Oropharyngeal cancer is a type of head and neck cancer. Cancers affecting the head and neck are not common. People with this type of cancer are usually treated in specialist centres by a team of specialist healthcare professionals.
Your treatment will depend on the stage and grade of the cancer, as well as your general health. Your specialist doctor or nurse will explain the best treatment for you and any likely side effects.
The aim is to treat the cancer, while doing as little damage as possible to your throat and facial appearance. They will talk to you about the best treatment options for you and any likely side effects.
You may only need one type of treatment. But sometimes two or more treatments are given. If you have a small, early-stage cancer, you may be treated with either surgery or radiotherapy. If the cancer is bigger or has spread to the lymph nodes, you usually have a combination of treatments.
Often chemotherapy and radiotherapy are given together. This is called chemoradiation. Some people have surgery followed by radiotherapy or chemoradiation.
Surgery may be used to remove early-stage oropharyngeal cancer. Sometimes surgery is used to treat more advanced stages of oropharyngeal cancer.
For small cancers, it may be possible to do the operation through the mouth. This is called transoral surgery. The surgeon carefully removes the cancer, often using a laser. Transoral surgery does not leave any scars on the neck or face. You may also recover faster and have fewer problems with your speech or ability to swallow.
If the cancer is bigger or in a difficult position, the surgeon may do the operation through a cut in the neck. Sometimes they need to divide part of the jawbone or tongue to remove all the cancer. The surgeon may use tissue, skin or bone taken from somewhere else in the body to rebuild these areas.
The surgeon may also remove some lymph nodes from the neck. They do this through a cut in the neck. They may do this to remove cancer that has spread to the lymph nodes, or to reduce the risk of the cancer coming back.
Your doctor will explain the operation to you beforehand. You will be able to ask any questions you have about it.
Radiotherapy uses high-energy rays to destroy the cancer cells, while doing as little harm as possible to normal cells.
Radiotherapy can be given on its own with the aim of curing an early-stage cancer. It may also be used with surgery, chemotherapy or targeted therapy to treat bigger cancers and cancer that has spread to the lymph nodes.
Radiotherapy can also be used after surgery to reduce the risk of the cancer coming back. The lymph nodes in the neck are often treated if there are no signs of cancer there. This is because some of the lymph nodes may contain some cancer cells that cannot be seen on scans.
You may have side effects during radiotherapy. These usually get better slowly after treatment finishes.
Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. For oropharyngeal cancer, it is usually given with radiotherapy (chemoradiation). Chemotherapy may be given alone if cancer has spread to other parts of the body. The chemotherapy drugs most often used to treat oropharyngeal cancer are:
These are usually given into a vein (intravenously).
Chemoradiation is when you have chemotherapy and radiotherapy together. Chemotherapy can make the cancer cells more sensitive to radiotherapy treatment.
Chemoradiation is often used as the main treatment for locally advanced oropharyngeal cancer. It may also be given after surgery.
Having chemoradiation is more effective than having chemotherapy or radiotherapy alone, but it can cause more severe side effects. It is important that you are well enough to cope with having both treatments together.
Targeted therapy drugs work by targeting something in or around the cancer cell that is helping it grow and survive.
Cetuximab is the most commonly used targeted therapy to treat oropharyngeal cancer. This drug may stop the cancer cells growing and dividing. It may also make the cancer more sensitive to the effects of radiotherapy. It is given as a drip (infusion) into a vein once a week. You might have cetuximab with radiotherapy if you cannot have chemoradiation. You may also have it with chemotherapy to treat cancer that has spread or come back.