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An graphic representation of the intersection of human head, annotated with location of Laryngeal cancer

咽喉癌

咽喉癌也是頭頸癌的一種,
是一種惡性癌細胞在咽喉組織中形成的疾病1
HPV感染是咽喉癌的高危因素之一2
大部分HPV感染可自行清除,但持續感染可導致某些相關癌症3

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儘管年輕人也有感染咽喉癌的風險,但咽喉癌多見於年齡超過55歲的人士2在2022年,香港共有 71宗下咽癌新症,當中29宗是45-64歲,其餘有40宗年齡均超過65歲4

咽喉癌病徵

早期的咽喉癌症狀為聲音嘶啞或出現其他不尋常的變化,且這些異常情況在兩星期內並沒有消失5。另外,咽喉癌的病人也會有以下病徵:頸部淋巴結腫大或腫塊、氣道阻塞、呼吸困難和呼吸嘈雜、持續性喉嚨痛及吞嚥困難等5。一些咽喉癌患者也會出現耳朵疼痛的症狀5。儘管上述情況並不一定由咽喉癌引起,但若症狀並沒有得到改善或每況愈下,請立即求醫。

咽喉癌存活率

下咽癌的5年存活率並不是太理想,比其他頭頸癌的預後情況更差6。原位性的下咽癌的5年存活率只有61%,若下咽癌已經有區域性的轉移,患者的5年存活率會大幅下降至39%7。但是,當癌細胞已經遠端轉移,患者的5年存活率便只有28%7

咽喉癌治療

儘管咽喉癌的5年存活率比其他頭頸癌差,但在早期發現的情況下配以適當的治療方法,通常可以成功清除咽喉癌8。咽喉癌的治療方法主要可以分為3種:手術、放射治療和化學治療1。醫生會利用喉咽切除術或頸部清掃術去清除癌細胞9。但是咽喉癌患者接受手術治療後可能會永遠失去言語能力9,故醫生也會考慮患者的情況去選擇局部後咽切除術以保留他的說話能力1

除此以外,咽喉癌患者有機會需要接受放射治療或化學治療。完成放射治療後,患者會出現皮膚泛紅、口乾、噁心和口腔潰瘍等短期副作用10。化學治療的副作用的嚴重程度和多寡視藥物的劑量和患者的身體情況而定,常見的副作用包括:疲勞、血細胞數量下降、脫髮和食慾不振等10

預防咽喉癌

我們應注意飲食習慣和體重以預防咽喉癌11。此外,有煙酒習慣人士更應注意應定期每年進行一次身體檢查,讓醫生檢查鼻子、嘴巴、頸部和喉嚨是否有異常,例如出現頸部腫塊。這樣便可以盡早發現患癌並得到適當的治療10

References: 1. American Cancer Society. What are Laryngeal and Hypopharyngeal Cancers? Available from https://www.cancer.org/cancer/types/laryngeal-and-hypopharyngeal-cancer/about/what-is-laryngealand-hypopharyngeal.html. Accessed on: 21 Feb 2025. 2. American Cancer Society. What Causes Laryngeal and Hypopharyngeal Cancers? Available from: https://www.cancer.org/cancer/types/laryngeal-and-hypopharyngeal-cancer/causes-risks-prevention/what-causes.html. Accessed on: 21 Feb 2025. 3. NCI. HPV and Cancer. Available at: https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-and-cancer. Accessed on: 21 Feb 2025. 4. Hong Kong Cancer Registry, Hospital Authority. Hong Kong Cancer Statistics. Hypopharynx cancer (age). Available at: https://www3.ha.org.hk/cancereg/allages.asp. Accessed on: 21 Feb 2025. 5. American Cancer Society. Signs and Symptoms of Laryngeal and Hypopharyngeal Cancers. Available at: https://www.cancer.org/cancer/types/laryngeal-and-hypopharyngeal-cancer/detection-diagnosis-staging/signs-symptoms.html. Accessed on: 21 Feb 2025. 6. Patel EJ, et al. Otolaryngol Head Neck Surg. 2022 Jan;166(1):109–17. 7. American Cancer Society. Survival Rates for Laryngeal and Hypopharyngeal Cancers. Available at: https://www.cancer.org/cancer/laryngeal-and-hypopharyngeal-cancer/detection-diagnosis-staging/survival-rates.html. Accessed on: 21 Feb 2025. 8. American Cancer Society. Can Laryngeal and Hypopharyngeal Cancers Be Found Early?. Available at: https://www.cancer.org/cancer/types/laryngeal-and-hypopharyngeal-cancer/detection-diagnosis-staging/signs-symptoms.html. Accessed on: 21 Feb 2025. 9. American Cancer Society. Surgery for Laryngeal and Hypopharyngeal Cancers. Available from: https://www.cancer.org/cancer/types/laryngeal-and-hypopharyngeal-cancer/treating/surgery.html. Accessed on 21 Feb 2025. 10. American Cancer Society. Radiation and Chemotherapy for Laryngeal and Hypopharyngeal Cancers. Available at: https://www.cancer.org/cancer/types/laryngeal-and-hypopharyngeal-cancer/treating.html. Accessed on: 21 Feb 2025. 11. American Cancer society. Can Laryngeal and Hypopharyngeal Cancers Be Prevented? Available from: https://www.cancer.org/cancer/types/laryngeal-and-hypopharyngeal-cancer/causes-risks-prevention/prevention.html. Accessed on 21 Feb 2025.

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