Oropharyngeal Cancer

What is the oropharynx?

The oropharynx is the middle part of the pharynx (throat). The pharynx is a hollow tube that begins behind the nose and goes down to the neck, becoming part of the tube that extends into the stomach (esophagus). The oropharynx includes the base of the tongue, the tonsils, the soft palate (back of the mouth), and the walls of the pharynx.

What is oropharyngeal cancer?

Oropharyngeal cancer is a disease in which cancer cells are found within the anatomical borders of the oropharynx. The majority of oropharyngeal cancers are squamous cell carcinomas.

What are the symptoms of oropharyngeal cancer?

The following might be signs of oropharyngeal cancer or of other conditions. See a doctor if any of the following symptoms are present:

• A sore throat that persists
• Pain or difficulty with swallowing
• Unexplained weight loss
• Voice changes
• Ear pain
• A lump in the back of the throat or mouth
• A lump in the neck

What are the risk factors for oropharyngeal cancer?

Risk factors for oropharyngeal cancer include the following:

• Use of alcohol
• Use of tobacco
• Being infected with the human papilloma virus (HPV), especially HPV-type-16 (HPV-16)

How is oropharyngeal cancer diagnosed?

A doctor can diagnose oropharyngeal cancer by examining the throat. The doctor will use a mirror and lights to look at the throat and will feel the neck for masses. If the doctor finds abnormal tissue, he or she will obtain a piece of tissue in a procedure called a biopsy. The tissue will be checked for cancer cells.

What are the stages of oropharyngeal cancer?

The stages of oropharyngeal cancer span from Stage 0 to Stage IV. In Stage 0, cancer is found only in the cells that line the oropharynx. Additional stages are described as follows:

Stage I

The cancer is 2 centimeters or smaller and has not spread outside the oropharynx.

Stage II

The cancer is larger than 2 centimeters, but not larger than 4 centimeters and has not spread outside the oropharynx.

Stage III

In this stage, cancer is larger than 4 centimeters and has not spread outside the oropharynx. An alternate form of this stage is that cancer is any size and has spread to only one lymph node on the same side of the neck as the cancer. The lymph node that contains cancer is 3 centimeters or smaller.

Stage IV

This stage contains the sub-stages of IVA, IVB and IVC.

Stage IVA

In Stage IVA, one of the following is the case:

• The cancer has spread to tissues near the oropharynx, including the voice box, roof of the mouth, jaw, muscle of the tongue, or central muscles of the jaw. The cancer might have spread to one or more nearby lymph nodes, which are still not larger than 6 centimeters.
• The cancer is any size, is only in the oropharynx, and has spread to one lymph node that is larger than 3 centimeters but no larger than 6 centimeters, or to more than one lymph node, none larger than 6 centimeters.

Stage IVB

In Stage IVB, one of the following is true:

• The cancer appears in a lymph node that is larger than 6 centimeters and might have spread to other tissues around the oropharynx.
• The cancer surrounds the main artery in the neck or has spread to bones in the jaw or skull, to muscle in the side of the jaw, or to the upper part of the throat behind the nose. The cancer might have spread to nearby lymph nodes.

Stage IVC

In Stage IVC, the cancer has spread to other parts of the body. The tumor might be any size and might have spread to lymph nodes.