How Is Oropharynx Cancer Diagnosed?

How Is Oropharynx Cancer Diagnosed? [the_ad id=”28610″]

Oropharyngeal cancer is diagnosed with a physical exam and medical history, followed by tests such as a neurological exam, PET-CT scan, MRI, and biopsy

Oropharyngeal cancer is diagnosed with a physical exam and medical history, followed by tests such as a neurological exam, PET-CT scan, MRI, and biopsy.

Physical exam: Thorough examination of the mouth and neck to check for lumps or abnormalities under the tongue and down the throat.
Medical history: History of current and prior illnesses, as well as family history.
Neurological exam: Series of questions and tests to assess the function of the brain, spinal cord, and nerves to check for coordination, reflexes, and walking ability.
PET-CT scan: Combines positron emission tomography (PET) scan and a computed tomography (CT) scan in order to obtain more detailed images of certain areas of the body.
MRI: Succession of detailed photographs of locations inside the body using a magnet, radio waves, and a computer.
Biopsy: Removal of cells or tissues to analyze for signs of cancer.
- Endoscopic biopsy: Involves inserting a thin tube into the mouth or nose to examine the esophagus, stomach, larynx, trachea, and major airways and collect abnormal tissue for analysis
- Laryngoscopic biopsy: Involves inserting a thin tube to examine the throat and larynx and collect abnormal tissue for analysis.
Human papillomavirus (HPV) test: If cancer is found, an HPV test may be done, since HPV infection has been linked to oropharyngeal cancer. Oropharyngeal cancer caused by HPV has a better prognosis and is treated differently from other types of cancer.

After cancer has been diagnosed, it will be staged to assess the extent of the disease before a treatment plan is devised.

What causes oropharyngeal cancer?

Oropharyngeal cancer is caused by a mass or ulcer due to abnormal and uncontrolled cell growth at the base of the tongue, tonsils, or soft palate. Causes and risk factors include:

Human papillomavirus (HPV)
Chewing betel nut
Alcohol consumption
Tobacco consumption
Poor nutrition

What are symptoms of oropharyngeal cancer?

The World Health Organization estimates that 657,000 new cases of oral cancer are diagnosed each year, with over 330,000 deaths. Oropharyngeal cancer is rare, accounting for about 3% of oral cancers. Symptoms may include:

What are the stages of oropharyngeal cancer?

If oropharyngeal cancer has been diagnosed, staging is important to determine whether the cancer has spread.

Stage 0 (cancer in situ)
- Oropharynx lining contains abnormal cells that are not yet cancerous
Stage I
- Cancer has grown to a size of 2 mm or less but is restricted to the oropharynx
- No evidence of cancer in surrounding lymph nodes or other areas of the body
Stage II
- Cancer is found only in the oropharynx and is larger than 2 cm but not more than 4 cm
- Cancer has not spread to other parts of the body and has not been detected in nearby lymph nodes
Stage III
- Cancer may be 4 cm in diameter or less
- Tumor may have spread to the epiglottis but has not spread to lymph nodes or has spread to one lymph node on the same side of the neck
- Cancer has not spread to other areas of the body
Stage IV
- Stage IVA
  - Cancer has spread to the larynx, roof of the mouth, lower jaw, and epiglottis
  - Cancer may have spread to one or more lymph nodes although they are no more than 6 mm in diameter
  - Cancer has not spread to other areas of the body
- Stage IVB
  - Tumors can be of any size and may encircle the carotid artery or have spread to the jaw muscles and bones, nasopharynx, or base of the skull
  - Although cancer has not spread to other parts of the body, it has affected one or more lymph nodes
- Stage IVC
  - Tumor may be of any size and has spread to other areas of the body from the oropharynx

SLIDESHOW

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What are the treatment options for oropharyngeal cancer?

Treatment for oropharyngeal cancer depends on the stage:

Treatment stage 0
- Wait and watch
- Removal of risk factors, as well as dietary and lifestyle changes
Treatment stage I
Treatment stage II
Treatment stage III
- Surgery to remove the tumor, followed by radiation therapy
- Clinical trial of chemotherapy followed by surgery or radiation therapy
- Clinical trial of chemotherapy combined with radiation therapy
- Clinical trial of new radiation therapy methods
Treatment stage IV:
- For cases in which oropharyngeal cancer can be removed via surgery, treatment may include one of the following:
  - Surgery to remove cancer followed by radiation therapy
  - Radiation therapy alone
  - Clinical trial combining radiation therapy and chemotherapy
  - Clinical trial of new radiation therapy methods
- For cases in which cancer cannot be removed via surgery, treatment may include one of the following:
  - Clinical trial of radiation therapy administered with chemotherapy or radiosensitizers (drugs to make the cancer cells more sensitive to radiation therapy)
  - Clinical trial of new radiation therapy methods
  - Clinical trial of hyperthermia and radiation therapies

What is the survival rate for oropharyngeal cancer?

The outcome for patients with oropharyngeal cancer varies depending on factors such as age, overall health, and the stage of the disease.

Lifetime follow-up exams may be necessary because the cancer can spread to other parts of the body. Furthermore, risk factors such as smoking and drinking that increase the chance of cancer recurrence must be avoided.

The overall 5-year survival rate for oropharyngeal cancer is 65%, meaning that about 6 out of 10 people with the disease will live for at least 5 years after diagnosis.

Medically Reviewed on 4/14/2022

References

Image Source: iStock Images

NYU Langone Hospitals. Diagnosing Oropharyngeal Cancer. https://nyulangone.org/conditions/oropharyngeal-cancer/diagnosis#

American Cancer Society. Tests for Oral Cavity and Oropharyngeal Cancers. https://www.cancer.org/cancer/oral-cavity-and-oropharyngeal-cancer/detection-diagnosis-staging/how-diagnosed.html

Parvathaneni U, Lavertu P, Gibson MK, Glastonbury CM. Advances in Diagnosis and Multidisciplinary Management of Oropharyngeal Squamous Cell Carcinoma: State of the Art. Radiographics. 2019 Nov-Dec;39(7):2055-2068. https://pubs.rsna.org/doi/full/10.1148/rg.2019190007

Coffey C, Ghanem T. Cancer of the Oropharynx: Risk Factors, Diagnosis, Treatment, and Outcomes. American Head and Neck Society. https://www.ahns.info/oropharyngeal-carcinoma-overview/

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