Oropharyngeal Cancer: Symptoms, Causes and Treatment in Chicago, IL
Understanding Oropharyngeal Cancer
Where is the pharynx?
Your throat is called the pharynx, and the oropharynx is the middle section of your throat. The oropharynx includes the base of the tongue, tonsils, soft palate (roof of the mouth), and the sides of back walls of the throat. This entire area keeps your mouth and throat moist by making saliva. This moist environment also aids in digestion.
Oropharyngeal cancer is a type of head and neck cancer. Generally, there is an average risk of developing this type of cancer. However, there are risk factors that can greatly affect that risk.
HPV and the Risk of Oropharyngeal Cancer
HPV (human papillomavirus) is very common. HPV is a group of more than 200 viruses and is the most common sexually transmitted infection. There are about 42 million people that are currently infected with HPV in the United States, with 13 million additional cases being identified every year. If not reinfected, the body’s immune system can clear the virus within 1-2 years. These viruses are known to cause cancers in the mouth, throat, cervix and pelvic areas. HPV vaccines can prevent more than 90% of HPV cancers. Certain types of these viruses, mainly HPV 16 have been identified as a major cause of oropharyngeal cancers. The significant rise in HPV infections is attributed to the rise in oropharyngeal cancers. Most oropharyngeal cancers are divided into two types: HPV-related tumors and HPV-unrelated tumors.
HPV is the most significant risk for oropharyngeal cancer but there are other risk factors.
- Using tobacco products, including cigarettes, cigars, chewing tobacco-these products damage the cells in the lining of the throat.
- Alcohol consumption-alcohol can also damage the lining of the throat. Drinking alcohol and using tobacco together can increase the risk even greater.
- History of head and neck cancer
- History of radiation therapy to head and neck
Symptoms of Oropharyngeal Cancer
- A sore throat that does not go away
- Pain or difficulty swallowing
- Difficulty opening your mouth or moving your tongue
- Unexplained weight loss
- Voice change that does not go away
- Ear pain that does not go away
- A lump in the back of your throat or mouth
- A lump in your neck
- Coughing up blood
- A white patch on your tongue or lining of the mouth that doesn’t go away
- Any abnormalities identified by your dentist
Early diagnosis will lead to better prognosis. One or more of these symptoms may seem minor, but if they persist, it is crucial to consult a specialist. Our providers are leaders in managing oropharyngeal cancers. Whether you are questioning symptoms or need a second opinion, we look forward to caring for you at the Oral Cancer Institute.
Diagnosis
During your first visit, you will meet with our team to begin your assessment. Please bring your medication list and any pertinent health history. Also bring copies of outside records, (biopsy results, x-rays, CT scans, etc.). Consider bringing a family member or support person. Your doctor will review all the information provided.
- A thorough physical examination, including:
- An oral examination looking for abnormalities.
- Checking for any abnormal lumps or growths in the face and neck.
- Additional x-rays or diagnostic tests, to determine size and location of the tumor.
- CT scan
- MRI
- PET scan
- Biopsy-a sample of the tumor will be examined under the microscope by a pathologist to determine the presence of cancer cells.
- HPV testing-to determine if cancer is related to HPV.
Staging
After a cancer diagnosis, it is helpful to discover how much cancer is in the body and if it has spread. This process is called staging. Doctors use staging systems to decide what treatment plan is best for each patient. It can also be helpful in determining a prognosis. There are four oropharyngeal cancer stages ranging from Stage I to Stage IV. There will be variations depending on whether the cancer is related to HPV.
Other factors used for staging:
- Tumor size
- Lymph node involvement
- Metastasis (If the cancer has spread to other parts of the body)
Staging can be complex, but we will make sure that you are included in every discussion in all aspects of your care. It is important to remember that each person is unique, your ongoing care is more than a stage. Your surgeon will discuss your diagnosis, explain procedures, and create a treatment plan that best fits your individual needs. Patients with malignant conditions will be presented before a multidisciplinary tumor board for discussion and consensus. Depending on the diagnosis, treatment options will be discussed including surgical and non-surgical options.
