test About Medicine OnLine Medicine OnLine Home Page Cancer Libraries DoseCalc Online Oncology News
Cancer Forums Medline Search Cancer Links Glossary



National Cancer Institute

PDQ® bullet Treatment  bullet Patients

Oropharyngeal cancer


Table of Contents

OVERVIEW OF PDQ
What is PDQ?
How to use PDQ
DESCRIPTION
What is cancer of the oropharynx?
STAGE EXPLANATION
Stages of cancer of the oropharynx
Stage I
Stage II
Stage III
Stage IV
Recurrent
TREATMENT OPTION OVERVIEW
How cancer of the oropharynx is treated
Treatment by stage
STAGE I OROPHARYNGEAL CANCER
STAGE II OROPHARYNGEAL CANCER
STAGE III OROPHARYNGEAL CANCER
STAGE IV OROPHARYNGEAL CANCER
RECURRENT OROPHARYNGEAL CANCER
TO LEARN MORE

OVERVIEW OF PDQ


What is PDQ?

PDQ is a computer system that gives up-to-date information on cancer and its prevention, detection, treatment, and supportive care. It is a service of the National Cancer Institute (NCI) for people with cancer and their families and for doctors, nurses, and other health care professionals.

To ensure that it remains current, the information in PDQ is reviewed and updated each month by experts in the fields of cancer treatment, prevention, screening, and supportive care. PDQ also provides information about research on new treatments (clinical trials), doctors who treat cancer, and hospitals with cancer programs. The treatment information in this summary is based on information in the PDQ summary for health professionals on this cancer.


How to use PDQ

PDQ can be used to learn more about current treatment of different kinds of cancer. You may find it helpful to discuss this information with your doctor, who knows you and has the facts about your disease. PDQ can also provide the names of additional health care professionals who specialize in treating patients with cancer.

Before you start treatment, you also may want to think about taking part in a clinical trial. PDQ can be used to learn more about these trials. A clinical trial is a research study that attempts to improve current treatments or finds information on new treatments for patients with cancer. Clinical trials are based on past studies and information discovered in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help patients with cancer. Information is collected about new treatments, their risks, and how well they do or do not work. When clinical trials show that a new treatment is better than the treatment currently used as "standard" treatment, the new treatment may become the standard treatment. Listings of current clinical trials are available on PDQ. Many cancer doctors who take part in clinical trials are listed in PDQ.

To learn more about cancer and how it is treated, or to learn more about clinical trials for your kind of cancer, call the National Cancer Institute's Cancer Information Service. The number is 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615. The call is free and a trained information specialist will be available to answer cancer-related questions.

PDQ is updated whenever there is new information. Check with the Cancer Information Service to be sure that you have the most up-to-date information.


DESCRIPTION


What is cancer of the oropharynx?

Cancer of the oropharynx is a disease in which cancer cells are found in the tissues of the oropharynx. The oropharynx is the middle part of the throat (also called the pharynx). The pharynx is a hollow tube about 5 inches long that starts behind the nose and goes down to the neck to become part of the esophagus (tube that goes to the stomach). Air and food pass through the pharynx on the way to the windpipe (trachea) or the esophagus. The oropharynx includes the soft palate (the back of the mouth), the base of the tongue, and the tonsils.

Cancer of the oropharynx most commonly starts in the cells that line the oropharynx. If a person has cancer that started in the lymph cells of the oropharynx (a lymphoma), see the PDQ patient information summary on non-Hodgkin's lymphoma.

A doctor should be seen if a person has a sore throat that does not go away, trouble swallowing, a lump in the back of the mouth or throat, a change in the voice, or pain in the ear.

If there are symptoms, a doctor will examine the throat using a mirror and lights. The doctor will also feel the throat for lumps. If tissue that is not normal is found, the doctor will need to cut out a small piece and look at it under the microscope to see if there are any cancer cells. This is called a biopsy.

