Treatment options for metastatic and recurrent oropharyngeal cancer include the following:
- Surgical resection, if technically feasible and the tumor does not respond to radiation therapy. [ 1 ]
- Radiation therapy, if the tumor is not completely removed by surgery and curative doses of radiation have not been given...
- A second surgery, if the tumor was not completely...
What are the stages of oropharyngeal cancer?
Oropharyngeal cancer can be divided into two categories ... Among the 25 patients, 19 were at clinical stage I, 1 was stage II, 3 were stage III, and 2 were stage IV, according to the 8th edition of the American Joint Committee on Cancer/International ...
How is targeted therapy effective for cancer treatment?
The type of radiation therapy that you may have depends on many factors, including:
- The type of cancer
- The size of the tumor
- The tumor’s location in the body
- How close the tumor is to normal tissues that are sensitive to radiation
- Your general health and medical history
- Whether you will have other types of cancer treatment
- Other factors, such as your age and other medical conditions
Can surgery cure nasopharyngeal cancer?
Surgery is not a common treatment for nasopharyngeal cancer. You are more likely to have it for cancer that has come back in the nasopharynx or the lymph nodes in your neck. You may have tests to check you are fit enough for surgery and that you'll make a good recovery.
How is radiation therapy used to treat nasopharyngeal cancer?
Treatment of stage III nasopharyngeal cancer may include the following:
- Chemotherapy given with radiation therapy, which may be followed by more chemotherapy.
- Radiation therapy.
- Radiation therapy followed by surgery to remove cancer -containing lymph nodes in the neck that remain or come back after radiation therapy.
- A clinical trial of chemotherapy given before, with, or after radiation therapy.
What is the best treatment for oropharyngeal cancer?
In general, surgery is the first treatment for cancers of the oral cavity and may be followed by radiation or combined chemotherapy and radiation. Oropharyngeal cancers are usually treated with a combination of chemotherapy and radiation.
What type of chemo is used for oropharyngeal cancer?
A commonly used combination is carboplatin and 5-FU. This combination works better than either drug alone in shrinking cancers of the oral cavity and oropharynx. Another combination often used is cisplatin, 5-FU, plus docetaxel. In certain cases, chemo might be given along with a targeted drug or immunotherapy.
How is oropharyngeal cancer removed?
Doctors may use transoral laser microsurgery, which involves placing a laser through an endoscope, to remove an oropharyngeal tumor. This approach can be less damaging to healthy tissue, because it doesn't require the use of surgical tools, as do other procedures. Doctors use general anesthesia for this procedure.
What is the most common treatment for oral cancer?
Most patients with stage I or II oral cavity cancers do well when treated with surgery and/or radiation therapy. Chemotherapy (chemo) given along with radiation (called chemoradiation) is another option. Both surgery and radiation work equally well in treating these cancers.
What is the survival rate for oropharyngeal cancer?
Survival rates for oral and oropharyngeal cancer vary widely depending on the original location and the extent of the disease. In the United States, the overall 5-year survival rate for people with oral or oropharyngeal cancer is 67%. The 5-year survival rate for Black people is 51%, and for White people, it is 69%.
Is oropharyngeal cancer slow growing?
See Risk Factors for Oral Cavity and Oropharyngeal Cancers . Verrucous carcinoma is a rare type of squamous cell cancer that is most often found in the gums and cheeks. It's a low-grade (slow growing) cancer that hardly ever spreads to other parts of the body.
How long does it take for oropharyngeal cancer to develop?
Cancers of the oral cavity and oropharynx usually take many years to develop, so they're not common in young people. Most patients with these cancers are older than 55 when the cancers are first found. HPV-linked cancers tend to be diagnosed in people younger than 50.
What does oropharynx cancer look like?
A lump or thickening in the lips, mouth, or cheek. A white or red patch on the gums, tongue, tonsil, or lining of the mouth. A sore throat or a feeling that something is caught in your throat that doesn't go away. Trouble chewing or swallowing.
Why does oropharyngeal cancer happen?
The leading risk factors for developing oropharyngeal cancer are smoking tobacco, heavy alcohol consumption, and HPV infection, especially a specific type known as HPV-16.
Can oropharynx cancer be cured?
Oral and oropharyngeal cancers can often be cured, especially if the cancer is found at an early stage. Although curing the cancer is the primary goal of treatment, preserving the function of the nearby nerves, organs, and tissues is also very important.
How many radiotherapy sessions are needed for mouth cancer?
Standard EBRT for oral cavity or oropharyngeal cancers is usually given in daily fractions (doses) 5 days a week for about 7 weeks. But sometimes other schedules might be used: Hyperfractionation radiation is a slightly lower radiation dose given more than once a day (for example, twice a day for 7 weeks).
How long is radiation treatment for mouth cancer?
