oropharyngeal Cancer 
treatment

INCLUDES TONSIL CANCER

 

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.


 
PRINT
All the information in this section is available in a PDF.
Download it here.
IN THIS SECTION

1. Treatment options for Oropharyngeal Cancer

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.

Generally, people with curable Oropharyngeal Cancer may be offered one of two treatment options: surgery and definitive radiation therapy.
  • 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:


2. Surgery for 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.

Adding another type of treatment after surgery is called adjuvant therapy.

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.

The different surgical options for oropharyngeal cancer include: 

TRANS-ORAL ROBOTIC SURGERY (TORS)

Sometimes, oropharyngeal cancers can be removed through the mouth without any external cuts using a robotic system or by using laser surgery.

download pdf

NECK DISSECTION

This involves removal of lymph nodes from the neck. This is important even when there is no sign of cancer in the lymph nodes on your scan, because there is a risk of microscopic cancer in the lymph glands of the neck.
download pdf

MANDIBULOTOMY

Surgery for oropharyngeal cancer may need to be more extensive in some patients. This can be because the cancer is too far back to remove through the mouth or because it is very large. A mandibulotomy involves cutting the jaw bone to allow better access to the cancer in the throat. The jaw is put back together at the end of the operation with titanium plates.
download pdf

FREE FLAP RECONSTRUCTIVE SURGERY

In people, who have had a large area of tissue taken out, they may need reconstructive surgery. This involves taking skin and its blood supply from another part of the body and using that skin to cover the throat. This operation is carried out by a surgeon who specialises in reconstructive surgery, your head and neck surgeon or another surgeon.
download pdf

TRACHEOSTOMY

A tracheostomy is used to create an opening in the trachea (windpipe) in the lower neck, where a tube is inserted to allow air to flow in and out, when you breathe. This is used as swelling after major head and neck surgery may affect your ability to breathe. The tracheostomy tube is usually removed within a week of surgery once normal breathing is possible.
download pdf

FEEDING TUBES

  • A gastrostomy tube (called a PEG tube) goes through the skin and the muscles of your abdominal wall into the stomach. Gastrostomy is recommended if feeding is needed for a medium to longer time (months or years).
  • A nasogastric tube goes through the nose down into the stomach. Nasogastric feeding is used for short time (days or weeks).
 download pdf 

3. Radiation Therapy for Oropharyngeal Cancer

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:

Definitive

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.

Adjuvant

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.

Palliative

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.


4. Chemotherapy for Oropharyngeal Cancer

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:

Definitive

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.

Adjuvant

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.

Neo-adjuvant

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.

Palliative

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

IN THIS SECTION
 
FURTHER INFORMATION
  1. Head and Neck Cancer Australia Resources 
  2. External Links to other Head and Neck Cancer Resources