The oropharynx consists of the structures in the back of the throat, including the base of tongue, palatine tonsils, posterior pharyngeal wall and soft palate. There are many different types of cancers of the oropharynx, however the vast majority are squamous cell carcinomas. Squamous cell carcinomas can be divided into two types, HPV-positive and HPV-negative. There are about 15,000 new cases of oropharyngeal cancer each year, with the vast majority being HPV-positive.
Symptoms :
- Neck mass
- Difficulty swallowing
- Muffled voice quality
- Ear pain
- Throat pain or sore throat
- Lump or mass in the back of the throat
Diagnosis:
Many patients with oropharyngeal cancer initially present with a neck mass. Any adult with a neck mass for more than two weeks should see an otolaryngologist for an evaluation. An evaluation consists of a complete head and neck examination, including looking into the throat and voice box with a small scope that is passed through the nose to allow the physician to see if there are any suspicious masses.
A fine-needle aspiration biopsy, a procedure that places a small needle into the neck mass to extract cells, is performed under local anesthesia. This allows a pathologist to evaluate the cells under a microscope to determine the cause of the neck mass. Oftentimes the pathologist is able to determine whether the mass is cancerous or benign, and if cancerous, the type of cell the cancer comes from. A complete workup involves imaging, which may include a MRI, CT scan or PET scan.
Treatment
Treatment for oropharyngeal cancer depends on a number of factors, including but not limited to: type of cancer, size of the tumor and location of cancer, speech and swallow function and overall medical condition of the patient.
Treatments include surgery, radiation and chemotherapy. Our team specializes in both open and minimally invasive robotic surgery, the most advanced techniques in head and neck radiation and the newest chemotherapy options. Usually one treatment modality is used for early stage cancers (either radiation or surgery) and combined treatment modalities are recommended for advanced stage cancers (surgery and radiation).
Scientists are currently investigating immunotherapy for head and neck cancers. This treatment approach, which has been effective in other types of cancer, uses drugs and vaccines to harness the immune system’s natural ability to fight cancer. A few immunotherapy drugs have been approved for second-line therapy in some advanced head and neck cancers, and investigators are looking into whether a combination of immunotherapy and radiation could improve outcomes.
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