What do we mean by 'Oropharyngeal Cancer'? It is a type of Throat Cancer that your doctor might call by the part it has grown in, like tonsil or tongue base cancer. If it's not the cancer type you're looking for, please explore the information about other types of Throat Cancers or other types of Head and Neck Cancers.
Following a diagnosis of Oropharyngeal Cancer, your cancer care team will discuss the treatment options including the possibility of participating in a clinical trial that is suitable for you. This is also a good time to consider if you would like a second opinion. The most suitable treatment for Oropharyngeal Cancer depends on many things including:
size and location of the cancer
whether the cancer has spread
whether the cancer is caused by smoking or HPV
personal factors (e.g. age, general health and treatment history)
treatments available (and whether any clinical trials are available)
your preferences for treatment
There are three types of treatment available for Oropharyngeal Cancer. These include:
Surgery
Radiation therapy
Chemotherapy
For many people there may be more than one treatment option that gives approximately the same chance of curing the cancer. Each treatment option has its advantages and disadvantages.
Surgery — which depending on the pathology results, may need to be followed by a course of radiation therapy (adjuvant radiation therapy); either on its own or at the same time (concurrent) as chemotherapy.
Definitive radiation therapy — either on its own or at the same time as chemotherapy (concurrent chemoradiation)
Watch a 3D video explainer about Oropharyngeal Cancer:
There are a number of different operations that can help treat Oropharyngeal Cancer. If surgery is recommended, the type of operation will depend on the person and their cancer. While some people can be treated with surgery alone, others may need extra treatment after surgery to reduce the risk of the cancer returning. Your cancer care team will help decide whether it is necessary for you, based on a detailed report on the cancer from the pathologist 1–2 weeks after surgery.
This can be either radiation therapy alone or in combination with chemotherapy (chemoradiation), which is typically started about 4 weeks after surgery to allow recovery and for planning purposes. The treatment itself usually lasts about 6 weeks.
Your doctor will explain details of the surgery, general risks and side effects of surgery. Ask your doctor if you have questions. They may recommend:
stopping blood thinners (e.g. aspirin) before surgery to reduce the risk of bleeding
special stockings to reduce the risk of blood clots
early mobilisation (i.e. not to stay in bed) to reduce the risk of blood clots and chest infection
antibiotics to lower the risk of wound infection.
If you smoke, it is important that you consider stopping smoking before starting treatment to help reduce the risk of infection and help you recover after your treatment.
Sometimes, oropharyngeal cancers can be removed through the mouth without any external cuts using a robotic system or by using laser surgery.
The most common radiation therapy approach for Oropharyngeal Cancer is called external beam radiation. This type of radiation therapy applies radiation from outside the body. Radiation therapy can be used in the following ways:
Radiation therapy is the main treatment for oropharyngeal cancer. It is used without surgery to cure oropharyngeal cancer. Typically radiation therapy is delivered daily (but not on weekends) for 7 weeks. Sometimes chemotherapy is added to the radiation therapy (chemoradiation) to make it more effective.
This is when radiation therapy is given after surgery to kill cancer cells that may not have been taken out during surgery. It usually starts about 4 weeks after surgery to allow recovery from surgery. Radiation therapy treatment usually lasts for about 6 weeks. Sometimes chemotherapy is added to the adjuvant radiation therapy (chemoradiation) to make it more effective.
In cases where a cure is not possible, radiation therapy is used to relieve symptoms of advanced oropharyngeal cancer. Symptoms that may require palliative radiation therapy include pain, bleeding, breathing and trouble swallowing.
You might need to have some of your teeth taken out, this will depend on the area being treated and the dose of radiation therapy. It is important to take out any broken or infected teeth before radiation therapy. Taking out unhealthy teeth after radiation therapy can cause problems with the jaw bone.
Your cancer and its treatment can make it hard to eat and drink. Your doctor will recommend you see a dietitian to maximise your nutrition during treatment as well as while you are recovering. Sometime feeding tubes may be recommended depending on the area being treated and the dose of radiation therapy. There are two common types of feeding tubes:
Gastrostomy tube (sometimes called a PEG tube): this type of tube is inserted through your abdominal wall into your stomach, with part of the tube staying outside the stomach. A syringe can be attached to the tube to give you food this way if needed. The tube is inserted using a camera through the mouth into the stomach (gastroscopy) or using a CT scanner to guide insertion directly through the skin. If a PEG tube is needed, your doctor will organise this before starting your radiation therapy.
Nasogastric tube: this type of tube goes through the nose down into the stomach and is usually used for short periods (days or weeks). A nasogastric tube can be inserted at any time (before, during or after treatment).
There are many other aspects of supportive care that are available, ask your doctor if you have any specific needs.
Side effects of radiation therapy depend on:
the dose of radiation therapy
the area being treated
whether or not chemotherapy is added to the radiation therapy.
tiredness
skin irritation in the treated area e.g. redness, dryness and itching, weeping skin, scaling or sometimes skin breakdown (sores)
dry mouth and throat due to loss of saliva (called xerostomia)
altered taste, which is usually a loss of taste or sometimes an unpleasant taste in the mouth
pain on swallowing or difficulty with swallowing
loss of weight.
Most side effects are short lived and may go away within 4–6 weeks of finishing radiation therapy. Some side effects may last for months after you finish radiation therapy and some may be permanent.
Chemotherapy works by destroying or damaging cancer cells. For Oropharyngeal Cancers, it is usually given into a vein through a needle with a cannula (tube) attached. There are a number of different types of chemotherapy that may be used to treat Oropharyngeal Cancers:
Sometimes chemotherapy is added to definitive radiation therapy (chemoradiation). It is usually used for advanced stage oropharyngeal cancers. This may be given once every 3 weeks or once a week throughout the duration of radiation therapy. Although chemotherapy makes the radiation more effective at destroying cancer cells, it may also lead to increased side effects for most patients.
This is when chemotherapy is given after surgery, usually in combination with radiation therapy (called concurrent chemoradiation). This may be given once every 3 weeks or once a week throughout the duration of radiation therapy. Although chemotherapy makes the radiation more effective at destroying cancer cells, it may also lead to increased side effects for most patients.
This is when chemotherapy is given before surgery or radiation therapy to help shrink large cancers making them easier to remove during surgery, or target with radiation therapy.
This is used when the cancer is incurable. The cancer may be too large or has spread too much to be removed by surgery. Palliative chemotherapy helps to slow the growth of cancer and reduce symptoms. It is important to remember that palliative chemotherapy is not as intense as other types and is much less likely to have significant side effects.
Before you start treatment, your medical oncologist will choose one or more chemotherapy medication that will be best to treat the type of cancer you have. The particular chemotherapy medications used will depend on:
whether the treatment is curative or palliative
when it is used
your medical history
The side effects of chemotherapy depend on the medication used and the the dose. The most common medications are cisplatin, carboplatin and 5-Fluoruracil (5-FU). Each person responds to chemotherapy differently. Some people may experience a few side effects while others may not experience any at all. The following are common side effects of chemotherapy:
a feeling of wanting to vomit (nausea) or vomiting
more side effects of radiation, if you have chemotherapy at the same time as radiation
loss of feeling in the fingers and toes
kidney damage (caused by some medications)
hearing loss/thinning
ringing in the ears
rash
higher risk of infection (if the chemotherapy reduces the number of white cells in the blood).
Loading...