What are the other Names for this Condition? (Also known as/Synonyms)

• Cancer of the Oropharynx
• Mouth Cancer
• Throat Cancer

What is Oropharyngeal Cancer? (Definition/Background Information)

• Oropharyngeal Cancer is cancer of the mouth and throat that includes the base of the tongue, tonsils, soft palate, and pharynx
• It is mainly classified into 2 types depending on the cause:
  • HPV-positive type linked to human papilloma virus (HPV) infection
  • HPV-negative related to tobacco and alcohol usage
• About 90% of the Oropharyngeal Cancers are squamous cell carcinomas arising from cells that cover the insides of the mouth and throat
• Remaining 10% are either salivary gland tumors, adenoid cystic carcinomas (cancer of glandular tissue), lymphomas (lymph node cancer), and melanomas (cancer of pigment producing cells of the skin)
• Oropharyngeal Cancer is mainly caused by usage of tobacco products, alcohol, and HPV infection due to unsafe sexual practices
• Individuals with Oropharyngeal Cancer usually complain of persistent ulcer or lump in the mouth or throat. This may lead to complications such as ulceration and bleeding from the tumor
• The treatment of Oropharyngeal Cancer may include a combination of surgical procedures, chemotherapy and radiation therapy. The prognosis is good, if the cancer is detected early

Who gets Oropharyngeal Cancer? (Age and Sex Distribution)

• Oropharyngeal Cancer is the 6^th most common type of cancer around the world
• The condition is much more prevalent in males and older adults

What are the Risk Factors for Oropharyngeal Cancer? (Predisposing Factors)

Following are the risk factors for Oropharyngeal Cancers:

• Smoking and chewing tobacco
• Heavy alcohol use
• Multiple sexual partners and history of orogenital sex (oral sex)
• Poor oral hygiene
• Poor nutrition
• Plummer Wilson syndrome
• Immunodeficiency due to various health centers
• Chewing betel nut (areca nut)
• Mutations in tumor suppressor genes such as p53
• Marijuana usage

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Oropharyngeal Cancer? (Etiology)

There are multiple causes for Oropharyngeal Cancers and these include:

• Increased exposure to risk factors, such as tobacco and alcohol, which contains carcinogens (cancer causing chemicals)
• Random mutations in DNA that go unrepaired
• Expression of HPV oncogenic proteins, such as E6 and E7, in the cells after infection, results in the inactivation of cellular tumor suppressor proteins (p53 and Rb)

In many cases, the cause is unknown or they may be multiple factors that are responsible for Cancer of the Oropharynx.

What are the Signs and Symptoms of Oropharyngeal Cancer?

Often the first symptom of Oropharyngeal Cancer is a persistent non-healing, painless ulcer in the mouth, or a painless lump in the neck. A persistent discomfort in the mouth follows the presence of this painless ulcer.

The other signs and symptoms may include:

• Red or white patches in the mouth
• Persistent sore throat
• Difficulty in swallowing
• Unexplained weight loss
• Changes in the voice
• Coughing-up blood
• Ear pain
• Persistent bad breath

Sometimes, Oropharyngeal Cancers are asymptomatic and may be incidentally diagnosed by the physician or dentist during a routine oral examination.

How is Oropharyngeal Cancer Diagnosed?

Oropharyngeal Cancer is diagnosed by a detailed medical history and physical examination. Additionally, the following examinations and tests are performed:

• Physical examination of head and neck for lumps and other abnormal areas in the head and neck
• Complete ENT examination using laryngoscope or panendoscope
• HPV testing of biopsied sample
• Chest X-ray to detect the spread of cancer to the lungs
• Other imaging tests, such as CT, MRI, and PET scans, to detect the spread of cancer
• Biopsy of the lesion

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Oropharyngeal Cancer?

The complications of Oropharyngeal Cancers can occur either due to the cancer or secondary to the treatment. They include:

• Ulceration and bleeding from the tumor
• Inability to speak or swallow
• Metastasis of the tumor to lungs, brain, or spine resulting in breathlessness, headaches, or backaches
• Dry mouth, increased bleeding or bruising
• Difficulty in swallowing or breathing
• Hair loss
• Headache and confusion
• Nausea and vomiting
• Loss of appetite
• Chemotherapy-induced bone marrow damage resulting in aplastic anemia, low white blood cells, and low platelet counts 
• Increased susceptibility to infections

How is Oropharyngeal Cancer Treated?

The treatment of Oropharyngeal Cancer is based on the stage, type, and location of the tumor. It may include:

• Surgery to remove the tumor and the lymph nodes draining the tumor region
• Radiation therapy to destroy cancer cells using high-energy radiation
• Chemotherapy to kill cancer cells using cytotoxic drugs
• Targeted therapy to selectively kill the cancer cells
• Palliative therapy - for advanced cases and when the cancer is inoperable

How can Oropharyngeal Cancer be Prevented?

Some Oropharyngeal Cancers may not be preventable, but the risk of acquiring them can be reduced by:

• Avoiding usage of tobacco, excessive consumption of alcohol
• Practicing safe sex
• Consumption of diets rich in fruits and vegetables
• Routine screening by dentist or a physician to identify any precancerous oral lesions

What is the Prognosis of Oropharyngeal Cancer? (Outcomes/Resolutions)

The prognosis of Oropharyngeal Cancer depends on the underlying cause, type, and stage of the cancer.

• If the cancer is diagnosed in the early stages and there is no involvement of the lymph nodes, surrounding tissues, or distant metastasis, the prognosis is usually good
• The prognosis decreases as the cancer spreads to the lymph nodes and surrounding structures and undergoes distant metastasis
• Individuals with human papilloma virus (HPV) linked Oropharyngeal Cancers have functional P53 gene and have better survival rates, than those who have HPV-negative type of Oropharyngeal Cancers

Additional and Relevant Useful Information for Oropharyngeal Cancer:

• The gene chip assays can identify multiple mutations in the tumor and help physicians to decide on the best course of treatment
• There are many online groups available for individuals diagnosed with Oropharyngeal Cancer that provide supportive care, encouragement, and bring a measure of relief to the affected individuals and their families