Mr. Cui has been suffering from chronic gastritis, and when he underwent a gastroscopy this year, the doctor told him that the examination found that a rough cauliflower-like neoplasm could be seen in his left piriform fossa, and the possibility of malignant tumors could not be ruled out. The degree of malignancy of the tumor in this location is high, because the site of the disease is hidden and not easy to be detected early, and patients often miss the best time for treatment, resulting in unsatisfactory long-term treatment results. When Mr. Cui heard about it, he walked into the otolaryngology-head and neck surgery clinic with a nervous heart.
A condition that seriously affects the quality of life of patients
Mr. Cui was diagnosed with hypopharyngeal cancer. This is a malignant tumor that occurs in the hypopharynx, and the most common pathological type is squamous cell carcinoma, while other pathological types such as adenocarcinoma, sarcoma, and adenoid cystic carcinoma are relatively rare. According to the location of occurrence, hypopharyngeal carcinoma can be divided into piriformis fossa carcinoma, posterior annular carcinoma and posterior hypopharyngeal wall cancer, with piriformis fossa carcinoma being the most common.
Hypopharyngeal carcinoma has the characteristics of high metastasis and high aggressiveness, due to the concealment of the anatomical location of the hypopharynx, the symptoms of patients are not obvious, and most patients are in the middle and advanced stages at the time of initial diagnosis, so it is difficult to treat. Patients with advanced hypopharyngeal cancer are likely to have their functions such as breathing, swallowing, and speech affected after treatment. Hypopharyngeal cancer seriously affects the quality of life of patients, brings great physical and mental trauma to patients, and the survival time is not ideal, and there is no radical cure.
Smoking and drinking alcohol are associated with the onset of the disease
At present, the medical community believes that the incidence of hypopharyngeal cancer is directly related to long-term smoking and excessive alcohol consumption. Statistical analysis showed that the consumption of tobacco and alcohol was positively correlated with the incidence of hypopharyngeal cancer, and human papillomavirus (HPV) infection was also associated with the occurrence of hypopharyngeal cancer.
In addition, regular consumption of foods with high nitrite content or excessively hot foods may also induce hypopharyngeal cancer. This may be the reason why the incidence of hypopharyngeal cancer in Inner Mongolia and Northeast China is much higher than in other regions.
How to diagnose hypopharyngeal cancer
Most patients with hypopharyngeal cancer are in the middle and advanced stages at the time of initial diagnosis because of the lack of specific symptoms in the early stage.
Endoscopy is an effective test to understand the hypopharyngeal region. Endoscopic white light combined with narrow-band imaging (NBI) is particularly recommended, as it allows doctors to see superficial mucosal surface structures more accurately.
On the basis of endoscopy, patients need to undergo further imaging examinations, mainly including enhanced CT of the neck, MRI, B-ultrasound, etc.
The gold standard for diagnosing hypopharyngeal carcinoma is histopathological examination. If the patient has enlarged lymph nodes, a cervical lymph node aspiration or biopsy may also be an option.
Treatment: surgery and radiotherapy
Patients with early-stage hypopharyngeal cancer can be treated with a single treatment modality such as surgery or radiotherapy, and there is no significant difference in treatment effect between the two. The choice of treatment requires a comprehensive assessment based on the size and location of the tumor, possible functional impairment after surgery, the experience of the surgeon and radiation oncologist, and the patient's wishes.
Surgical treatment, or radical surgery, requires the doctor to remove the tumor completely while preserving the patient's laryngeal function as much as possible. If the tumor is small, patients can choose transoral endoscopic laser surgery, plasma surgery, and if possible, patients can also choose transoral robotic surgery. If you are concerned that minimally invasive surgery will not ensure complete removal of the tumor, you can choose open surgery.
Patients with early-stage hypopharyngeal cancer who have opted for radiotherapy should have dietary, speech, and oral assessments prior to treatment. Whether or not to choose to have cervical lymph node dissection should be analyzed on a case-by-case basis according to the patient's own situation. Patients with very localized lesions and no significant lymphadenopathy on examination may be eligible for close observation.
It is more appropriate for patients with advanced hypopharyngeal cancer to choose a comprehensive treatment mode of surgery combined with chemoradiotherapy. After treatment, advanced patients have great trauma, which often affects the function of breathing, swallowing and pronunciation, and the 5-year survival rate is only 30%~40%. Therefore, early diagnosis and early treatment are very important for the treatment of hypopharyngeal cancer.
Postoperative lifelong follow-up is important
After patients with hypopharyngeal cancer are discharged from the hospital, they must be followed up on time, and it is recommended that all patients with hypopharyngeal cancer be followed up for life.
After receiving treatment, patients with hypopharyngeal cancer must quit smoking and drinking, work and rest regularly, and pay attention to nutritional support.
After learning about his condition, Mr. Cui chose to undergo surgery. Because the local lesion is small and Mr. Cui's general condition is good, transoral endoscopy can well expose the extent of the tumor. Eventually, Mr. Choi had his tumor completely removed through minimally invasive surgery.