The chance of recovery (prognosis) depends on where the cancer is in the throat, whether the cancer is just in the throat or has spread to other tissues (the stage), and the patient's general state of health. After the treatment, a doctor should be seen regularly because there is a chance of having a second cancer in the head or neck region.


STAGE EXPLANATION


Stages of cancer of the oropharynx

Once cancer of the oropharynx is found, more tests will be done to find out if cancer cells have spread to other parts of the body. This is called staging. A doctor needs to know the stage of the disease to plan treatment. The following stages are used for cancer of the oropharynx.


Stage I

The cancer is no more than 2 centimeters (about 1 inch) and has not spread to lymph nodes in the area (lymph nodes are small bean-shaped structures that are found throughout the body; they produce and store infection-fighting cells).


Stage II

The cancer is more than 2 centimeters, but less than 4 centimeters (less than 2 inches), and has not spread to lymph nodes in the area.


Stage III

Either of the following may be true:


Stage IV

Any of the following may be true:


Recurrent

Recurrent disease means that the cancer has come back (recurred) after it has been treated. It may come back in the oropharynx or in another part of the body.


TREATMENT OPTION OVERVIEW


How cancer of the oropharynx is treated

There are treatments for all patients with cancer of the oropharynx. Three kinds of treatment are used:

Hyperthermia (warming the body to kill cancer cells) is being tested in clinical trials.

Surgery is a common treatment of cancer of the oropharynx. A doctor may remove the cancer and some of the healthy tissue around the cancer. If cancer has spread to lymph nodes, the lymph nodes will be removed (lymph node dissection). A new type of surgery called micrographic surgery is being tested in clinical trials for early cancers of the oropharynx. Micrographic surgery removes the cancer and as little normal tissue as possible. During this surgery, the doctor removes the cancer and then uses a microscope to look at the cancerous area to make sure there are no cancer cells remaining.

Radiation therapy uses high-energy x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external radiation therapy) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes in the area where the cancer cells are found (internal radiation therapy). External radiation to the thyroid or the pituitary gland may change the way the thyroid gland works. The doctor may wish to test the thyroid gland before and after therapy to make sure it is working properly. Giving drugs with the radiation therapy to make the cancer cells more sensitive to radiation (radiosensitization) is being tested in clinical trials. If smoking is stopped before radiation therapy is started, there is a better chance of surviving longer.

Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by a needle in the vein or muscle. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and can kill cancer cells throughout the body.

People with oropharyngeal cancer have a higher risk of getting other cancers in the head and neck area. Clinical trials of chemoprevention therapy are testing whether certain drugs can prevent second cancers from developing in the mouth, throat, windpipe, nose, or esophagus (the tube that connects the throat to the stomach).

Hyperthermia uses a special machine to heat the body for a certain period of time to kill cancer cells. Because cancer cells are often more sensitive to heat than normal cells, the cancer cells die and the cancer shrinks.

Because the oropharynx helps in breathing, eating, and talking, patients may need special help adjusting to the side effects of the cancer and its treatment. A doctor will consult with several kinds of doctors who can help determine the best treatment. Trained medical staff can also help patients recover from treatment and adjust to new ways of eating and talking. Plastic surgery, or help learning to eat and speak, may be needed if a large part of the oropharynx is taken out.


Treatment by stage

Treatment of cancer of the oropharynx depends on where the cancer is in the oropharynx, the stage of the disease, and the patient's age and overall health.

Standard treatment may be considered because of its effectiveness in patients in past studies, or participation in a clinical trial may be considered. Not all patients are cured with standard therapy and some standard treatments may have more side effects than are desired. For these reasons, clinical trials are designed to find better ways to treat cancer patients and are based on the most up-to-date information. Clinical trials are ongoing in many parts of the country for patients with cancer of the oropharynx. To learn more about clinical trials, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.


