Oropharyngeal Cancer Treatment in Mumbai, India

Overview

Oropharyngeal cancer is cancer in the oropharynx or middle part of the throat behind the mouth. It includes the base of the tongue, tonsils, soft palate, and sidewalls of the throat. Symptoms of this cancer include a lump in the throat, white patches inside the mouth, bloodstained sputum, and many more.

Associated Anatomy

Oropharynx or part of the throat behind the mouth

Alternate Name

Oral cancer

Signs or Symptoms of Oropharyngeal Cancer

Non-healing sores in the mouth and on lips
Difficulty in swallowing
Lumps in back of throat, neck, mouth, or lips
Persistent sore throat
White patches on the tongue and inner lining of mouth
Change in voice
Unexplained weight loss
Pain in ears and jaws

Common Causes of Oropharyngeal Cancer

Tobacco and smoking, damage the inner lining of the mouth and throat
Contracting Human Papillomavirus (HPV), which manufactures proteins that interfere with normal cell growth
Genetic mutations in the cells of the throat, result in the accumulation of the cells forming a tumor

Oropharyngeal Cancer Stages

It is mandatory to diagnose the stage to determine the spread of oropharyngeal cancer in the body.

Stage 0: Cancer is localized within the epithelium lining the oral cavity and oropharynx.
Stage I: Cancer is less than 2 centimeters and is present only in the epithelium and doesn't spread to nearby lymph nodes or distant sites.
Stage II: Cancer is more than 4 cm in size.
Stage III: Cancer spreads to the epiglottis or base of the tongue.
Stage IV: This stage is divided into A and IV B. In the A stage, cancer spreads to the larynx, tongue muscle, hard palate, or jaw. In the B state, it spreads to the nearby soft tissues and lymph nodes.

Additional Types

Based on the different parts of the throat, oral cancer is of many types:

Nasopharyngeal Cancer: Cancer of the nasopharynx or the part of the throat behind the nose
Glottic Cancer: Cancer in the vocal cords
Hypopharyngeal Cancer: Cancer in the hypopharynx or the lower part of the throat above the esophagus and trachea

Possible Treatment For Oropharyngeal Cancer

Surgery

Mandibulotomy: The splitting of the jawbone to reach the tumor cells.

Glossectomy: The surgical removal of the tongue.

Maxillectomy: Removing the bony roof of the mouth.

Transoral robotic surgery: Minimally invasive surgery to cut and remove the tumor cells using a robot.

Chemotherapy

Chemotherapy includes medications that kill cancerous cells. Oral or intravenous chemotherapeutic drugs attack cancerous cells throughout the body. Specified chemotherapeutic medications injected in the spinal cord, organs, body cavities, or directly on the skin can kill cancerous cells at specific locations.

Radiation Therapy

External radiation therapy delivers high-energy radiation through the skin to the targeted region using a machine and kills the cancerous cells. Internal radiation therapy transfers the radioactive substances sealed in needles, wires, or catheters directly into cancerous cells.

Biological Therapy

Many biological or synthetic substances can boost the immune system of cancer patients. It helps the body to fight HPV and thus treat precancerous cells.

Typical Test to Diagnose Oropharyngeal Cancer

There are several ways to diagnose oropharyngeal cancer:

Physical Examination – The doctor examines the larynx, lymph nodes of the neck, area behind the nose, and feels lumps on the lips, mouth, and gums during routine check-ups.
Endoscopy – An endoscope (flexible tube with attached light and lens) helps to view the mouth and throat in detail.
Biopsy – It helps to determine the abnormal or cancerous cells in the oral cavity.
X-Ray – It determines the spread of cancer to the organs and bones.
CT Scan or CAT scan and MRI – These imaging tests use waves to form a detailed image of the mouth.
PET Scan – The doctor injects radioactive glucose in the veins and collects images of the cancerous cells containing this radioactive sugar.
HPV Testing – A test done to detect the presence of HPV.
Barium Swallow – It helps to examine the oropharynx by asking the patient to swallow barium. When liquid barium passes to the stomach, doctors can see any changes in the structure of the oral cavity.

Risk Factors Associated With Oropharyngeal Cancer

Consumption of tobacco
Addiction to alcohol and smoking
Infection of HPV and Epstein-Barr virus
Gastroesophageal reflux disease
Exposure to toxins
Radiation therapy for head and neck

Some Possible Complications of Oropharyngeal Cancer

Spread of oropharyngeal cancer to lymph nodes
Hyposalivation or reduced saliva production
Osteoradionecrosis or bone death due to radiation therapy
Tissue fibrosis or formation of scar tissue
Morbidity from jaw resection
Oral mucositis or swelling in the mouth

Prevention of Oropharyngeal Cancer Treatment

Primary Prevention

There are many ways to prevent the onset of oropharyngeal cancer:

Stop smoking and tobacco consumption
Avoid regular or heavy intake of alcohol
Vaccination against HPV
Follow a balanced diet

Secondary Prevention

Follow-up after the cancer treatment includes some tests to determine the cell size and shape. The tests check the effectiveness of the treatment. They note the cell size, hence preventing a recurrence of the cancer.

Regular check-ups and physical examinations by a doctor
Avoid smoking
Self-examination of mouth and lips

Epidemiology

Oropharyngeal cancer is more common in men than in women. People usually get diagnosed at the age of 62. This cancer is rarely found in children while 25% of the cases are common in people below the age of 55. About 90% of oropharyngeal cancers are squamous cell carcinoma.

Expected Prognosis

The prognosis of oropharyngeal cancer depends on various factors including the stage of cancer, overall health, age, infection of HPV, and smoking history. The five-year survival rate of oropharyngeal cancer is 70%. To decrease the chances of recurrence, people must quit smoking and tobacco consumption.

Natural Progression

Oropharyngeal cancer takes many years to develop and begins with cancerous growth in the epithelium. Eventually, it spreads to distant sites and lymph nodes.

Pathophysiology

The cancerous cells start growing in the outer layer of cells in the oral cavity and oropharynx. In later stages, it spreads to the larynx, tongue, palate, or jaw.

Other Conditions & Treatments

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