What is Oropharynx Cancer?
Cancer starts when cells begin to grow out of control. Oropharynx cancer starts in the oropharynx - part of the throat just behind the mouth. The oropharynx starts where the oral cavity ends. It includes the back third of the tongue, the back part of the roof of the mouth, the tonsils, and the side and back walls of the throat.
What causes Oropharynx Cancer?
Oropharynx Cancer is linked with many risk factors that may lead to cells becoming cancerous. Some risk factors may damage the DNA of cells that line the inside of the mouth and throat and hence cause cancer. DNA is the chemical in each of our cells that makes up our genes. Cancers can be caused by DNA changes that create oncogenes or turn off the tumor suppressor genes.
We at CAN-C provide top-quality oropharynx cancer treatment in Bangalore.
Here, you will find information about signs and symptoms, causes and risk factors, types, diagnosis, staging and prevention about oropharynx cancer.
Some of the possible symptoms of the oropharyngeal cancer are:
Pain in the mouth which does not go away
Not healing sore in the mouth
Trouble moving the jaw or tongue
Lump or thickening in the cheek
Trouble chewing or swallowing
White/red patch on the gums, tongue, tonsil, or lining of the mouth
Numbness of the tongue or other area of the mouth
Sore throat or discomfort which does not fade away
Voice changes
Swelling of the jaw causing ill fit of the dentures
Lump or mass in the neck
Loosening of the teeth or pain around the teeth or jaw
Constant bad breath
Weight loss
A risk factor is something that changes or increases the chances of getting a disease like cancer. Different cancers have different risk factors. There are various types of risk factors. Some risk factors are changeable while some cannot be changed.
Tobacco and alcohol: These are 2 of the strongest risk factors for oropharyngeal cancers. It is commonly observed that about 7 out of 10 patients with oropharyngeal cancer are heavy drinkers. The risk is even higher in people who both smoke and drink alcohol.
Betel quid and gutka: People who chew betel quid or gutka have an increased risk of cancer of the mouth.
Human papillomavirus (HPV) infection: Certain types of HPV infection can cause various types of cancers, one of them being the oropharynx cancer.
Gender: Oropharyngeal cancers are comparatively more in men than in women.
Age: Oropharynx cancer usually takes many years to develop, so rarely seen in young people. Most often the patients are above the age of 55 when the cancers are first traced.
CAN-C: Best centre for oropharynx cancer treatment in Bangalore.
Different types of oropharyngeal cancers are:
Squamous cell carcinomas: Majority of the oropharynx cancers are squamous cell carcinomas which is also called as squamous cell cancers. The earliest form of squamous cell cancer is called as carcinoma in situ. Where as invasive squamous cell carcinoma is where the cancer cells have grown into deeper layers of the oropharynx.
Verrucous carcinoma is also a type of squamous cell carcinoma which is a very rare occurrence. It is a low-grade cancer that rarely spreads to other parts of the body, but can grow deeply in the nearby tissue.
Minor salivary gland carcinomas: These cancers start in the glands in the lining of the mouth and throat. There are many types of minor salivary gland cancers, including adenoid cystic carcinoma, mucoepidermoid carcinoma, and polymorphous low-grade adenocarcinoma.
Lymphomas: The tonsils and base of the tongue contain the lymphoid tissue, where cancers called lymphomas can start.
a. Non-Hodgkin Lymphoma
b. Hodgkin Lymphoma
Medical history and physical exam: Most often this is the first step and information about the symptoms, possible risk factors, and any other medical problems will be collected.
The doctor would examine to look for possible signs and symptoms of oropharynx cancer such as lumps, bumps or other changed areas on the head, face or neck, or problems with the nerves of the face and mouth. The doctor will look inside of the mouth and a complete head and neck exam might be done to look for any abnormal areas.