Treatment and Management
Surgery, radiation therapy, chemotherapy, targeted drug therapy or immunotherapy can be used to treat oropharyngeal cancer.
Surgery
- Robotic surgery-this minimally invasive technique can remove small tumors with smaller incisions which lead to a faster recovery
- TORS (Transoral robotic surgery)-This is a type of robotic surgery that enables the surgeons to reach and remove tumors that are difficult to reach. Instead of having an incision in the neck, the surgeon can perform the entire procedure through the mouth.
Benefits include:
- Less hospital time
- Faster recovery
- Less damage to surrounding muscles and tissue.
- Less issues with speech and ability to swallow.
Side Effects after surgery
- Bleeding
- Difficulty chewing or swallowing
- Vocal cord damage leading to difficulty talking or voice loss
- Dry mouth
- Changes in taste
- If side effects are significant, additional treatments may be necessary such as speech therapy or nutritional therapy.
Chemotherapy
With large tumors, chemotherapy can be necessary. This treatment can be used alone or in conjunction with radiation. These are some reasons for this combination therapy.
- To treat cancer that has spread to other areas of your body.
- Sometimes, surgeons will need to shrink the tumor before surgery.
- Used after surgery to kill any remaining potential cancer cells.
Immunotherapy
This therapy uses your own immune system to attack the cancer cells. It can aid in destroying cancer cells to prevent recurrence. It can be used with chemotherapy or radiation.
Targeted Therapy
This therapy is a customized therapy to fight against specific proteins in the tumor. These drugs are made in a lab to precisely target and kill the cancer cells.
Prevention: Can Oropharyngeal Cancer Be Prevented?
Usually oropharyngeal cancers cannot be prevented, but there are ways to greatly reduce the risk of developing these cancers.
- Prevent HPV infection-The vaccines for HPV have been shown to decrease more than 90% of HPV related cancers. Oral sex and having multiple sex partners greatly increase the risk of acquiring HPV.
- Stop smoking or using any tobacco product. Use of tobacco products greatly increase the risk of developing many types of cancers, including oral and oropharyngeal.
- Avoid alcoholic beverages. Drinking often and in large quantities is harmful to your health. Alcohol is toxic and used in combination with smoking has been shown to increase the risk of cancer.
- Live a healthy lifestyle with a balanced diet and regular exercise.
- Regular dental checkups are extremely important to detect any early abnormalities. Your dentist will do an oral cancer screening at every 6-month appointment.
- Perform an oral cancer self-exam every month.
Prognosis
The survival rates for oropharyngeal cancers are about 90%. Your prognosis will depend on several factors, including size and location of the tumor and if any cells have spread. As with all cancers, early diagnosis leads to better outcomes. Staging and if cancer is HPV related are also factors in determining prognosis.
If you have had oropharyngeal cancer, you should expect to have regular follow-up care with your surgeon. Drinking and smoking can increase the risk of a recurrence or even a new cancer. Speech and swallowing therapies are frequently recommended to return you to your normal function.
3 factors that improve prognosis
- Being treated before cancer has spread.
- HPV related cancers have better prognosis than cancers that aren’t HPV related.
- Non-smokers have a better prognosis than smokers.
Any cancer diagnosis is scary and navigating healthcare can be overwhelming. We at the Oral Cancer Institute are here to help you from diagnosis to treatment and recovery. All patients are presented at our multidisciplinary tumor board, which consists of head and neck surgical oncologists, medical oncologists, radiation oncologists, radiologists, and pathologists allowing for a comprehensive treatment plan.
Schedule an Appointment
We pledge to give compassionate and patient centered care with the highest standards of excellence. Our team has a strong dedication to helping patients maintain the best possible quality of life during and after treatment.
Please contact us to make an appointment for a consultation with one of our OCI providers.