Laryngopharynx cancer is a malignant tumor located in the lower part of the pharynx. At the initial stage of progression, the disease does not show any symptoms, therefore, for a long time continues to remain invisible. In the future, the patient begins to show severe pain, a feeling of something foreign in the throat, sore, burning, increased salivation, hoarseness, coughing, and respiratory distress. The severity of the first signs of the disease will directly depend on the place of spread of neoplasia.
Disease Description
Cancer of the piriform sinus of the larynx is distinguished by its aggressive development, it leads to the appearance of early metastases in the patient. The diagnosis is established, taking into account the results after an ultrasound scan of the neck, MRI and CT of the larynx, pharyngeal rhinolaryngoscopy and biopsy. Therapeutic measures are carried out by means of resection of the piriform sinus, expansion of laryngectomy, chemotherapy, radiotherapy and lymphadenectomy.
Features of piriform sinus cancer
Hypopharyngeal cancer - a definition that is used to describe malignant tumor formations in the upper part of the digestive tract, including the larynx and pharynx. As in many other subsite designations, distinguishing features in pituitary cancer of the anatomical rather than pathophysiological form. In general, this type of cancer refers to neck and head cancer.
The cyst of the piriform sinus of the larynx is named so because of its location. This includes the lateral, posterior, middle walls of the pharynx, as well as the cricoid site.
Many forms of malignant tumors are formed precisely in the piriform sinus. The disease is common. In the United States and Canada, about 56-85 percent of hypopharyngeal carcinomas are diagnosed in a piriform sinus. From 10 to 20 percent of such formations are formed on the back wall of the pharynx, and from 3 to 5 percent - in the sap-shaped section.
Anatomy of the piriform sinus of the larynx
The larynx is the area located between the oropharynx (level of the hyoid bone) and the esophagus (in the lower part of the cricoid cartilage). The larynx itself can be called a structure that is separable from the pharynx, since it is located slightly in front, speaking for it. The pear-shaped sinus is filled with soft tissue contents, in which oncology quickly spreads. Cancerous formations of a malignant nature with hypopharyngeal cancer spread, as a rule, without going beyond the boundaries of the sinus.
The larynxopharynx includes three distinct pharyngeal segments. It is wide from above, with an increase in its size, it narrows significantly towards the lower part of the cricopharyngeal muscles. In front, such an organ is bounded by the posterior surface of the cricoid cartilage. In the two opposite sides of the pharynx, pear-shaped forms of the sinus or fossa are formed (for this reason the name of such a part of the body appeared). Thus, the anatomy of the piriform sinus of the larynx is understood by many.
As in other cases, neck or head cancer is diagnosed in 95% of all malignant tumors, neoplasms are formed on the mucous membrane, therefore this condition is referred to as squamous cell cancer. The precancerous state of the mucous membrane can quickly change to a hyperproliferating form, which over time will begin to actively progress, increase in size and move to adjacent tissues. After the cancer cells spread to the lymph nodes, a dangerous disease disrupts the work of other organs in the body, which provokes the development of metastases.
Detection rate
Pharyngeal cancer is diagnosed in 7 percent of cases of all oncology of the upper respiratory tract and digestive tract. Laryngeal cancer disease is 4-5 times higher than the frequency of laryngeal pharyngeal cancer. Now on the planet every year, laryngeal cancer is diagnosed in 125 thousand people.
Men suffer from this form of the disease three times more often than women. But despite this, oncological processes in the pharyngeal-esophageal junction in women are a more frequent occurrence. Doctors believe that the disease develops due to an improperly prepared diet (when eating too much junk food or with insufficient content of vitamins and minerals in the daily products consumed). For different nationalities, the incidence of such a disease is also markedly different: African Americans suffer from cancer of the larynx and pharynx much more than other races.
What do doctors say for cancer?
The biological reactions of pharyngeal carcinoma are different from simple laryngeal cancer. Pharyngeal carcinomas most often do not lead to the development of severe symptoms, so patients continue to be unaware of their disease for a long time. It is for this reason that the final prognosis established by the doctor is usually unfavorable. The rate of development and spread of metastases in piriform sinus cancer is very high.
