Oropharyngeal cancer
Encyclopedia
Oropharyngeal cancer is a disease which malignant
cells form in the tissue of oropharynx. Oropharynx
is a middle part of the throat which includes the base of the tongue, the tonsils, the soft palate
, and the walls of the pharynx
.
appears to be as efficient as surgical management. Shiley et al compared the maintenance of swallowing function with the two approaches. They studied 27 patients who underwent the advanced stage (III and IV) of oropharyngeal cancer. Among those patients, 67% had base of tongue lesions and 82% of them used gastrostomy tube either before or during the treatment. Three months after the chemoradiation, 33% of the patients were consuming all nutrition orally, 45% had some oral intake but still had the tube feeding, and 22% had no oral intake at all. The results showed that the short-term incidence of gastrostomy tube dependence after chemo radiation was similar to that after surgical management of oropharyngeal cancer at their institution.
CONDITIONS ASSOCIATED WITH MALIGNANT TRANSFORMATION
HIGH-risk lesions
Medium- risk lesions.
low-risk lesions.
for people with oropharyngeal cancer depends on the age and health of the person and the stage of the disease. It is important for people with oropharyngeal cancer to have follow-up exams for the rest of their lives as cancer can occur in nearby areas. In addition, it is important to eliminate risk factors such as smoking and drinking alcohol, which increase the risk for second cancers.
, These may become cancer and spread into nearby normal tissue
.
.
.
may be any size and may have spread to lymph nodes.
Glossary
Malignant
Malignancy is the tendency of a medical condition, especially tumors, to become progressively worse and to potentially result in death. Malignancy in cancers is characterized by anaplasia, invasiveness, and metastasis...
cells form in the tissue of oropharynx. Oropharynx
Oropharynx
The Oropharynx reaches from the Uvula to the level of the hyoid bone.It opens anteriorly, through the isthmus faucium, into the mouth, while in its lateral wall, between the two palatine arches, is the palatine tonsil....
is a middle part of the throat which includes the base of the tongue, the tonsils, the soft palate
Palate
The palate is the roof of the mouth in humans and other mammals. It separates the oral cavity from the nasal cavity. A similar structure is found in crocodilians, but, in most other tetrapods, the oral and nasal cavities are not truly separate. The palate is divided into two parts, the anterior...
, and the walls of the pharynx
Pharynx
The human pharynx is the part of the throat situated immediately posterior to the mouth and nasal cavity, and anterior to the esophagus and larynx. The human pharynx is conventionally divided into three sections: the nasopharynx , the oropharynx , and the laryngopharynx...
.
Studies
For patients with advanced oropharyngeal cancer the combination of radiotherapy and chemotherapyChemotherapy
Chemotherapy is the treatment of cancer with an antineoplastic drug or with a combination of such drugs into a standardized treatment regimen....
appears to be as efficient as surgical management. Shiley et al compared the maintenance of swallowing function with the two approaches. They studied 27 patients who underwent the advanced stage (III and IV) of oropharyngeal cancer. Among those patients, 67% had base of tongue lesions and 82% of them used gastrostomy tube either before or during the treatment. Three months after the chemoradiation, 33% of the patients were consuming all nutrition orally, 45% had some oral intake but still had the tube feeding, and 22% had no oral intake at all. The results showed that the short-term incidence of gastrostomy tube dependence after chemo radiation was similar to that after surgical management of oropharyngeal cancer at their institution.
Symptoms
Following are the possible signs of oropharyngeal cancer.- 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
- A dull pain behind the sternum
- Cough
Risk factors
Following are the risk factors that can increase the risk of developing oropharyngeal cancer.- Smoking and chewing tobacco.
- Heavy alcohol use.
- A diet low in fruits and vegetables.
- Chewing betel quid, a stimulant commonly used in parts of Asia.
- Being infected with human papilloma virus (HPV).
- EBV infection.
- plummer-Vinson syndrome.
- poor nutrition.
- P53 mutation
CONDITIONS ASSOCIATED WITH MALIGNANT TRANSFORMATION
HIGH-risk lesions
- Erythroplakia
- speckled Erythroplakia
- Chronic hyperplastic candidiasis
Medium- risk lesions.