The treatment is usually given every day over the course of 6 weeks, depending on the size of the cancer and how far it has spread. As well as killing cancerous cells, radiotherapy can also affect healthy tissue. The side effects of radiotherapy include: sore, red skin (like sunburn)
How to treat oropharyngeal cancer?
Most locally advanced oropharyngeal cancers (p16/HPV-positive or p16/HPV-negative) are treated with chemoradiation. Surgery might also be an option if the surgeon thinks that the cancer can be removed safely. The choice of treatment is often guided by where the cancer is, how much it has spread, the expected side effects, patient preferences, and the patient’s current health status.
What is the treatment for metastatic oropharyngeal cancer?
These cancers are usually treated with chemo , cetuximab, or both. Immunotherapy, alone or with chemo, might be another option. Treatments such as radiation may also be used to help relieve symptoms from the cancer or to help prevent new problems.
What is the cancer in the back of the tongue called?
Locally advanced oropharyngeal cancers are larger cancers in the back of the tongue, soft palate, and tonsils that have grown into nearby tissues, and/or have spread to nearby lymph nodes in the neck. In general, this would include most stage III, IVA, and IVB p16/HPV-negative cancers and most stage I, II and III p16/HPV-positive cancers in ...
What is the treatment for cancer in the neck?
The main treatment options include radiation therapy aimed at the cancer and the lymph nodes in the neck or surgery of the main tumor along with removal of the lymph nodes in the neck (lymph node dissection). After surgery, if any cancer remains or if there is a high chance of the cancer coming back, chemoradiation is often used.
What is stage 0 cancer?
Stage 0 (carcinoma in situ) oropharyngeal cancer. Although cancer in this stage is on the surface layer and has not started to grow into deeper layers of tissue, it can do so if not treated. The usual treatment is surgery (usually Mohs surgery, surgical stripping, or thin resection) to remove the top layers of tissue along with a small margin ...
Is oropharyngeal cancer based on stage?
Treatment for oropharyngeal cancer is based largely on the stage (extent) of the cancer and if it is caused by an HPV infection (p16-positive), but other factors can also be important. Most experts agree that treatment in a clinical trial should be considered for any cancer in the head and neck areas. This way, people might have a chance ...
Can cancer be removed after chemo?
Any cancer that is still present after chemoradiation is often removed with surgery. If the cancer has spread to neck lymph nodes, they may also need to be removed (a lymph node dissection) after chemoradiation is done.
What is standard of care for oral cancer?
This section explains the types of treatments that are the standard of care for oral and oropharyngeal cancers. “Standard of care” means the best treatments known. When making treatment plan decisions, you are encouraged to consider clinical trials as an option.
How is medication used to treat cancer?
Medication may be given through the bloodstream to reach cancer cells throughout the body. When a drug is given this way, it is called systemic therapy . Medication may also be given locally, which is when the medication is applied directly to the cancer or kept in a single part of the body.
How to treat recurrent cancer?
Often the treatment plan will include the treatments described above, such as surgery, medications, and radiation therapy , but they may be used in a different combination or given at a different pace. Your doctor may suggest clinical trials that are studying new ways to treat this type of recurrent cancer. Whichever treatment plan you choose, palliative care will be important for relieving symptoms and side effects.
How does chemotherapy destroy cancer cells?
Chemotherapy is the use of drugs to destroy cancer cells, usually by keeping the cancer cells from growing, dividing, and making more cells.
What is a medical oncologist?
Medical oncologist: A doctor who treats cancer using chemotherapy or other medications, such as targeted therapy and immunotherapy.
What is a speech pathologist?
Speech-language pathologist: A health care professional who specializes in communication and swallowing disorders. A speech-language pathologist helps patients regain their speaking, swallowing, and oral motor skills after cancer treatment that affects the head, mouth, and neck.
How many surgeries are needed to remove cancer?
Depending on the location, stage, grade, and other features of the cancer, some people may need more than 1 operation to remove the cancer and to help restore the appearance and function of the affected tissues.
What is the most common location for a primary tumor of the oropharynx?
The anterior tonsillar pillar and tonsil are the most common location for a primary tumor of the oropharynx. [ 4] Lesions involving the anterior tonsillar pillar may appear as areas of dysplasia, inflammation, or a superficial spreading lesion. These cancers can spread across a broad region, including the lateral soft palate, retromolar trigone and buccal mucosa, and tonsillar fossa. [ 3, 4] The lymphatic drainage is primarily to level II nodes.
Where is the oropharynx located?
Anatomically, the oropharynx is located between the soft palate superiorly and the hyoid bone inferiorly; it is continuous with the oral cavity anteriorly and communicates with the nasopharynx superiorly and the supraglottic larynx and hypopharynx inferiorly.
How many patients were randomly assigned to receive neoadjuvant chemotherapy?