Also, with such a disease, a high degree of damage to the lymph nodes is noted, it ranges from 50 to 70 percent of the total cases of damage. About 70 percent of patients who go to the doctor because of the appearance of unpleasant symptoms receive a diagnosis of "third stage of cancer" from a specialist. Metastases and affected lymph nodes are detected in most patients. The number of distant metastases with the development of cancer of the left piriform sinus (or right) remains as high as with other forms of cancer of the neck and head.
The prognosis for any form of cancer will directly depend on the stage of development of the tumor, its general size, the severity of the disease, symptoms and the patient’s health at the time of the development of the disease. Cancer of degree T1-T2 gives the patient another five years of life (this occurs in 60 percent of cases), but in the presence of cancer of the T3 or T4 degree of development, survival is sharply reduced, surviving only up to 17-32 percent. Five-year life expectancy for all stages of cancer is about 30 percent.
What factors affect the patient's life expectancy?
There are certain factors that influence the progression of piriformis cancer and decrease the patient's life span. These include:
- gender of the patient and his age category;
- race (it is important to remember that African Americans are the most affected by this defeat);
- Karnowski performance assessment (patients with underweight, with poor nutrition and not getting the right amount of nutrients, minerals and vitamins, as a rule, have an unfavorable prognosis);
- tumor formations (stage of disease development, prevalence and localization);
- histology (especially the boundaries of tumor formation, the rapid spread of cells to adjacent tissue areas after irradiation);
- site of localization of tumor formation;
- the total size of the cancer in cross section.
Accelerated development of the lesion
Negative factors leading to the accelerated development of the disease:
- regular smoking;
- drinking excessive amounts of alcohol (daily or 3-4 times a week, the appearance of alcoholism);
- Plummer-Winson syndrome;
- irritable process in the pharynx as a result of gastroesophageal or laryngotracheal reflux;
- the presence of a predisposition to the disease at the genetic level;
- poorly composed nutrition; lack of foods enriched with vitamins and nutritional components.
Symptoms of a patient having a disease
The first stage of the development of piriform sinus cancer in humans sometimes speaks of itself with the following unpleasant symptoms:
- Strong headache;
- the presence of bleeding;
- regular cough with an admixture of blood;
- problems swallowing food;
- partial aspiration;
- with a large tumor formation in the patient, airway obstruction may begin;
- rapid weight loss due to malnutrition (the patient ceases to eat food in the right amount, since it brings him discomfort when swallowing);
- tumor formation can actively develop in the area of the larynx.
Malignant hypopharyngeal tumors are considered very dangerous, they can reach a huge size in a short period of time. The larger the size of the tumor, the more the main signs of the disease appear.
Additional signs
Doctors also identify additional symptoms of the disease:
- a feeling of a foreign object in the throat;
- dysphagia;
- enlarged lymph nodes;
- a feeling of bitterness in the mouth, the presence of an unpleasant odor;
- the presence of swelling on the neck and face in the morning immediately after waking up.
The duration of the asymptomatic course of the disease can vary from two to four months. At later stages of the development of the disease, the patient’s voice becomes hoarse, his body weight quickly decreases, sputum and drool come out together with blood. In about 70 percent of patients, the disease provokes death in the third stage of development.
Diagnostics
Diagnostic measures for detecting larynxopharyngeal cancer will begin with a thorough examination of the neck and head. For this, palpation or fiber-optic examination is carried out using a flexible endoscope. Typical visual symptoms of laryngopharynx cancer are the development of ulcers on the mucous membranes, a large amount of saliva of a viscous consistency can accumulate in the piriform sinus, in addition, severe swelling of one or two vocal cords, asymmetry of the tonsils, hyperkeratosis, or mucous erythematosis can be detected.
In addition, the doctor evaluates the condition of the nerves of the skull, the mobility of the jaw, checks the condition of the lungs and finds in them a possible infection of a chronic form. Examination of the extremities helps determine peripheral vascular disease or symptoms of advanced stage lung disease and secondary lung cancer.
About 30 percent of patients have an additional developing disease at the time of diagnosis of piriform sinus cancer.
Conducting therapeutic measures
As with other oncological diseases of the head and neck, malignant tumors of the piriform sinus are treated with the following methods:
- surgical intervention;
- chemotherapy course;
- radiation therapy.
In addition, a subspecies of surgical removal is used - transoral laser resection. Due to its specific location, there is a high risk of partial or complete loss of voice, in addition, the operation may complicate the process of eating, chewing, swallowing, and also worsen respiratory activity.