Symptoms 

• chronic sore throat
• ear pain
• lump in the neck
• vocal changes
• difficulty swallowing or pain while swallowing

they’ll do a physical examination that may include feeling your neck for swollen lymph nodes and examining your throat.

Depending on your symptoms, your provider may refer you to an ear, nose and throat (ENT) specialist or otolaryngologist, a provider who specializes in diagnosing and treating head and neck conditions. Your ENT may order the following tests to determine if you have hypopharyngeal cancer:

• Endoscopy: In this test, a provider places a long thin tube (endoscope) in your throat to check your lower throat. They may also order a laryngoscopy to examine your larynx.
• Biopsy: Your provider may order a fine-needle aspiration (FNA) to obtain tissue that a pathologist will view under a microscope for signs of cancerous cells.
• Imaging tests: If biopsy results show you have hypopharyngeal cancer, your otolaryngologist may refer you to an oncologist. Your oncologist may order imaging tests to see if cancer has spread from your lower throat to other areas of your body. Imaging tests may include computed tomography (CT), magnetic resonance imaging (MRI) or positron emission tomography (PET) scans.

The most common treatments are surgery to remove the tumor and radiation therapy to kill any cancerous cells that may remain after surgery. Your oncologist may combine surgery with chemotherapy or immunotherapy.

Hypopharyngeal cancer surgical options are:

• Partial or total pharyngectomy: This surgery involves removing all or part of your throat. Surgery may include a laryngectomy to remove your larynx (voice box). Your throat helps you breathe, so surgery includes creating a stoma to hold a laryngectomy tube. This tube is how you’ll breathe in air after surgery.
• Laryngectomy: If you have a laryngectomy, your surgeon may create a tracheoesophageal puncture (TEP), which is a small hole between your trachea and esophagus. A TEP is how providers insert a voice prosthesis (laryngectomy speaking device).
• Neck dissection: Your surgeon may do this to remove affected lymph nodes in your neck.
• Transoral robotic surgery (TORS): This surgery allows surgeons to remove tumors in hard-to-reach places like your lower throat.
• Reconstructive surgery: Surgery that removes all or part of your throat or voice box may require reconstructive surgery to help restore function such as eating, breathing and the ability to use your voice prosthesis.

Throat surgery for cancer affects your ability to speak, eat and breathe. Before your surgery, ask your surgeon how treatment will affect you. 

Situations when chemotherapy is prescribed for nasopharyngeal cancer, are as follows: 

• before chemoradiotherapy (such chemotherapy is called induction).
• in combination with radiation therapy, as part of chemoradiotherapy as pre- or post-surgical.
• at the metastatic stage

Radiation therapy for nasopharyngeal cancer is considered the main treatment option. It is combined with chemotherapy often.

IMRT (Intensity-modulated radiation therapy). The variant of three-dimensional irradiation is one of the safest. IMRT is used in cases of anatomical proximity of functionally important organs and irregular tumor configuration. With its help, even cancer that is around an organ at risk can be safely irradiated: for example, if it surrounds a large artery. The dose of radiation corresponds to the three-dimensional shape of the tumor by controlling or modulating the intensity of the radiation beam. The radiation dose intensity increases near the total tumor volume. It is reduced or absent for adjacent normal tissues. As a result, IMRT provides better tumor targeting, reduces the risk of side effects, and improves treatment outcomes. In studies, IMRT has proved most advantages in irradiating head and neck tumors compared to other types of cancer. The main advantage is treatment toxicity reduction.

VMAT (Volumetric modulated arc therapy). This is a new and improved version of IMRT. Nasopharyngeal cancer is irradiated using a rotating gantry along one or more arcs. The speed and shape of the beam changes. The main benefit is reduced delivery time for the required dose of radiation. VMAT is characterized by a sparing effect on organs at risk.

