Tumour

Oropharyngeal cancer

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Oropharyngeal cancer is a disease in which malignant cells form in the tissue of oropharynx. The oropharynx is the middle part of the throat that includes the base of the tongue, the tonsils, the soft palate, and the walls of the pharynx. Oropharyngeal cancers can be divided into two types, HPV-positive, which are related to human papillomavirus infection, and HPV-negative cancers, which are usually linked to alcohol or tobacco use

Signs and symptoms

The possible signs of oropharyngeal cancer are:

  • A sore throat that persists
  • Pain or difficulty with swallowing
  • Unexplained weight loss
  • Voice changes
  • Ear pain
  • A lump in the back of the throat or mouth
  • A lump in the neck
  • A dull pain behind the sternum
  • Cough

Risk factors

The risk factors that can increase the risk of developing oropharyngeal cancer are:

  • Smoking and chewing tobacco
  • Heavy alcohol use
  • A diet low in fruits and vegetables
  • Chewing betel quid, a stimulant commonly used in parts of Asia
  • Mucosal infection with human papilloma virus (HPV) (HPV-mediated oropharyngeal cancer)
  • HPV infection
  • Plummer-Vinson syndrome
  • Poor nutrition
  • Asbestos exposure
  • P53 mutation
  • CDKN2A (p16) mutations

Conditions associated with malignant transformation

High-risk lesions:

  • Erythroplakia
  • Speckled erythroplakia
  • Chronic hyperplastic candidiasis

Medium-risk lesions:

  • Oral submucosal fibrosis
  • Syphilitic glossitis
  • Sideropenic dysphagia (or Paterson-Kelly-Brown syndrome)

Low-risk lesions:

  • Oral lichen planus
  • Discoid lupus erythematosus
  • Discoid keratosis congenita

Prognosis

Patients with HPV-mediated oropharyngeal cancer tend to have higher survival rates. The prognosis for people with oropharyngeal cancer depends on the age and health of the person and the stage of the disease. It is important for people with oropharyngeal cancer to have follow-up exams for the rest of their lives, as cancer can occur in nearby areas. In addition, it is important to eliminate risk factors such as smoking and drinking alcohol, which increase the risk for second cancers.

Spread

The cancer can spread three ways:

  • Cancer invades the surrounding normal tissues.
  • Cancer invades the lymph system and travels through the lymph vessels to other places in the body.
  • Cancer invades the veins and capillaries and travels through the blood to other places in the body.

Stages

Stage 0 carcinoma in situ

Abnormal cells are found in the lining of the oropharynx. These may become cancer and spread into nearby normal tissue.

Stage 1

Cancer has formed and is 20 mm or smaller and has not spread outside the oropharynx.

Stage 2

Cancer has formed and is larger than 20 mm, but not larger than 40 mm. Also, it has not yet spread outside the oropharynx.

Stage 3

  • Cancer is larger than 40 mm and has not spread outside the oropharynx.
  • Any size and has spread to only one lymph node on the same side of the neck as the cancer. The lymph node with cancer is 30 mm or smaller.

Stage 4A

  • Cancer has spread to tissues near the oropharynx, including the larynx (voice box), roof of the mouth, lower jaw, muscle of the tongue, or central muscles of the jaw, and may have spread to one or more nearby lymph nodes; none is larger than 60 mm.
  • Cancer is any size and has spread to one lymph node that is larger than 30 mm, but not larger than 60 mm on the same side of the neck as the cancer or to more than one lymph node, none larger than 60 mm, on one of both sides of the neck.

Stage 4B

  • Cancer surrounds the main artery in the neck or has spread to bones in the jaw or skull, to muscle in the side of the jaw, or to the upper part of the throat behind the nose, and may have spread to nearby lymph nodes.
  • Cancer has spread to a lymph node that is larger than 60 mm and may have spread to tissues around the oropharynx.

Stage 4C

Cancer has spread to other parts of the body; the tumor may be any size and may have spread to lymph nodes.

Source: wikipedia