In a meta-analysis of five randomized trials, a total of 1,022 patients with locally advanced head and neck SCC were randomly assigned to receive either neoadjuvant chemotherapy with TPF (docetaxel, cisplatin, and fluorouracil) followed by concurrent chemoradiation therapy or concurrent chemoradiation therapy alone. The analysis failed to show an OS (HR, 1.01; 95% confidence limits [CLs], 0.84, 1.21; P = .92) or PFS (HR, 0.91; 95% CLs, 0.75, 1.1; P = .32) advantage for neoadjuvant chemotherapy using the TPF regimen over concurrent chemoradiation therapy alone. [ 37 ] [ Level of evidence: 1iA]
How to determine primary tumor?
The assessment of the primary tumor is based on inspection and palpation, when possible, and by indirect mirror examination. The appropriate nodal drainage areas are examined by careful palpation. The presence of tumor must be confirmed histologically. Any other pathologic data obtained from a biopsy and additional radiographic studies are also considered in the diagnosis.
Why is the base of the tongue asymptomatic?
Because the base of the tongue is devoid of pain fibers, these tumors are often asymptomatic until there is significant tumor progression. [ 4] Signs and symptoms of advanced base-of-the-tongue cancers may include the following: [ 3, 4] Pain. Dysphagia.
Is oropharyngeal cancer increasing?
Oropharyngeal cancer is increasing in incidence, which is attributed to the rise in human papillomavirus (HPV)-associated oropharyngeal cancer; men are more than twice as likely as women to have oropharyngeal cancer. [ 1 - 3]
Where are soft palate tumors found?
Soft palate tumors are primarily found on the anterior surface. [ 4] Lesions in this area may remain superficial and in early stages. [ 3] The lymphatic drainage is primarily to level II nodes.
How are oral cavity and oropharyngeal cancers treated?
The main treatment options for people with oral cavity and oropharyngeal cancers are:
Who treats oropharyngeal cancer?
These doctors may include: An otolaryngologist (al so known as an ear, nose, and throat, or ENT doctor): a surgeon who treats certain diseases of the head and neck.
What is the treatment for oral cancer?
Different treatments might be used either alone or in combination, depending on the stage and location of the tumor. In general, surgery is the first treatment for cancers of the oral cavity and may be followed by radiation or combined chemotherapy and radiation. Oropharyngeal cancers are usually treated with a combination ...
Why is it important to discuss treatment options with your doctor?
It's important to discuss all of your treatment options, including treatment goals and possible side effects, with your doctors to help make the decision that best fits your needs. It’s also very important to ask questions if there is anything you’re not sure about.
Why do we do clinical trials?
Clinical trials are carefully controlled research studies that are done to get a closer look at promising new treatments or procedures . Clinical trials are one way to get state-of-the art cancer treatment. In some cases they may be the only way to get access to newer treatments. They are also the best way for doctors to learn better methods to treat cancer. Still, they're not right for everyone.
Why is it important to communicate with your cancer care team?
Communicating with your cancer care team is important so you understand your diagnosis, what treatment is recommended, and ways to maintain or improve your quality of life.
What to consider when choosing a cancer treatment plan?
When you choose a treatment plan, consider your overall health, the type and stage of the cancer, the chances of curing the disease, and the possible impact of the treatment on important functions like speech, chewing, and swallowing. If time permits, it is often a good idea to seek a second opinion.
What are the symptoms of oropharyngeal cancer?
Often, oropharyngeal cancers are asymptomatic. Typically, the first sign is a lump in the neck. Other symptoms may include:
How is oropharyngeal cancer diagnosed?
Any adult with a neck mass for more than two weeks should see an otolaryngologist-head and neck surgeon for an evaluation, which is a complete head and neck examination to determine if there is a tumor from which the cancer has migrated to the neck. This may include looking into the throat with a small scope that is passed through the nose to allow the physician to see if there are any suspicious masses.
What is the oropharynx?
The oropharynx consists of the structures in the back of the throat, including the base of the tongue, palatine tonsils, posterior pharyngeal wall and soft palate. There are many types of cancer of the oropharynx. The vast majority are squamous cell carcinomas, which can be divided into two types based on human papillomavirus (HPV) testing.
What is the treatment for a tumor in the neck?
Treatments include surgery (minimally invasive robotic surgery and neck dissection), radiation and chemotherapy. Radiation is sometimes needed after surgery. When surgery is not used to treat these tumors, typically a combination of radiation and chemotherapy is recommended. A multidisciplinary team helps provide an optimal plan for each patient.
What is the best treatment for oropharyngeal cancer?
For people who have oropharyngeal cancer that has spread to distant parts of the body, such as the lungs or liver, doctors may prescribe chemotherapy alone. Chemotherapy can also help relieve pain in people with advanced oropharyngeal cancer. Common drugs given to manage oropharyngeal cancer include cisplatin, carboplatin, taxotere, and 5-fluorouracil.
