Overview of Oropharyngeal Cancer
Oropharyngeal cancer is a disease in which malignant (cancer) cells form in the tissues of the oropharynx.
The oropharynx is the middle part of the pharynx (throat), behind the mouth. The pharynx is a hollow tube about 5 inches long that starts behind the nose and ends where the trachea (windpipe) and esophagus (tube from the throat to the stomach) begin. Air and food pass through the pharynx on the way to the trachea or the esophagus.
Most oropharyngeal cancers are squamous cell carcinomas. Squamous cells are the thin, flat cells lining the inside of the oropharynx.
Common risk factors for developing oropharyngeal cancer:
- History of smoking cigarettes and other tobacco use.
- Heavy alcohol use.
- Being infected with human papillomavirus (HPV), especially HPV type 16. The number of cases of oropharyngeal cancers linked to HPV infection is increasing.
- Previous history of head and neck cancer.
Signs and symptoms of oropharyngeal cancer
- A sore throat that does not go away.
- Trouble swallowing.
- Trouble opening the mouth fully.
- Trouble moving the tongue.
- Weight loss for no known reason.
- Ear pain.
- A lump in the back of the mouth, throat, or neck.
- A white patch on the tongue or lining of the mouth that does not go away.
- Coughing up blood.
- Sometimes oropharyngeal cancer does not cause early signs or symptoms.
Diagnosis of Oropharyngeal Cancer
Physical exam and health history: An exam of the body to check general signs of health, swollen lymph nodes in the neck or anything else that seems unusual. Includes a complete exam of the mouth and neck and looks under the tongue and down the throat with a small, long-handled mirror to check for abnormal areas.
CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, such as the head, neck, chest, and lymph nodes, taken from different angles. The pictures are made by a computer linked to an x-ray machine.
PET scan (positron emission tomography scan): A procedure that makes a series of detailed pictures of areas inside the body after injecting asmall amount of radioactive glucose (sugar) into a vein. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.
MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body.
Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. A fine-needle biopsy is usually done to remove a sample of tissue using a thin needle.
Endoscopy: A procedure to look at organs and tissues inside the body to check for abnormal areas. An endoscope is a thin, tube-like instrument with a light and a lens for viewing. The nose, throat, back of the tongue, esophagus, stomach, larynx, windpipe, and large airways is checked.
HPV test (human papillomavirus test): A laboratory test used to check the sample of tissue for certain types of HPV infection, such as HPV type 16. This test is done because oropharyngeal cancer can be caused by HPV infection. This is important because HPV-positive oropharyngeal cancer has a better prognosis.
Stage of Oropharyngeal Cancer
The process used to find out if cancer has spread within the oropharynx or to other parts of the body is called staging.
Cancer can spread to nearby tissue, through the lymph system, and through blood.
The following stages are used for HPV-positive oropharyngeal cancer:
- Stage I
- Stage II
- Stage III
- Stage IV
The following stages are used for HPV-negative oropharyngeal cancer:
- Stage 0 (Carcinoma in Situ)
- Stage I
- Stage II
- Stage III
- Stage IV
In stage 0, abnormal cells are found in the lining of the oropharynx (throat). These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.
