Radiation Therapy for Hypopharyngeal Cancer

NYU Langone doctors may recommend radiation therapy, in which high-energy beams destroy hypopharyngeal cancer cells.

This may be the only treatment necessary for people with an early hypopharyngeal tumor that has not spread to nearby lymph nodes. The lymph nodes are often the first place cancer spreads.

Together, radiation oncologists and surgical oncologists decide which approach—radiation therapy or minimally invasive surgery—is most likely to spare nearby healthy tissue, such as other portions of the pharynx or the larynx.

Radiation therapy may also be recommended after surgery for hypopharyngeal cancer to destroy any remaining cancer cells.

For tumors that have spread to nearby lymph nodes or other structures, doctors may combine radiation therapy with chemotherapy, in which drugs are used to help destroy cancer cells throughout the body. This approach is called chemoradiation. It may be the only treatment used to manage these tumors, or it may follow surgery.

Radiation Therapy Planning

NYU Langone radiation oncologists use CT scans in conjunction with software to create treatment plans specific to the size and location of the tumor, area lymph nodes, and other nearby tissues where the cancer may have spread. The software creates three-dimensional images of a tumor and nearby tissues and structures. These include the esophagus, as well as the larynx and the thyroid gland, which helps regulate metabolism.

These images help doctors deliver highly targeted radiation therapy to the tumor, while avoiding healthy tissue.

Intensity Modulated Radiation Therapy

Doctors at NYU Langone usually use intensity modulated radiation therapy to manage hypopharyngeal cancer. With this therapy, the radiation beams come from various directions and are divided into many small, computer-controlled doses of differing strengths.

Tailored to the size, shape, and location of the tumor and area lymph nodes, these “minibeams” allow doctors to deliver high doses of radiation to the cancer while avoiding nearby healthy tissues. Treatment is delivered in fractions—typically once daily, five days a week, for six to seven weeks.

A special imaging technology called cone-beam CT is used before each treatment to ensure that the radiation therapy is delivered precisely. This imaging allows doctors to view the tumor and adjacent critical organs and to adjust the delivery of radiation to reflect changes in body positioning, weight loss, and tumor shrinkage.

Managing the Side Effects of Radiation Therapy

Side effects of radiation therapy for hypopharyngeal cancer are often temporary and may include a sore throat, problems with speech and swallowing, fatigue, and nausea. It may also cause tightening of the muscles in the face, jaw, and neck. Dry mouth is another side effect of radiation therapy and may be permanent.

To ease discomfort, doctors can prescribe medication or refer you to integrative health services. Rehabilitation is available if you experience speech and swallowing problems or muscle tightness due to treatment. Specialists can also help you learn how to manage dry mouth.