When you’re facing the diagnosis of a rare cancer, such as oropharyngeal cancer, it can be overwhelming, especially when choosing where to be treated and finding a care team with expertise in treating your specific cancer.
The OSUCCC – James sees and cares for people with rare cancers daily, and our head and neck oncology specialists are some of the country’s foremost experts in cancers like oropharyngeal cancer. They, along with a collaborative team, will work diligently to provide you with an accurate diagnosis, a comprehensive treatment plan and compassionate care.
Where you go for oropharyngeal cancer treatment matters. If you or a loved one have oropharyngeal cancer or have worrisome symptoms, our head and neck specialists will walk with you through every step of care.
What is oropharyngeal cancer?
Oropharyngeal cancer is a head and neck cancer that occurs when cancerous cells form in the tissues of the oropharynx, the middle portion of the pharynx (throat). The middle part of the throat:
- Connects nose and mouth to swallowing and breathing passages
- Helps to prevent aspiration, choking and nasal regurgitation while swallowing
- Supports the immune system with tonsillar tissue to help ward off viruses and infections
Most oropharyngeal cancers are squamous cell carcinomas. Squamous cells are the thin, flat cells lining the inside of the oropharynx.
Oropharyngeal cancer is rare and usually occurs in people between the ages of 50 and 80. The most common risk factors are smoking and excessive alcohol use. There has, however, been an increase in incidences of this type of cancer among younger people who are infected with human papillomavirus (HPV).
About 42,000 new cases of cancer in the oropharynx and oral cavity are diagnosed in the United States each year.
Types of oropharyngeal cancer
Tonsil cancer is the most common oropharyngeal cancer, but it can also occur in the gums, bottom of the mouth and the middle portion of the throat.
While most oropharyngeal cancers begin in the squamous cells, other types of oropharyngeal cancer include:
- Minor salivary gland tumors
- Lymphomas
- Lymphoepitheliomas (cancer that begins in the tissue covering the nasopharynx, or upper part of the throat)
Causes and risk factors of oropharyngeal cancer
An oropharyngeal cancer risk factor is anything that increases your risk of developing it. Risk factors may be environmental, behavioral or genetic.
Oropharyngeal risk factors include:
- Exposure to the human papillomavirus (HPV), including HPV type 16
- Tobacco use (cigarettes, pipes, cigars, chewing tobacco)
- Alcohol consumption
- Previous history of head and neck cancer
Oropharyngeal cancers related to tobacco or alcohol use have decreased in recent years, while we’re seeing more cases of head and neck cancers caused by HPV infections.
It’s important to remember that just because you may have a risk factor, you might not develop oropharyngeal cancer. Talk to your doctor about understanding your risk factors for oropharyngeal cancer.
Oropharyngeal cancer symptoms
Signs and symptoms of oropharyngeal cancer can vary based on the exact location, type, stage of cancer and individual genetic makeup of the tumor.
Common oropharyngeal cancer symptoms include:
- A lump in the neck or throat
- Pain or difficulty with chewing or swallowing
- Sore throat
- Unexplained ear pain
- A sore or ulcer in the mouth area lasting more than two weeks
- Trouble opening the mouth or moving the tongue
- A white patch on the tongue or lining of the mouth that does not go away
- Coughing up blood
Having these symptoms doesn’t necessarily mean you have oropharyngeal cancer. If you have one or a combination of these symptoms lasting more than a few weeks, you should talk to your doctor, dentist, or ear, nose and throat (ENT) specialist.
Diagnosing oropharyngeal cancer
With head and neck cancers, early diagnosis is a key contributor to successful treatment outcomes. Depending on your symptoms, our experts will do a physical exam to check overall health and look for signs of cancer. We’ll discuss your health habits, past illnesses and treatments. This will include a comprehensive exam of the mouth, tongue, throat and neck.
After a thorough exam, your doctor may also recommend additional tests including:
- Computed tomography (CT) scan
- Needle biopsy
- Endoscopy
- Positron emission tomography (PET) scan
- Magnetic resonance imaging (MRI) scan
- Blood test for circulating tumor DNA (ctDNA)
These tests can uncover abnormal growths, masses or lesions, as well as what might be causing them. The tests can also help your medical team tailor an individualized treatment plan specifically for your condition.
Oropharyngeal cancer treatment
At the OSUCCC – James, various treatment options are available for oropharyngeal cancer, and your treatment will depend on the location of your tumor, the stage of cancer, your overall health and other factors. The goal of creating a personalized plan is to pinpoint the most effective course of treatment that minimizes side effects and preserves the highest level of function and quality of life.
Your comprehensive care for oropharyngeal cancer could include:
- Transoral robotic surgery (TORS) and a neck dissection – This surgery is used to remove cancer from areas of the throat that may be difficult to reach. Cameras are attached to a robot and produce 3D images that specialized surgeons can see. A surgeon uses special controls with small tools at the end of the robot’s arms to remove the tumor without needing a visible, external incision. The neck dissection is done through an external excision.
- Radiation therapy (IMRT or protons) – Radiation therapy uses high-powered energy rays, such as X-rays, to kill remaining cancer cells after surgery or to treat smaller or inoperable tumors. Sometimes this treatment is used alongside chemotherapy to make the chemotherapy more effective.
- Chemo-radiation therapy – When chemotherapy is used alongside radiation, it’s called chemo-radiation therapy (often abbreviated CRT).
- Immunotherapy – Immunotherapy uses your body’s own immune system to attack cancer cells. It’s often used if your oropharyngeal cancer has returned, or if it has spread.
Oropharyngeal cancer clinical trials
As a National Cancer Institute-designated comprehensive cancer center, our expert head and neck oncology specialists are conducting the latest research in oropharyngeal cancer. At any given time, they’re involved in more than 20 clinical trials specific to head and neck cancers, including research related to immunotherapy, proton therapy and vaccines — and you’ll have access to these latest innovations.
Using a multidisciplinary approach, our researchers and physicians collaborate to create breakthroughs in oropharyngeal cancer treatment. Learn more about our clinical trials.
Oropharyngeal cancer and human papillomavirus
Research studies led by physician–scientists at the OSUCCC – James investigated the progression of head and neck cancers and discovered that HPV infections produce head and neck cancers in a high proportion of younger patients.
Cancers caused by HPV infections are considered an epidemic and are increasingly becoming one of the most common forms of cancer for people ages 45–65 over the last decade. This revelation has led to dynamic new strategies designed to protect at-risk individuals from developing cancers associated with HPV and create groundbreaking treatment protocols.
Does the HPV vaccine help prevent oropharyngeal cancer?
The HPV vaccine can help protect you from contracting the human papillomavirus, which is a leading cause of oropharyngeal cancer, among other types.
The vaccine, which only protects against future HPV infections, is given in a series of shots. It is recommended that children start receiving the vaccine in two series starting at age 12, but the HPV vaccine can be given to anyone ages 9–45. Anyone 15 years or older will receive a series of three vaccinations. This ensures the best possible protection against developing HPV. Older populations may be candidates for the vaccine, but it’s best to talk to your doctor to see if you’re eligible.