GENERAL INFORMATION ABOUT OROPHARYNGEAL CANCER

Oropharyngeal cancer is a disease in which malignant (cancer) cells form in the tissues of the oropharynx.

The oropharynx is the middle part of the pharynx (throat) behind the mouth, and includes the back one-third of the tongue, the soft palate, the side and back walls of the throat, and the tonsils. The pharynx is a hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes from the throat to the stomach). Air and food pass through the pharynx on the way to the trachea or the esophagus.

The oropharynx is the middle part of the pharynx (throat) behind the mouth, and includes the back one-third of the tongue, the soft palate, the side and back walls of the throat, and the tonsils. The pharynx is a hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes from the throat to the stomach). Air and food pass through the pharynx on the way to the trachea or the esophagus.

Anatomy of the pharynx (throat). The three parts of the pharynx are the nasopharynx, oropharynx, and hypopharynx.

Most oropharyngeal cancers are squamous cell carcinomas. Squamous cells are the thin, flat cells that line the inside of the oropharynx.

Oropharyngeal cancer is a type of head and neck cancer.

Use of tobacco products and drinking too much alcohol can increase the risk of developing oropharyngeal cancer.

Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. People who think they may be at risk should discuss this with their doctor. Risk factors include the following:

• Smoking and chewing tobacco.
• Heavy alcohol use.
• A diet low in fruits and vegetables.
• Drinking maté, a stimulant drink common in South America.
• Chewing betel quid, a stimulant commonly used in parts of Asia.
• Being infected with human papillomavirus (HPV).

Possible signs of oropharyngeal cancer include a sore throat and a lump in the neck.
These and other symptoms may be caused by oropharyngeal cancer. Other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems occur:

• A sore throat that does not go away.
• A dull pain behind the breastbone.
• Cough.
• Trouble swallowing.
• Weight loss for no known reason.
• Ear pain.
• A lump in the back of the mouth, throat, or neck.
• A change in voice.

Tests that examine the mouth and throat are used to help detect (find), diagnose, and stage oropharyngeal cancer.

The following tests and procedures may be used:

• Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as swollen lymph nodes in the neck or anything else that seems unusual. The doctor does a complete exam of the mouth and neck and looks down the throat with a small, long-handled mirror to check for abnormal areas. A history of the patient’s health habits and past illnesses and treatments will also be taken.

• CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.

• MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).

• X-rays: An x-ray of the organs and bones. An x-ray is a type of energy beam that can go through the body and onto film, making pictures of areas inside the body.

• PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radionuclide glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.

• Endoscopy: A procedure to look at organs and tissues inside the body to check for abnormal areas. An endoscope is inserted through the patient’s nose or mouth to look at areas in the throat that cannot be seen during a physical exam of the throat. An endoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue or lymph node samples, which are checked under a microscope for signs of disease.

• Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer.

Certain factors affect prognosis (chance of recovery) and treatment options.

The prognosis (chance of recovery) depends on the following:

• The stage and grade of the cancer.
• The location of the tumor.
• Whether the tumor is associated with HPV infection.
Treatment options depend on the following:
• The stage and grade of the cancer.
• The location of the tumor.
• The patient's general health.

Dr Neophytos Demetriades (DDS, MD, MSc)

American Medical Center, Nicosia

215, Spyrou Kyprianou Ave Strovolos,
P.O.Box 25610 Nicosia,
Cyprus

T.: +357 70007484  |  M.: +357 99400200  |  Fax: +357 22 476797
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