What Is Pharyngeal Cancer?
Pharyngeal cancer (also called throat cancer) is a cancer that forms in tissues of the pharynx (the hollow tube inside the neck that starts behind the nose and ends at the top of the windpipe and esophagus).
Most pharyngeal cancers are squamous cell carcinomas (cancer that begins in thin, flat cells that look like fish scales).
Types of Pharyngeal Cancer
Pharyngeal cancer includes cancer of the:
- Nasopharynx (the upper part of the throat behind the nose)
- Oropharynx (the middle part of the pharynx)
- Hypopharynx (the bottom part of the pharynx)
- Cancer of the larynx (voice box) may also be included as a type of pharyngeal cancer
How Is Pharyngeal Cancer Diagnosed?
Tests that examine the nose, throat, and neck are used to detect (find) and diagnose pharyngeal cancer.
The following tests and procedures may be used:
Physical exam of the throat
Throat and Neck Exam
A throat and neck exam is an examination in which the doctor feels for swollen lymph nodes in the neck and looks down the throat with a small, long-handled mirror to check for abnormal areas.
Nasoscopy
Nasoscopy
A nasoscopy is a procedure to look inside the nose for abnormal areas. A nasoscope is inserted through the nose. A nasoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer.
Endoscopy
Endoscopy
A procedure used to look at areas in the throat that cannot be seen with a mirror during the physical exam of the throat. An endoscope (a thin, lighted tube) is inserted through the nose or mouth to check the throat for anything that seems unusual. Tissue samples may be taken for biopsy.
Neurological exam
Neurological Exam
A neurological exam is a series of questions and tests to check brain, spinal cord, and nerve function. The exam checks an individual’s mental status, coordination, and ability to walk normally and how well the muscles, senses, and reflexes work.
Head and chest X-rays
Head and Chest X-ray
An X-ray of the skull and organs and bones inside the chest. An X-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
MRI
What Is Magnetic Resonance Imaging (MRI)?
A magnetic resonance (REZ-oh-nans) imaging scan is usually called an MRI. An MRI does not use radiation (X-rays) and is a noninvasive medical test or examination. The MRI machine uses a large magnet and a computer to take pictures of the inside of your body. Each picture or “slice” shows only a few layers of body tissue at a time. The pictures can then be examined on a computer monitor.
Pictures taken this way may help caregivers find and see problems in your body more easily. The scan usually takes between 15 to 90 minutes. Including the scan, the total examination time usually takes between 1.5 to 3 hours.
A substance called gadolinium is injected into a vein to help the physicians see the image more clearly. The gadolinium collects around cancer cells so they show up brighter in the picture. Sometimes a procedure called magnetic resonance spectroscopy (MRS) is done during the MRI scan. An MRS is used to diagnose tumors based on their chemical make-up.
How does MRI work?
The MRI machine is a large, cylindrical (tube-shaped) machine that creates a strong magnetic field around the patient. This magnetic field, along with a radiofrequency, alters the hydrogen atoms’ natural alignment in the body.
A magnetic field is created and pulses of radio waves are sent from a scanner. The radio waves knock the nuclei of the atoms in the body out of their normal position; as the nuclei realign back into proper position, they send out radio signals.
These signals are received by a computer that analyzes and converts them into an image of the part of the body being examined. This image appears on a viewing monitor. Some MRI machines look like narrow tunnels, while others are more open.
MRI may be used instead of a CT scan in situations where organs or soft tissue are being studied, because with MRI scanning bones do not obscure the images of organs and soft tissues, as does CT scanning.
Other related procedures that are used to assess the heart may include:
- Resting or exercise electrocardiogram (ECG)
- Signal-averaged electrocardiogram (ECG)
- Holter monitor
- Cardiac catheterization
- Chest X-ray
- Computed tomography (CT scan) of the chest
- Electrophysiological studies
- Myocardial perfusion scans
- Radionuclide angiography
- Ultrafast CT scans
CT scan
Computed Tomography Scan (CT Scan)
Computed tomography scan (CT or CAT scan) is a non-invasive diagnostic imaging procedure that uses a combination of special X-ray equipment and sophisticated computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. These cross-sectional images of the area being studied can then be examined on a computer monitor or printed.
CT scans are more detailed than general X-rays, showing detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans of internal organs, bone, soft tissue and blood vessels provide greater clarity and reveal more details than regular X-ray exams. CT scans also minimize exposure to radiation. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly.
In standard X-rays, a beam of energy is aimed at the body part being studied. A plate behind the body part captures the variations of the energy beam after it passes through skin, bone, muscle, and other tissue. While much information can be obtained from a standard X-ray, a lot of detail about internal organs and other structures is not available.
In computed tomography, the X-ray beam moves in a circle around the body. This allows many different views of the same organ or structure. The X-ray information is sent to a computer that interprets the X-ray data and displays it in a two-dimensional (2D) form on a monitor.
Using specialized equipment and expertise to create and interpret CT scans of the body, radiologists can more easily diagnose problems such as cancers, cardiovascular disease, infectious disease, trauma and musculoskeletal disorders.