Laryngoscopy and direct (flexible) pharyngoscopy and laryngoscopy
Biopsy: A piece of tissue is removed, to be looked at under a microscope. A biopsy is the only way to know for sure that oropharyngeal cancer is present and is always needed to confirm cancer. Several types of biopsies may be used, depending on each case.
a. Incisional biopsy
b. Fine needle aspiration (FNA) biopsy
c. punch biopsy
HPV testing: Biopsy samples are also tested to check if HPV infection is present. This is a key part of staging. Immunohistochemistry is adviced and used as marker of HPV Infection
Computed tomography (CT): A CT scan uses x-rays to make detailed, cross-sectional images of your body. It helps in knowing the size and location of the tumor as well as the spread of cancer.
Magnetic resonance imaging (MRI): MRI scans also show detailed images of soft tissues in the body with the use of radio waves and strong magnets instead of the x-rays.
Positron emission tomography (PET): A form of radioactive sugar is put into the blood. Though, it does not provide clarity like a CT or MRI scan, it provides information about the whole body.
The staging system most often used for oropharyngeal cancers is the TNM system, which is based on 3 key informations.
How is the stage determined?
TNM staging system is the most commonly used method to describe the different stages of oropharyngeal cancer, which is based on 3 key pieces of information:
The extent of the tumor (T): How large is the main (primary) tumor and which, if any, tissues of the oropharynx has it spread to?
The spread to nearby lymph nodes (N): Has the cancer spread to nearby lymph nodes?
The spread (metastasis) to distant sites (M): Has the cancer spread to distant organs such as the lungs?
We provide the finest treatment for oropharyngeal cancer in Bangalore.
Though oropharyngeal cancer cannot be altogether prevented, but the risk of developing the cancer can be reduced by avoiding the risk factors.
Avoid smoking and alcohol
Avoid HPV infection and HPV vaccination
Limit exposure to ultraviolet (UV) light
Follow a healthy diet
Wear proper fitting dentures
Treat pre-cancerous growths
"CAN-C: Top specialists in Oropharynx Cancer treatment in Bangalore."
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How Oropharynx Cancer is treated?
When diagnosed with oropharynx cancer, it is important to know the benefits as well as the risks and side effects of each mode of treatment. There are lots of ways to treat oropharynx cancer depending on the type and stage of the cancer. It is also dependent on many other factors such as on the age, overall health, and other unique features or criteria. We provide top-class treatment for oropharynx cancer.
Several types of operations can be used to treat oropharyngeal cancers. Depending on where the cancer is and the stage, different operations may be used to remove the cancer. Surgery is often the first treatment used for these cancers and is often used for early stage cancers.
Tumor resection: The entire tumor and an edge of the normal-looking tissue around is removed. The margin of normal tissue is taken out to reduce the chance of any cancer cells being left behind.
BASED ON EXTENT OF RESECTION
1. Glossectomy: The removal of the tongue may be needed to treat cancer of the tongue. Based on the extent of resection of tongue, terminologies may vary.
2. Mandibulectomy: For removal of the jaw bone the surgeon removes all or part of the jaw bone. This operation may be needed if the tumor has grown into the jaw bone.
If bone does not need to be cut all the way through, then the operation, also known as a partial-thickness mandibular resection or marginal mandibulectomy is performed where only part or a piece of jaw bone is removed.
If the x-ray shows the tumor has grown into the jaw bone, a large part of the jaw will need to be removed in an operation called a segmental mandibulectomy.
3. Lateral oropharyngectomy: Tumours involving tonsil and lateral oropharyngeal wall is resected. Based on depth of resection lateral orophargectomy is further classified into type I-IV
BASED ON ACCESS
1. Mandibulotomy: The jaw bone may be split open to access deeply seated tumours of oropharynx and is plated back to normal position at the end of surgery. This procedure is called mandibulotomy.
2. Robotic surgery: Increasingly, trans-oral robotic surgery (TORS) is being used to remove cancers of the oropharynx. Stage I / II can be treated with TORS with significantly reduced morbidity than open surgeries.
3. Trans oral laser microsurgery: CO2 laser may be used to resect tumours in early stage. However trans oral robotic surgery has largely replaced laser surgery.