STAGE I OROPHARYNGEAL CANCER

Treatment may be one of the following:

1. Surgery to remove the cancer.

2. Radiation therapy. Clinical trials are testing new ways of giving radiation therapy.

3. A clinical trial of microsurgery followed by radiation therapy.


STAGE II OROPHARYNGEAL CANCER

Treatment may be one of the following:

1. Surgery to remove the cancer.

2. Radiation therapy. Clinical trials are testing new ways of giving radiation therapy.

3. A clinical trial of microsurgery followed by radiation therapy.

4. A clinical trial of chemoprevention therapy to prevent a second cancer in the mouth, throat, windpipe, nose, or esophagus.


STAGE III OROPHARYNGEAL CANCER

Treatment may be one of the following:

1. Surgery to remove the cancer followed by radiation therapy.

2. A clinical trial of chemotherapy followed by surgery or radiation therapy.

3. A clinical trial of chemotherapy combined with radiation therapy.

4. A clinical trial of new ways of giving radiation therapy.

5. A clinical trial of microsurgery followed by radiation therapy.

6. A clinical trial of chemoprevention therapy to prevent a second cancer in the mouth, throat, windpipe, nose, or esophagus.


STAGE IV OROPHARYNGEAL CANCER

If the cancer can be removed by surgery, treatment may be one of the following:

1. Surgery to remove the cancer followed by radiation therapy.

2. A clinical trial of radiation therapy combined with chemotherapy.

3. A clinical trial of new ways of giving radiation therapy.

4. A clinical trial of microsurgery followed by radiation therapy.

If the cancer cannot be removed by surgery, treatment may be one of the following:
1. Radiation therapy. Clinical trials are testing new ways of giving radiation therapy.

2. A clinical trial of chemotherapy followed by surgery or radiation therapy.

3. A clinical trial of radiation therapy given with chemotherapy or with drugs to make the cancer cells more sensitive to radiation therapy (radiosensitizers).

4. A clinical trial of hyperthermia plus radiation therapy.


RECURRENT OROPHARYNGEAL CANCER

Treatment may be one of the following:

1. Surgery to remove the cancer.

2. Radiation therapy.

3. A clinical trial of chemotherapy.

4. A clinical trial of hyperthermia plus radiation therapy.


TO LEARN MORE

TO LEARN MORE..... CALL 1-800-4-CANCER

To learn more about cancer of the oropharynx, call the National Cancer Institute's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615. By dialing this toll-free number, trained information specialists can answer your questions.

The Cancer Information Service also has booklets about cancer that are available to the public and can be sent on request. The following booklet about oral cancer may be helpful:

What You Need To Know About Oral Cancer

The following general booklets on questions related to cancer may be helpful:

What You Need To Know About Cancer
Taking Time: Support for People with Cancer and the People Who Care About
Them
What Are Clinical Trials All About?
Chemotherapy and You: A Guide to Self-Help During Treatment
Radiation Therapy and You: A Guide to Self-Help During Treatment
Eating Hints for Cancer Patients
Advanced Cancer: Living Each Day
When Cancer Recurs: Meeting the Challenge Again

There are many other places where people can get material and information about cancer treatment and services. The social service office at a hospital can be checked for local and national agencies that can help with getting information about finances, getting to and from treatment, getting care at home, and dealing with problems.

For more information from the National Cancer Institute, please write to this address:

National Cancer Institute
Office of Cancer Communications
31 Center Drive, MSC 2580
Bethesda, MD 20892-2580

Date Last Modified: 04/1998


If you want to know more about cancer and how it is treated, or if you wish to know about clinical trials for your type of cancer, you can call the NCI's Cancer Information Service at 1-800-422-6237, toll free. A trained information specialist can talk with you and answer your questions.


Home | 

test About Medicine OnLine Medicine OnLine Home Page Cancer Libraries DoseCalc Online Oncology News
Cancer Forums Medline Search Cancer Links Glossary