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• Diagnosis:

The program includes:

• Initial presentation in the clinic
• clinical history taking
• review of medical records
• physical examination
• laboratory tests:
• complete blood count
• biochemical analysis of blood
• tumor markers
• inflammation indicators (CRP, ESR)
• indicators of blood coagulation
• CT scan, MRI scan (if indicated clinically).
• general otolaryngological examination
• endoscopy with biopsy.
• histopathological examination for the excised tissue.
• nursing services
• tumor board involving oncologist, radiologist, surgeon
• consultation of the chief physician and all leading experts
• development of individual treatment plan

Required documents

• Medical records
• MRI/CT scan (not older than 3 months)
• Biopsy results (if available)

Price from: On request

Type of program: Outpatient

Expected duration of the program: 4 days

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• Surgery:

The program includes:

• Initial presentation in the clinic
• clinical history taking
• review of medical records
• physical examination
• laboratory tests:
• complete blood count
• biochemical analysis of blood
• TSH-basal, fT3, fT4
• tumor markers
• inflammation indicators (CRP, ESR)
• indicators blood coagulation
• CT/MRI of the head, neck
• general otolaryngological examination
• endoscopy with biopsy
• preoperative care
• operations:

• tumor resection with lymph node dissection with or without reconstruction

• histologically and immunohistochemically examination of the removed tissues
• symptomatic treatment
• control examinations
• the cost of essential medicines and materials
• nursing services
• full hospital accommodation
• explanation of future recommendations

Required documents

• Medical records
• MRI/CT scan (not older than 3 months)
• Biopsy results (if available)

Price from: on request

Type of program: Inpatient

Expected duration of the program: 14 days

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• Radiotherapy:

The program includes:

• Initial presentation in the clinic
• clinical history taking
• review of medical records
• physical examination
• laboratory tests:
• complete blood count
• biochemical analysis of blood
• inflammation indicators (CRP, ESR)
• TSH-basal, fT3, fT4
• indicators of blood coagulation
• CT simulation and planning of radiation therapy
• Physics calculations
• full course of radiation therapy with different modalities (3D, IMRT, VMAT).
• symptomatic treatment
• cost of essential medicines and materials
• nursing services
• control examinations
• consultations of related specialists

How program is carried out

During the first visit, the doctor will conduct a clinical examination and go through the results of previous laboratory tests and instrumental examinations. After that, you will undergo an additional examination, including complete blood count, laboratory assessment of liver and kidney function. Based on the received results, the physician will conduct radiotherapy planning with the help of CT or MRI, make the permanent tattoo marks on the skin and conduct CT simulation in order to assess the accuracy of the rays and the radiation dose. If necessary, related medical specialists will be involved in the elaboration of a treatment regimen (tumor board).

Radiation therapy is carried out as the day hospital procedure, without mandatory admission to the hospital. At each visit, the physician will assess your general condition and the marks on the skin. After that, you will be placed in a shielded radiation therapy room, on a special table.

Each radiation therapy session lasts less than half an hour (including preparation). All this time, doctors and nurses are monitoring your condition, you can communicate with them through a loudspeaker. The procedure is completely painless. Depending on the planned course of treatment, you will visit the hospital from 1 to 3-5 times a week.

After the completion of the radiation therapy course, you will undergo control examinations aimed at assessing your condition and efficacy of treatment. After that you will receive the medical report with detailed recommendations regarding further follow-up and treatment. In the future, you will be able to have a distant consultation with your attending physician and schedule the next course of treatment, if necessary.

Required documents

• Medical records
• MRI/CT scan (not older than 3 months)
• Biopsy results (if available)

Price from: on request

Type of program: Outpatient

Expected duration of the program: 39 days

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• Chemo-radiotherapy:

The program includes:

• Initial presentation in the clinic
• clinical history taking
• review of medical records
• physical examination
• CT /MRI (if indicated clinically) 
• laboratory tests:
• complete blood count
• general urine analysis
• biochemical analysis of blood
• tumor markers (If indicated clinically)
• indicators of inflammation (CRP, ESR)
• indicators of blood coagulation
• CT simulation and planning of radiation therapy
• Physics calculation
• full course of radiation therapy with different modalities (3D, IMRT, VMAT) according to your treatment plan.
• individual plan of the chemotherapy, the cost of medicines is included
• symptomatic treatment (for side effects of chemo and radiotherapy that may developed).
• cost of essential medicines and materials
• nursing services
• control examinations
• consultations of related specialists
• explanation of future recommendations

