Oropharyngeal Cancer Treatment in Mumbai, India
Overview
Oropharyngeal cancer is cancer in the oropharynx or middle part of the throat behind the mouth. It includes the base of the tongue, tonsils, soft palate, and sidewalls of the throat. Symptoms of this cancer include a lump in the throat, white patches inside the mouth, bloodstained sputum, and many more.
Associated Anatomy
Oropharynx or part of the throat behind the mouth
Alternate Name
Oral cancer
Oropharyngeal Cancer Symptoms
- Non-healing sores in the mouth and on lips
- Difficulty in swallowing
- Lumps in back of throat, neck, mouth, or lips
- Persistent sore throat
- White patches on the tongue and inner lining of mouth
- Change in voice
- Unexplained weight loss
- Pain in ears and jaws
Oropharyngeal Cancer Causes
- Tobacco and smoking, damage the inner lining of the mouth and throat
- Contracting Human Papillomavirus (HPV), which manufactures proteins that interfere with normal cell growth
- Genetic mutations in the cells of the throat, result in the accumulation of the cells forming a tumor
Oropharyngeal Cancer Stages
It is mandatory to diagnose the stage to determine the spread of oropharyngeal cancer in the body.
- Stage 0: Cancer is localized within the epithelium lining the oral cavity and oropharynx.
- Stage I: Cancer is less than 2 centimeters and is present only in the epithelium and doesn't spread to nearby lymph nodes or distant sites.
- Stage II: Cancer is more than 4 cm in size.
- Stage III: Cancer spreads to the epiglottis or base of the tongue.
- Stage IV: This stage is divided into A and IV B. In the A stage, cancer spreads to the larynx, tongue muscle, hard palate, or jaw. In the B state, it spreads to the nearby soft tissues and lymph nodes.
Oropharyngeal Cancer Types
Based on the different parts of the throat, oral cancer is of many types:
- Nasopharyngeal Cancer: Cancer of the nasopharynx or the part of the throat behind the nose
- Glottic Cancer: Cancer in the vocal cords
- Hypopharyngeal Cancer: Cancer in the hypopharynx or the lower part of the throat above the esophagus and trachea
Oropharyngeal Cancer Treatment
Surgery
Mandibulotomy: The splitting of the jawbone to reach the tumor cells.
Glossectomy: The surgical removal of the tongue.
Maxillectomy: Removing the bony roof of the mouth.
Transoral robotic surgery: Minimally invasive surgery to cut and remove the tumor cells using a robot.
Chemotherapy
Chemotherapy includes medications that kill cancerous cells. Oral or intravenous chemotherapeutic drugs attack cancerous cells throughout the body. Specified chemotherapeutic medications injected in the spinal cord, organs, body cavities, or directly on the skin can kill cancerous cells at specific locations.
Radiation Therapy
External radiation therapy delivers high-energy radiation through the skin to the targeted region using a machine and kills the cancerous cells. Internal radiation therapy transfers the radioactive substances sealed in needles, wires, or catheters directly into cancerous cells.
Biological Therapy
Many biological or synthetic substances can boost the immune system of cancer patients. It helps the body to fight HPV and thus treat precancerous cells.
Test to Diagnose Oropharyngeal Cancer
There are several ways to diagnose oropharyngeal cancer:
- Physical Examination – The doctor examines the larynx, lymph nodes of the neck, area behind the nose, and feels lumps on the lips, mouth, and gums during routine check-ups.
- Endoscopy – An endoscope (flexible tube with attached light and lens) helps to view the mouth and throat in detail.
- Biopsy – It helps to determine the abnormal or cancerous cells in the oral cavity.
- X-Ray – It determines the spread of cancer to the organs and bones.
- CT Scan or CAT scan and MRI – These imaging tests use waves to form a detailed image of the mouth.
- PET Scan – The doctor injects radioactive glucose in the veins and collects images of the cancerous cells containing this radioactive sugar.
- HPV Testing – A test done to detect the presence of HPV.
- Barium Swallow – It helps to examine the oropharynx by asking the patient to swallow barium. When liquid barium passes to the stomach, doctors can see any changes in the structure of the oral cavity.
Oropharyngeal Cancer Risk Factors
- Consumption of tobacco
- Addiction to alcohol and smoking
- Infection of HPV and Epstein-Barr virus
- Gastroesophageal reflux disease
- Exposure to toxins
- Radiation therapy for head and neck
Oropharyngeal Cancer Complications
- Spread of oropharyngeal cancer to lymph nodes
- Hyposalivation or reduced saliva production
- Osteoradionecrosis or bone death due to radiation therapy
- Tissue fibrosis or formation of scar tissue
- Morbidity from jaw resection
- Oral mucositis or swelling in the mouth
Oropharyngeal Cancer Prevention
Primary Prevention
There are many ways to prevent the onset of oropharyngeal cancer:
- Stop smoking and tobacco consumption
- Avoid regular or heavy intake of alcohol
- Vaccination against HPV
- Follow a balanced diet
Secondary Prevention
Follow-up after the cancer treatment includes some tests to determine the cell size and shape. The tests check the effectiveness of the treatment. They note the cell size, hence preventing a recurrence of the cancer.
- Regular check-ups and physical examinations by a doctor
- Avoid smoking
- Self-examination of mouth and lips
Epidemiology
Oropharyngeal cancer is more common in men than in women. People usually get diagnosed at the age of 62. This cancer is rarely found in children while 25% of the cases are common in people below the age of 55. About 90% of oropharyngeal cancers are squamous cell carcinoma.
Oropharyngeal Cancer Prognosis
Expected Prognosis
The prognosis of oropharyngeal cancer depends on various factors including the stage of cancer, overall health, age, infection of HPV, and smoking history. The five-year survival rate of oropharyngeal cancer is 70%. To decrease the chances of recurrence, people must quit smoking and tobacco consumption.
Natural Progression
Oropharyngeal cancer takes many years to develop and begins with cancerous growth in the epithelium. Eventually, it spreads to distant sites and lymph nodes.
Pathophysiology
The cancerous cells start growing in the outer layer of cells in the oral cavity and oropharynx. In later stages, it spreads to the larynx, tongue, palate, or jaw.
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