- oral submucosal fibrosis
- syphilitic glossitis
- sideropenic dysphagia (or paterson-kelly-brown syndrome)
low-risk lesions.
- oral lichen planus
- discoid lupus erythematosus
- discoid keratosis congenita.
Prognosis
The prognosisPrognosis
Prognosis is a medical term to describe the likely outcome of an illness.When applied to large statistical populations, prognostic estimates can be very accurate: for example the statement "45% of patients with severe septic shock will die within 28 days" can be made with some confidence, because...
for people with oropharyngeal cancer depends on the age and health of the person and the stage of the disease. It is important for people with oropharyngeal cancer to have follow-up exams for the rest of their lives as cancer can occur in nearby areas. In addition, it is important to eliminate risk factors such as smoking and drinking alcohol, which increase the risk for second cancers.
Spread
There are three ways of cancer spreading in the body.- Cancer invades the surrounding normal tissuesTissue (biology)Tissue is a cellular organizational level intermediate between cells and a complete organism. A tissue is an ensemble of cells, not necessarily identical, but from the same origin, that together carry out a specific function. These are called tissues because of their identical functioning...
. - Cancer invades the lymph system and travels through the lymph vessels to other places in the body.
- Cancer invades the veins and capillaries and travels through the blood to other places in the body.
Stage 0 carcinoma in situ
Abnormal cells are found in the lining of the oropharynxOropharynx
The Oropharynx reaches from the Uvula to the level of the hyoid bone.It opens anteriorly, through the isthmus faucium, into the mouth, while in its lateral wall, between the two palatine arches, is the palatine tonsil....
, These may become cancer and spread into nearby normal tissue
Tissue (biology)
Tissue is a cellular organizational level intermediate between cells and a complete organism. A tissue is an ensemble of cells, not necessarily identical, but from the same origin, that together carry out a specific function. These are called tissues because of their identical functioning...
.
Stage 1
Cancer has formed and is 2 centimeters or smaller and has not spread outside the oropharynxOropharynx
The Oropharynx reaches from the Uvula to the level of the hyoid bone.It opens anteriorly, through the isthmus faucium, into the mouth, while in its lateral wall, between the two palatine arches, is the palatine tonsil....
.
Stage 2
Cancer has formed and is larger than 2 centimeters, but not larger than 4 centimeters. Also it has not yet spread outside the oropharynxOropharynx
The Oropharynx reaches from the Uvula to the level of the hyoid bone.It opens anteriorly, through the isthmus faucium, into the mouth, while in its lateral wall, between the two palatine arches, is the palatine tonsil....
.
Stage 3
- Cancer is larger than 4 centimeters and has not spread outside the oropharynx
- Any size and has spread to only one lymph nodeLymph nodeA lymph node is a small ball or an oval-shaped organ of the immune system, distributed widely throughout the body including the armpit and stomach/gut and linked by lymphatic vessels. Lymph nodes are garrisons of B, T, and other immune cells. Lymph nodes are found all through the body, and act as...
on the same side of the neck as the cancer. The lymph nodeLymph nodeA lymph node is a small ball or an oval-shaped organ of the immune system, distributed widely throughout the body including the armpit and stomach/gut and linked by lymphatic vessels. Lymph nodes are garrisons of B, T, and other immune cells. Lymph nodes are found all through the body, and act as...
with cancer is 3 centimeters or smaller.
Stage 4A
- Cancer has spread to tissues near the oropharynx, including the voice boxVoice boxVoice box could mean:* The larynx , colloquially known as the voice box, is an organ in the neck of mammals involved in protection of the trachea and sound production....
