Treatments for recurrent hypopharyngeal cancer

Recurrent hypopharyngeal cancer means that the cancer has come back after it has been treated. The following are treatment options for recurrent hypopharyngeal cancer. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.

Treatment options depend on where the cancer comes back (recurs), the size of the cancer, which treatments you received for the original cancer and your overall health.

You may be offered surgery for resectable hypopharyngeal tumours that come back if the original cancer was treated with minimally invasive surgery, radiation or chemoradiation. Chemoradiation combines radiation therapy with chemotherapy. The 2 treatments are given during the same time period. The goal of surgery is to remove the recurrent tumour.

You may be offered radiation therapy for recurrent hypopharyngeal cancer. It may be used as the main treatment if radiation wasn’t used to treat the original cancer. In some cases, it may be given again (called re-irradiation) even if it was used to treat the original cancer. Radiation therapy may be given alone, as part of chemoradiation or with a targeted therapy drug.

You may be offered chemotherapy for recurrent hypopharyngeal cancer. Cancer that can’t be removed by surgery or comes back in distant places is often treated with chemotherapy. The following drugs may be used alone or in combination:

• cisplatin
• carboplatin
• fluorouracil (also called 5-fluorouracil or 5-FU)
• methotrexate
• paclitaxel
• docetaxel
• bleomycin
• ifosfamide (Ifex)

You may be offered chemoradiation for recurrent hypopharyngeal cancer. In chemoradiation, chemotherapy is given during the same time period as radiation therapy. For recurrent hypopharyngeal cancer, cisplatin is usually the chemotherapy drug given along with radiation to the tumour and lymph nodes on both sides of the neck.

You may be offered targeted therapy for recurrent hypopharyngeal cancer. It may be given alone or along with radiation therapy or chemotherapy. Cetuximab (Erbitux) is he most common targeted therapy drug used to treat hypopharyngeal cancer.

You may be offered immunotherapy for recurrent hypopharyngeal cancer. Immunotherapy helps to strengthen or restore the immune system's ability to fight cancer.

Pembrolizumab (Keytruda) may be used as a first-line therapy to treat unresectable recurrent hypopharyngeal cancer. It may be given with or without chemotherapy.

Nivolumab (Opdivo) may be used to treat recurrent hypopharyngeal cancer that has stopped responding to chemotherapy with platinum drugs such as cisplatin or carboplatin.

You may want to consider a type of care to make you feel better without treating the cancer itself. This may be because the cancer treatments don’t work anymore, they’re not likely to improve your condition or they may cause side effects that are hard to cope with. There may also be other reasons why you can’t have or don’t want cancer treatment.

Talk to your healthcare team. They can help you choose care and treatment for advanced cancer.

Talk to your doctor about clinical trials open to people with hypopharyngeal cancer in Canada. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.