchers found that Saponins in Jie Geng have been shown to very significantly augment the cytotoxicity of immunotoxins and other targeted toxins directed against human cancer cells.
4. Xia Ku Cao
Xia Ku Cao is also known as Common Selfheal Fruit-Spike. The acrid, bitter and cold herb has been used in TCM as diuretic, antibiotic agent and to treat hypertension and arteriosclerosis, acute tonsillitis, amnesia, whooping cough etc., as it disperses Liver-Fire and nodules, treat hypotension, etc. by enhancing the functions of liver and gallbladder channels.
Researchers found that cyasterone in Xia Ku Cao showed anti tumor activity.
5. Etc.
Speech therapies after surgery
If treatment involves total removal of the voice box due to advance stage of the tumor, a tracheostomy (surgery to create an artificial airway in the trachea) is then performed to improve breathing, patient will have to learn how to speech again with the help of below speech therapies.
1. Esophageal Speech
Esophageal Speech is also known esophageal voice. It is type or method of speech production using the oscillation of the esophagus. In this method, learner takes air in through the mouth, traps it in the throat, then released in a controlled manner to create sound used to produce speech.
An artificial larynx is a medical device was introduced in the 1940s, used to produce clearer speech by those who have lost their original voicebox as a result of larunx cancer. It is considered as one of more difficult method to master that requires training and practice.
3. Tracheoesophageal Puncture (TEP)
Tracheoesophageal Puncture (TEP), generally perform during the surgery of the removal of larynx, is a surgically created hole between the trachea (windpipe) and the esophagus with the help of a voice prosthesis is inserted into this puncture to keeps food out of the trachea but allows air into the esophagus for oesophageal speech. When speak, the person inhales air through a permanent breathing hole in the neck into the lungs with the cover of the stoma by a finger, air is directed from the tracheax into the esophagus to produce speech.
4. Etc.
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