, roof of the mouth, lower jaw, muscle of the tongue, or central muscles of the jaw, and may have spread to one or more nearby lymph nodes, none larger than 6 centimeters. - Cancer is any size and has spread to one lymph nodeLymph nodeA lymph node is a small ball or an oval-shaped organ of the immune system, distributed widely throughout the body including the armpit and stomach/gut and linked by lymphatic vessels. Lymph nodes are garrisons of B, T, and other immune cells. Lymph nodes are found all through the body, and act as...
that is larger than 3 centimeters but not larger than 6 centimeters on the same side of the neck as the cancer, or to more than one lymph nodeLymph nodeA lymph node is a small ball or an oval-shaped organ of the immune system, distributed widely throughout the body including the armpit and stomach/gut and linked by lymphatic vessels. Lymph nodes are garrisons of B, T, and other immune cells. Lymph nodes are found all through the body, and act as...
, none larger than 6 centimeters, on one of both sides of the neck.
Stage 4B
- Cancer surrounds the main arteryArteryArteries are blood vessels that carry blood away from the heart. This blood is normally oxygenated, exceptions made for the pulmonary and umbilical arteries....
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, and may have spread to nearby lymph nodes - Cancer has spread to a lymph nodeLymph nodeA lymph node is a small ball or an oval-shaped organ of the immune system, distributed widely throughout the body including the armpit and stomach/gut and linked by lymphatic vessels. Lymph nodes are garrisons of B, T, and other immune cells. Lymph nodes are found all through the body, and act as...
that is larger than 6 centimeters and may have spread to tissuesTissue (biology)Tissue is a cellular organizational level intermediate between cells and a complete organism. A tissue is an ensemble of cells, not necessarily identical, but from the same origin, that together carry out a specific function. These are called tissues because of their identical functioning...
around the oropharynxOropharynxThe Oropharynx reaches from the Uvula to the level of the hyoid bone.It opens anteriorly, through the isthmus faucium, into the mouth, while in its lateral wall, between the two palatine arches, is the palatine tonsil....
.
Stage 4C
Cancer has spread to other parts of the body; the tumorTumor
A tumor or tumour is commonly used as a synonym for a neoplasm that appears enlarged in size. Tumor is not synonymous with cancer...
may be any size and may have spread to lymph nodes.
Glossary
Society and culture
In 2010 American actor Michael Douglas reported to have oropharyngeal cancer.See also
- HPV-positive oropharyngeal cancerHPV-positive oropharyngeal cancerHuman papillomavirus -positive oropharyngeal cancer also known as HPV16+ oropharyngeal cancer or HPV+ OPC is a recognized subtype of Oropharyngeal squamous cell carcinomas , associated with the HPV type 16 virus.-Causes:...
- CancerCancerCancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...
- Head and neck cancerHead and neck cancerHead and neck cancer refers to a group of biologically similar cancers that start in the upper aerodigestive tract, including the lip, oral cavity , nasal cavity , paranasal sinuses, pharynx, and larynx. 90% of head and neck cancers are squamous cell carcinomas , originating from the mucosal lining...
- Cancer of the larynxCancer of the larynxLaryngeal cancer may also be called cancer of the larynx or laryngeal carcinoma. Most laryngeal cancers are squamous cell carcinomas, reflecting their origin from the squamous cells which form the majority of the laryngeal epithelium....
- Thyroid cancerThyroid cancerThyroid neoplasm is a neoplasm or tumor of the thyroid. It can be a benign tumor such as thyroid adenoma, or it can be a malignant neoplasm , such as papillary, follicular, medullary or anaplastic thyroid cancer. Most patients are 25 to 65 years of age when first diagnosed; women are more affected...
- OropharynxOropharynxThe Oropharynx reaches from the Uvula to the level of the hyoid bone.It opens anteriorly, through the isthmus faucium, into the mouth, while in its lateral wall, between the two palatine arches, is the palatine tonsil....
- LarynxLarynxThe larynx , commonly called the voice box, is an organ in the neck of amphibians, reptiles and mammals involved in breathing, sound production, and protecting the trachea against food aspiration. It manipulates pitch and volume...
- Human pharynxHuman pharynxThe human pharynx is the part of the throat situated immediately posterior to the mouth and nasal cavity, and anterior to the esophagus and larynx. The human pharynx is conventionally divided into three sections: the nasopharynx , the oropharynx , and the laryngopharynx...