Oropharyngeal cancer forms in your oropharynx, the middle section of your throat. Healthcare providers can treat oropharyngeal cancer, but the condition can come back. You may reduce your risk of developing oropharyngeal cancer by protecting yourself against human papillomavirus (HPV) and avoiding tobacco use and beverages containing alcohol.
Oropharyngeal cancer is cancer in your oropharynx, the middle section of your throat (pharynx) that makes saliva, keeps your mouth and throat moist and helps you digest food. Healthcare providers have different ways to treat oropharyngeal cancer, but the disease may come back (recur) after treatment. Although you may not be able to avoid oropharyngeal cancer, you may reduce your risk of developing it by protecting yourself against human papillomavirus (HPV), not smoking cigarettes and drinking beverages containing alcohol in moderation.
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Oropharyngeal cancer is a relatively rare kind of cancer. According to the American Cancer Society, about 53,000 people in the U.S. develop oropharyngeal cancer each year. In comparison, the American Cancer Society estimates more than 290,000 people in the U.S. are diagnosed with breast cancer each year.
Tonsil cancer is the most common type of oropharyngeal cancer. People may also develop oropharyngeal cancer in their gums, the floor of their mouths and their oropharynxes.
Oropharyngeal cancer symptoms may resemble symptoms of other less serious medical issues. Common oropharyngeal cancer symptoms include:
Human papillomavirus (HPV) infection is the most common cause. HPV makes proteins that interfere with genes that manage the cells lining your mouth and throat, including how fast these cells grow. Oropharyngeal cancer happens when genes stop managing cell growth and cells grow uncontrollably and form tumors. Other causes include:
The most significant risk factor is being infected with HPV, particularly HPV type 16. Other risk factors include:
A provider will ask about your symptoms and your medical history, including whether you have a history of head and neck cancer or if you’ve had radiation therapy to your head and neck. They’ll ask about your lifestyle, including if you use tobacco or used it in the past.
They’ll examine your mouth, throat and neck and feel your neck for lumps that may be signs of masses. Your provider may use a mirror, lights and/or a fiberoptic scope to examine the inside of your mouth and throat.
Providers may do an endoscopic biopsy to obtain tissues. Endoscopes are thin, flexible tubes that have tiny cameras and cutting tools on the tip that providers use to obtain a small sample of tissue. A medical pathologist examines the tissue under a microscope for signs of cancer and/or HPV.
They may do the following imaging tests:
Yes, there are. Healthcare providers use cancer staging systems to develop treatment plans and determine prognoses or expected outcomes. There are four oropharyngeal cancer stages (Stage I to Stage IV). Stages may vary depending on whether or not you have oropharyngeal cancer because you have HPV. Other factors in staging include tumor size and if cancer has spread to nearby lymph nodes or distant areas of your body.
Providers may use surgery, radiation therapy, chemotherapy, targeted drug therapy or immunotherapy to treat oropharyngeal cancer. Their goal is to remove cancer cells without limiting your ability to speak and swallow as normally as possible.
Providers may use surgery to treat cancers that are small and haven’t spread. They may use transoral robotic-assisted surgery to remove tumors.
Transoral robotic surgery (TORS) is a minimally invasive treatment method to remove difficult-to-reach oropharyngeal cancers through your mouth. By using robotic surgery, your surgeon doesn’t have to make a large incision in your neck or split your lower jaw to remove tumors in your oropharynx. They also don’t need to insert a tracheostomy breathing tube. Other advantages include:
Complications and/or side effects may include:
Some people who have TORS need may need additional treatment, including reconstructive surgery, speech therapy or nutritional therapy to manage surgery side effects.
Your provider may use chemotherapy alone or in combination with radiation therapy. They may use combination therapy when you can’t have surgery, including situations when you have tumors that are too large to remove with surgery. Providers may also use combination therapy to:
Combination therapy may affect your ability to speak. That’s because radiation therapy that targets your throat may damage healthy tissue and make it hard for you to speak or swallow. You may need additional treatment and specialized therapy to manage speech and swallowing issues.
Targeted therapies for cancer are lab-made versions of monoclonal antibodies. Monoclonal antibodies are proteins in your immune system. Targeted therapy works by blocking a protein that cancer cells rely on to divide, grow and spread.
Targeted therapy side effects vary. Common cetuximab side effects may include:
Immunotherapy is a first-line treatment option for oropharyngeal cancer that has returned or has spread. Immunotherapy helps your immune system find and destroy cancer cells. Immunotherapy for oropharyngeal cancer includes pembrolizumab (Keytruda®) and nivolumab (Opdivo®).
Most immunotherapy side effects are mild. The most common side effects include
You may not be able to prevent oropharyngeal cancer, but you can take steps to lower your risk. Changes you can make include:
If you have oropharyngeal cancer, you’ll need regular follow-up examinations so your healthcare provider can check for signs of new or second cancer near your oropharynx. If you drink beverages containing alcohol or you smoke, you should talk to your provider about quitting. Smoking and drinking beverages containing alcohol increase your risk of developing a new or second cancer, or that oropharyngeal cancer will come back.
Healthcare providers can treat oropharyngeal cancer, but it may come back after successful treatment. According to the American Cancer Society, 70% of people with oropharyngeal cancer were alive five years after diagnosis. Providers have identified some factors that affect prognosis:
The best ways for you to take care of yourself include:
It’s very important that you follow up with your provider after treatment. You may need regular checkups for the rest of your life. In general, providers typically do checkups every six to 12 weeks during the first year after treatment. They may do checkups every three months in the second year, every three to four months in the third year and then every six months.
If you had surgery to remove tumors, you should go to the emergency room if you have symptoms that may indicate infection. Symptoms may include:
No. They’re different forms of head and neck cancer:
A note from Cleveland Clinic
Oropharyngeal cancer is a relatively rare head and neck cancer. Healthcare providers can treat oropharyngeal cancer, but the condition can come back (recur) after treatment. Nearly all cases of oropharyngeal cancer are caused by exposure to the human papillomavirus (HPV). People who use tobacco and/or drink beverages containing alcohol are also more likely to develop oropharyngeal cancer. If you have oropharyngeal cancer, you can avoid a recurrence by obtaining treatment for HPV or being vaccinated against HPV. You may also help yourself by avoiding tobacco and beverages that contain alcohol. If you have oropharyngeal cancer and want help with tobacco and/or alcohol use, talk to your healthcare provider. They’ll be glad to help.
Last reviewed by a Cleveland Clinic medical professional on 02/24/2023.
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