CT scans of the chest can provide more detailed information about organs and structures inside the chest than standard X-rays of the chest, thus providing more information related to injuries and/or diseases of the chest (thoracic) organs.
Chest CT scans may also be used to visualize placement of needles during biopsies of thoracic organs or tumors, or during aspiration (withdrawal) of fluid from the chest. This is useful in monitoring tumors and other conditions of the chest before and after treatment.
While many images are taken during a CT scan, in some cases the patient receives the same or less radiation exposure than with a single standard X-ray.
CT scans may be done with or without “contrast.” Contrast refers to a substance taken by mouth or injected into an intravenous (IV) line that causes the particular organ or tissue under study to be seen more clearly. Contrast examinations may require you to fast for a certain period of time before the procedure. Your physician will notify you of this prior to the procedure.
Care agreement:
You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.
Related procedures
Other related procedures that may be used to assess the heart include:
- Resting or exercise electrocardiogram (ECG or EKG)
- Holter monitor
- Signal-averaged ECG
- Cardiac catheterization
- Chest X-ray
- Echocardiogram
- Electrophysiological studies
- Magnetic resonance imaging (MRI) of the heart
- Myocardial perfusion scans
- Radionuclide angiography
- Ultrafast CT scan
PET scan
What Is Positron Emission Tomography (PET) Scan?
Positron emission tomography, also called PET imaging or a PET scan, is a type of nuclear medicine imaging. A PET scan measures important body functions, such as blood flow, oxygen use, and sugar (glucose) metabolism, to help doctors evaluate how well organs and tissues are functioning.
PET is a powerful diagnostic test that is having a major impact on the diagnosis and treatment of disease. A PET scan (positron emission tomography scan) monitors the biochemical functioning of cells by detecting how they process certain compounds, such as glucose (sugar). PET can detect extremely small cancerous tumors, subtle changes of the brain and heart, and give doctors important early information about heart disease and many neurological disorders, like Alzheimer’s.
Most common medical tests, like CT and MRI scans, only show details about the structure of your body. PET scans give doctors images of function throughout the entire body, uncovering abnormalities that might otherwise go undetected. This allows doctors to treat these diseases earlier and more accurately. A PET scan puts time on your side. The earlier the diagnosis, the better the chance for treatment.
For example, a PET scan is the most accurate, non-invasive way to tell whether or not a tumor is benign or malignant, sparing patients expensive, often painful diagnostic surgeries and suggesting treatment options earlier in the course of the disease. Although cancer spreads silently in the body, PET can inspect all organs of the body for cancer in a single examination.
Today, most PET scans are performed on instruments that are combined PET and CT scanners. The combined PET/CT scans provide images that pinpoint the location of abnormal metabolic activity within the body. The combined scans have been shown to provide more accurate diagnoses than the two scans performed separately.
About nuclear medicine
Nuclear medicine is a branch of medical imaging that uses small amounts of radioactive material to diagnose or treat a variety of diseases, including many types of cancers, heart disease, and certain other abnormalities within the body. Depending on the type of nuclear medicine exam you are undergoing, the radiotracer is either injected into a vein, swallowed or inhaled as a gas and eventually accumulates in the organ or area of your body being examined, where it gives off energy in the form of gamma rays. This energy is detected by a device called a gamma camera, a PET scanner and/or probe.
Barium esophagogram
Barium Esophagram
Barium esophagram is an X-ray of the esophagus. The patient drinks a liquid that contains barium (a silver-white metallic compound). The liquid coats the esophagus and X-rays are taken.
Barium esophagrams are often used in diagnosing:
- Pharynx cancer
Esophagoscopy
Esophagoscopy
A procedure to look inside the esophagus to check for abnormal areas. An esophagoscope (a thin, lighted tube) is inserted through the mouth or nose and down the throat into the esophagus. Tissue samples may be taken for biopsy.
Bronchoscopy
What Is Bronchoscopy?
Bronchoscopy is the examination of the bronchi (the main airways of the lungs) using a flexible tube (bronchoscope). Bronchoscopy is performed under anesthesia and helps to evaluate and diagnose lung problems, assess blockages, obtain samples of tissue and/or fluid, and/or to help remove a foreign body. Bronchoscopy may include a biopsy or bronchoalveolar lavage.
Biopsy
What Is a Biopsy?
A biopsy is a procedure in which tissue samples are removed from the body by a needle or during surgery, for examination under a microscope to determine if cancer or other abnormal cells are present.
By examining and performing tests on the biopsy sample, pathologists and other experts can determine what kind of cancer is present, whether it is likely to be fast or slow growing, and what genetic abnormalities it may have. This information is important in deciding the best type of treatment. Open surgery is sometimes performed to obtain a biopsy, but in most cases, tissue samples can be obtained without open surgery using interventional radiology techniques.
Some biopsies can be performed in a doctor’s office, while others need to be done in a hospital setting. Most biopsies require use of an anesthetic to numb the area and may require sedation.
Laboratory tests
What Is a Laboratory Test?
Laboratory tests include a range of blood and urine tests. Blood work may include testing for genetics (inherited disorders) or to determine the amount of oxygen in the blood. Urine tests may be performed to check blood, chemicals, bacteria, and cells for infection or other abnormalities.
