Is Oropharyngeal Cancer Curable?

Oropharyngeal cancer is a malignant condition of the oropharynx (the middle part of the pharynx), behind the mouth.

Oropharyngeal cancer may develop in any of the oropharyngeal parts, such as:

• Soft palate
• Back one-third of the tongue
• Side or back walls of the throat
• Tonsils

• Stage 0 (cancer in situ)
  • The lining of the oropharynx contains abnormal cells that are still not cancerous.
• Stage I
  • Cancer is 2 cm or smaller and restricted to the oropharynx.
• Stage II
  • Cancer is larger than 2 cm but not more than 4 cm that has not spread to other parts of the body.
• Stage III
  • Cancer could be 4 cm in diameter or less, which may have spread to the epiglottis.
• Stage IV
  • Stage IVA: Cancer not more than 6 cm in diameter and has spread to the larynx, roof of the mouth, lower jaw, and epiglottis.
  • Stage IVB: Tumors of any size might have spread to the muscles and bones of the jaw, nasopharynx, or base of the skull.
  • Stage IVC: Tumor of any size that has spread to other areas of the body from the oropharynx.

Oropharyngeal cancer occurs due to abnormal cellular changes (mutations), causing uncontrolled cell growth at the base of the tongue, tonsils, or soft palate.

The most common risk factors include:

• Human papillomavirus, particularly type 16
• Smoking tobacco
• Chewing betel nut
• Heavy alcohol use
• Poor nutrition
• History of head and neck cancer

The most common symptom of oropharyngeal cancer is a lump in the neck.

Other symptoms may include:

• Muffled voice
• Persisting sore throat
• Difficulty or pain while swallowing
• Neck mass
• Earache
• Trouble opening the mouth
• Difficulty moving the tongue
• Weight loss (unintentional)
• Persistent white patch on the tongue
• Bleeding ulcers that do not heal
• Coughing up blood (hemoptysis)

Apart from a thorough medical history, certain tests recommended by the doctor to confirm the diagnosis include:

• Physical examination: To check for lumps or abnormalities under the tongue and in the throat.
• Neurological examination: A series of questions and tests to assess the proper functioning of the brain, spinal cord, and nerves.
• Positron emission tomography (PET) and CT scan: A combination of PET scan and CT scan is done to obtain detailed images of certain areas of the body.
• MRI scan: Detailed photographs of the affected area are taken using a magnet, radio waves, and a computer.
• Biopsy: Cells or tissues are removed to analyze for signs of cancer.
  • Endoscopic biopsy: A thin tube is inserted into the mouth or nose to examine the esophagus, stomach, larynx, and trachea and collect abnormal tissue for analysis.
  • Laryngoscopic biopsy: A thin tube is inserted to examine the throat and larynx and collect abnormal tissue for analysis.
• Human papillomavirus (HPV) test: If cancer is found in any of these tests, an HPV test could be performed. Oropharyngeal cancer caused by benign prostatic hyperplasia is treated differently than other types of cancer.

The treatment for oropharyngeal cancer depends on the following factors:

• Type of cancer
• Size of the tumor
• Location of the tumor
• Lymph node involvement
• Level of speech and swallowing function affected
• Overall medical condition

Oropharyngeal cancer can be treated in the following ways:

• Surgery: To remove the tumor.
  • Minimally invasive robotic surgery
  • Neck dissection
• Radiation: High-energy X-rays help kill any cancer cells that might still exist in the pelvic area after surgery.
• Chemotherapy: To get rid of any remaining cancer cells or if cancer has spread to other organs.
• Targeted therapy: To target cancer’s specific genes, proteins, or tissues (that help cancer grow).
• Immunotherapy: Antibodies or medications are used to enhance the immune system to fight cancer cells.