# Pharyngeal (Throat) Cancer

- Category: chronic
- Review status: reviewed (every claim checked against a document named on this page)
- Sources: ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class DD28.03 - condition scope only, no dose · NICE NG12: Suspected cancer: recognition and referral (recommendation 1.2) - https://www.ncbi.nlm.nih.gov/books/NBK555330/ · No dose - referral pathway, no medicine given in primary care
- Verified date: 2026-08

## Verified against

- No dose - referral pathway, no medicine given in primary care
- Pharyngeal (Throat) Cancer - disease-level clinical article (pharyngeal-cancer-full.txt)

## Treatment metadata

- No drug therapy in primary care (Referral & Advice)

## Complete treatment card

```text
PHARYNGEAL (THROAT) CANCER
Sources: ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class DD28.03 -
         condition scope only, no dose · NICE NG12: Suspected cancer: recognition and referral
         (recommendation 1.2) - https://www.ncbi.nlm.nih.gov/books/NBK555330/ · No dose - referral
         pathway, no medicine given in primary care
Review status: REVIEWED against No dose - referral pathway, no medicine given in primary care,
               Pharyngeal (Throat) Cancer - disease-level clinical article
               (pharyngeal-cancer-full.txt)  (2026-08)

IS IT THIS? - reference only, to read alongside your own examination
  SYMPTOMS - what the patient reports (3)
    - A painless neck lump is often the first sign, and any new neck mass lasting over 2 weeks in an
      adult should be presumed cancer until proven otherwise  [neck lump]
    - Hoarseness, painful or difficult swallowing, ear pain, one-sided nasal blockage, nosebleeds,
      vision changes, or persistent facial pain should raise suspicion  [blocked nose · ear pain ·
      facial pain · hoarseness · nosebleed]
    - Asian ancestry, heavy tobacco or alcohol use, and a prior head and neck or skin cancer are
      relevant risk history
  SIGNS - what you find (3)
    - A one-sided middle ear effusion in an adult can signal a blocking mass in the nasopharynx
    - Enlarged or lopsided adenoid tissue found in an adult, rather than a child, is a worrying
      finding
    - Cranial nerve testing is essential to catch any deficit or asymmetry pointing to tumor spread
  TESTS (5)
    - CT with contrast is best for bone invasion and lymph node staging but is less accurate for
      very small tumors or soft tissue extent
    - MRI is the most precise study for local tumor extent and can catch subclinical tumors that
      endoscopy and CT scans miss
    - A PET scan is recommended to look for distant spread and subclinical lymph node involvement
    - A neck node that tests positive for EBV can be assumed to come from a nasopharyngeal primary
      even if no tumor is visible
    - Biopsy of the mass, or needle sampling of an involved neck node when no primary is visible,
      confirms the histologic diagnosis
  IF NOT THIS - what else fits (2)
    - Enlarged adenoids or HIV-related lymphoid hyperplasia, an antrochoanal polyp, or an inverting
      papilloma can mimic a nasopharyngeal mass
    - Infectious mononucleosis and non-Hodgkin lymphoma are also on the differential for a neck mass
      with these symptoms
  Source  StatPearls "Nasopharyngeal Cancer" - disease-level clinical article
  Status  traced to the source above

1. NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)    [1st line]
   Adult    Cancer of the pharynx, less commonly encountered in Egyptian primary care than other
            regional cancers. GP recognises persistent throat symptoms, especially in smokers, and
            refers urgently to ENT/oncology. - Refer, with advice
   Peds     Children follow the same pathway: recognise and refer. No primary-care medicine is
            implied.
   Source   No dose - referral pathway, no medicine given in primary care
   Why      Cancer of the pharynx, less commonly encountered in Egyptian primary care than other
            regional cancers. GP recognises persistent throat symptoms, especially in smokers, and
            refers urgently to ENT/oncology.
   Caution  RED FLAG - Acute airway obstruction or stridor secondary to expanding pharyngeal mass:
            assess urgently and refer.
            Rare in Egyptian primary care.
            No medicine is prescribed for this in primary care - this entry is for recognition and
            referral. Anything given is decided by the service it is referred to.
            RED FLAG - In adults, any new neck mass persisting for more than 2 weeks must be
            presumed malignant until proven otherwise and referred.
            RED FLAG - Unilateral middle ear effusion in an adult should raise suspicion for
            nasopharyngeal obstruction/cancer.
            RED FLAG - Hoarseness or sore throat persisting more than 3 weeks, a one-sided neck
            lump, difficulty swallowing, unexplained weight loss, or ear pain with no ear cause
            found.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.
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