What are the side effects of chemo?
Most side effects of chemotherapy and targeted drugs are temporary. Chemotherapy side effects may include fatigue, loss of appetite, nausea, vomiting, dry mouth, and sores in the mouth and throat. Chemoradiation may also cause these side effects, as well as those associated with radiation therapy. The targeted drug cetuximab may cause a skin rash and itching.
Does NYU Langone do immunotherapy?
NYU Langone doctors may prescribe immunotherapy in a clinical trial setting to manage oropharyngeal cancer that has spread throughout the body. Immunotherapy helps boost the body’s immune response to oropharyngeal cancer. It is given through IV infusion on a schedule determined by your doctor. NYU Langone doctors can discuss whether a clinical trial is an option for you.
Why do they reconstruct the inside of the throat?
Reconstruction. The goal of this type of surgery is to restore structure and functions after cancer treatment.
What is the procedure used to guide a biopsy needle?
Image-guided biopsy: A radiologist uses an imaging technique such as ultrasound or MRI to guide the needle for the biopsy.
What is the treatment for oropharyngeal cancer?
Oropharyngeal cancer treatment options may include radiation therapy, surgery, chemoradiation, chemotherapy alone, and immunotherapy. Get detailed information about the treatment for newly diagnosed and recurrent oropharyngeal cancer in this summary for clinicians.
Why is oropharyngeal cancer increasing?
Oropharyngeal cancer is increasing in incidence, which is attributed to the rise in human papillomavirus (HPV)-associated oropharyngeal cancer ; men are more than twice as likely as women to have oropharyngeal cancer.[1-3]
What is field cancerization?
The process of field cancerization may be responsible, in part, for the multiple, synchronous, primary SCCs that occur in oropharyngeal cancer and that are associated with a smoking history. Originally described in 1953, the concept of field cancerization holds that tumors develop in a multifocal fashion within a field of tissue chronically exposed to carcinogens.[23] Molecular studies that detect genetic alterations in histologically normal tissue from high-risk individuals have provided strong support for the concept of field cancerization.[24-28]
Where is the oropharynx located?
Anatomically, the oropharynx is located between the soft palate superiorly and the hyoid bone inferiorly; it is continuous with the oral cavity anteriorly and communicates with the nasopharynx superiorly and the supraglottic larynx and hypopharynx inferiorly.
Which pillar of the thyroid is affected by tumors?
Tumors of the posterior tonsillar pillar can extend inferiorly to involve the pharyngoepiglottic fold and the posterior aspect of the thyroid cartilage. These lesions more frequently involve level V nodes.
Can cancer of the base of the tongue grow?
Clinically, cancers of the base of the tongue are insidious. These cancers can grow in either an infiltrative or exophytic pattern. Because the base of the tongue is devoid of pain fibers, these tumors are often asymptomatic until there is significant tumor progression.[4]
Is retropharyngeal lymph node a nodal site?
The retropharyngeal lymph nodes are a possible site for nodal spread in oropharyngeal cancer. In a large retrospective cohort from the MD Anderson Cancer Center, the clinical features of 981 oropharyngeal patients who underwent primary radiation therapy were described.[7][Level of evidence: 3iiA][Level of evidence: 3iiDii]
How to treat oropharynx cancer?
Your treatment depends on where in the mouth or oropharynx your cancer is. You might have: surgery. radiotherapy. surgery followed by radiotherapy. chemoradiotherapy. When deciding on your treatment plan, your doctor considers the possible side effects of treatment, and your general health.
What is the treatment for mouth cancer?
Surgery is a common treatment for early stage mouth and oropharyngeal cancer. How much surgery you have depends on the size and location of your cancer. You are most likely to have an operation under general anaesthetic.
Why do you have to have surgery to remove lymph nodes?
This is because there is a high risk that the cancer has spread to the lymph nodes.
Why do you have to have radiotherapy after surgery?
You may also have radiotherapy after surgery. This is to kill any cancer cells that might have been left behind. It lowers the risk of the cancer coming back .
What is the treatment for cancer that is too big?
When the cancer is too big or cannot be removed by surgery, you might have radiotherapy . You may have radiotherapy alongside chemotherapy (chemoradiotherapy) or targeted cancer drugs. You might have a targeted drug on its own if chemotherapy drugs are not working.
What is stage 0 cancer?
Stage 0 (carcinoma in situ) The cancer cells are all contained within the lining of the mouth or oropharynx. If left untreated, there is a high chance of the cells developing into a cancer. Your doctor may completely remove the cancer cells during a biopsy, if the affected area is very small.
How does a doctor remove cancer cells?
Your doctor removes the cancer cells by taking a thin layer of tissue from the affected area. Your doctor will monitor you closely after treatment. If the cancer cells come back, you may have radiotherapy.