How program is carried out

During the first visit, the doctor will conduct a clinical examination and go through the results of previous laboratory tests and instrumental examinations. After that, you will undergo an additional examination, including complete blood count, laboratory assessment of liver and kidney function. Based on the received results, the physician will elaborate the chemotherapy regimen, conduct radiotherapy CT or MRI SIMULATION then planning, make the permanent tattoo marks on the skin to assess the accuracy of the rays and the radiation dose. If necessary, related medical specialists will be involved in the elaboration of a treatment regimen (tumor board).

Chemotherapy and radiation therapy are carried out as the day hospital procedure, without mandatory admission to the hospital. At each visit, the physician will assess your general condition and the marks on the skin. After that, you will be placed in a shielded linear accelerator radiation therapy room.

Each radiation therapy session lasts less than half an hour (including preparation). All this time, doctors and nurses are monitoring your condition, you can communicate with them through a loudspeaker. The procedure is completely painless. Depending on the planned course of treatment, you will visit the hospital from 1 to 3-5 times a week.

Chemotherapy may be through intravenous route according to your treatment plan, during the chemotherapy session, after the placement of a venous catheter, you will stay in a comfortable ward. An infusion system will be connected to the catheter, through which the required drug or a drug combination will be administered. All drugs are administered by intravenous drip, slowly, so the total duration of the infusion can be up to several hours. All this time, doctors and nurses will monitor your health condition closely.

During radiotherapy, you are under close follow-up daily from doctors and nurses.

After the completion of the chemotherapy and radiation therapy course, you will undergo control examinations aimed at assessing your condition and efficacy of treatment. After that you will receive the medical report with detailed recommendations regarding further follow-up and treatment. In the future, you will be able to have a distant consultation with your attending physician and schedule the next course of treatment, if necessary.

Required documents

• Medical records
• MRI/CT scan (not older than 3 months)
• Biopsy results

Price from: on request

Type of program: Outpatient

Expected duration of the program: 39 days

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• Chemotherapy:

The program includes:

• Initial presentation in the clinic
• clinical history taking
• analysis of medical records
• physical examination
• laboratory tests:

• complete blood count
• biochemical analysis of blood
• tumor markers
• inflammation indicators
• indicators of blood coagulation
• ultrasound scan, CT / MRI scan (if indicated).
• 1 course of chemotherapy
• consultations of related specialists
• symptomatic and specific treatment
• the cost of essential medicines and materials
• nursing services
• control examinations
• full hospital accommodation
• recommendations for further treatment

How program is carried out

During the first visit, the doctor will conduct a clinical examination and go through the results of previous laboratory tests. After that, you will undergo an additional examination, including laboratory assessment of liver and kidney function. Based on the received results, the doctor will elaborate the chemotherapy regimen. If necessary, related medical specialists will be involved in the elaboration of a treatment regimen (tumor board).

Chemotherapy is carried out as outpatient according to chemotherapy protocol type. After the placement of a venous catheter, you will stay in a comfortable ward. An infusion system will be connected to the catheter, through which the required drug or a drug combination will be administered. All drugs are administered by intravenous drip, slowly, so the total duration of the infusion can be up to several hours. All this time, doctors and nurses will monitor your health condition closely.

After the course of chemotherapy, you will stay under medical supervision in the ward for a few more hours. After the completion of the chemotherapy course and control examinations you will receive the medical report with detailed recommendations regarding further treatment. In the future, you will be able to have a distant consultation with your attending physician and schedule the next course of chemotherapy, if necessary.

Required documents

• Medical records
• Colonoscopy data, MRI/CT scan (not older than 3 months)
• Biopsy results
• Any recent laboratory results.

Price from: On request (regarding chemotherapy protocol)

Type of program: outpatient

Expected duration of the program: from 1 to 4 days per cycle (regarding chemotherapy protocol)