N1 or N2 or N3: Lymph nodes are between less than 3 or up to 6 cm on one or both sides of the neck. "Stage IVC" (end stage)  The cancer could be anything from T1 to T4, N1 to N4, but the major difference is that the cancer has metastasized (M1) to other organs away from the hypopharynx. Stage IV hypopharyneal cancer only has a 10% five-year survival. Most cases of hypopharyneal cancer are found in the end stage because the cancer is close to several large lymphatic vessels, easily spreading to other regions of the body. There are several ways to diagnose Hypopharyngeal Cancer. The doctor checks for swollen lymph nodes and may look down the patient’s throat with a long handled mirror. Inserted into the nose or mouth of the patient, this uses a thin fiberoptic camera that allows the doctor to see directly down the throat. This is a small tissue sample taken from the lesion. The tissue is analyzed for the presences of cancer cells. These tests will give doctors a detailed cross-sectional image of the area in question in the body. It can confirm or suggest a diagnosis and also stage extent of disease. Treatment of hypopharyngeal cancer depends on the prognosis (chance of recovery), age, stage, and general health of the patient. Because hypopharyngeal cancer is often advanced at the time of diagnosis, treatment also depends on the overall goal. The goal may simply be to keep the patient talking, eating, and breathing normally. Treatment usually begins with surgery and then a course of radiation for cancer that has progressed past Stage I. For cancer that is advanced, which is typical of hypopharyngeal cancer, neoadjuvant chemotherapy may be used. This is performed by administering chemotherapy before surgery. Neoadjuvant chemotherapy in conjunction with radiation and surgery has yielded the best results in patients with Stage III and Stage IV cancers.