4. Neck dissection: Cancers of the oropharynx most often spread to the lymph nodes in the neck. Removing of these lymph nodes and also the other nearby tissues is called a neck dissection or lymph node dissection and is done at the same time as the surgery to remove the main tumor. The goal is to remove lymph nodes proven to contain cancer.
a. In a partial or selective neck dissection only a few lymph nodes are removed.
b. For a modified radical neck dissection, most lymph nodes on one side of the neck between the jaw bone and collarbone are removed, as well as some muscle and nerve tissue.
c. In a radical neck dissection, nearly all nodes on one side, as well as even more muscles, nerves, and veins are removed.
Radiation therapy uses high-energy x-rays or particles to destroy cancer cells or slow their rate of growth. Radiation therapy can be used in many ways to treat oropharyngeal cancers. It can be used as the main treatment for small cancers as well as for larger cancers used along with surgery, or a combination of radiation therapy and chemotherapy or a targeted drug. The current standard of treatment of most of oropharyngeal carcinoma is radiation therapy either alone or in combination with chemotherapy (Cisplatin)
After surgery, radiation therapy can be used, either alone or with chemotherapy, as an additional (adjuvant) treatment to try to kill any cancer cells that might not have been removed during surgery. This is called adjuvant radiation therapy.
Radiation therapy can also be used to help ease symptoms of advanced cancer, such as pain, bleeding, trouble swallowing, and problems caused by bone metastases.
External beam radiation therapy: Radiation is commonly given using techniques that help doctors focus the radiation more precisely, such as three-dimensional conformal radiation therapy (3D-CRT) and intensity modulated radiation therapy (IMRT).
CAN-C: Excellent centre for oropharynx cancer treatment (in Bangalore).
The use of anti-cancer drugs to treat cancer is chemotherapy. For oropharyngeal cancers, the drugs are given into a vein or taken by mouth, which allows them to enter the bloodstream and reach cancer that has spread throughout the body.
Chemo combined with radiation used instead of surgery as the main treatment for some cancers is called chemoradiation.
Chemo (with or without radiation therapy) can be used to treat cancers that are too large or have spread too far to be removed by surgery.
The chemo drugs used most often for cancers of the oropharynx are, Cisplatin, Carboplatin, 5-fluorouracil, Paclitaxel, Docetaxel, Hydroxyurea.
With more study and research newer drugs have been developed which specifically target the cancer known as targeted therapy. They work differently and are known to have lesser severe side effects.
Cetuximab is a man-made version of an immune system protein, called a monoclonal antibody. It targets a protein on the surface of certain cells called the epidermal growth factor receptor (EGFR) that helps cells grow and divide. Oropharyngeal cancer cells often have higher than normal amounts of EGFR. By blocking EGFR, cetuximab can help slow or stop cell growth.
As the name suggests immunotherapy is the use of medicines that help a person's own immune system find and destroy cancer cells. It can be used to treat some oropharyngeal cancer.
Immune checkpoint inhibitors, an important part of the immune system is its ability to keep itself from attacking normal cells in the body. Cancer cells sometimes use these checkpoints to avoid being attacked by the immune system. But newer drugs that target these checkpoints hold a lot of promise as cancer treatments.
In Bangalore, we at CAN-C offers the best immunotherapy treatment for oropharynx cancer
Treatments for oropharyngeal cancer are intended to remove or to destroy the cancer cells or slow their growth, though in the process maintaining a patient's quality of life is also an important treatment goal. Palliative treatments can help ease symptoms from the cancer treatment, or in some cases palliative treatment play an even larger role, helping to keep the person comfortable and maintain a good quality of life when in few advanced stages cancer cannot be treated.
Pain is a significant concern for many people with cancer.
Nutrition is another important concern for people with oropharyngeal cancers. Both the cancer and its treatment can make it hard to swallow.
There are many other ways your doctor can help you maintain your quality of life and help control your symptoms.