Oropharyngeal carcinoma is a cancer in the oropharynx region. The oropharynx forms the middle section of the pharynx.
What is oropharyngeal carcinoma?
Oropharyngeal carcinoma is also known as oropharyngeal cancer. What is meant by this is a malignant mucosal tumor in the oropharynx, which is the oropharynx or mesopharynx. Together with nasopharyngeal and hypopharyngeal carcinoma, oropharyngeal carcinoma is one of the throat cancers. See usvsukenglish for What does the abbreviation hyperprolactinemia stand for.
The middle section of the throat (pharynx) is formed by the oropharynx. It includes the rear wall of the pharynx, the soft palate, the pharyngeal tonsils and the base of the tongue and extends to the larynx transition. Oral or pharyngeal cancer is particularly common in older men over 60 years of age.
In Germany, there are about 0.5 to 2 new cases per 100,000 inhabitants per year. From a histological point of view, an oropharyngeal carcinoma is usually a squamous cell carcinoma that originates in the pharyngeal mucosa. Typically, secondary tumors (metastases) develop in the cervical lymph nodes.
Causes
What causes throat cancer or an oropharyngeal carcinoma could not be clarified exactly. Environmental influences, genetic factors and nutritional deficiencies are blamed. However, certain risk factors are known that favor the occurrence of oropharyngeal carcinoma.
These include high alcohol consumption, smoking, infections with the human papillomavirus (HPV), a diet low in vitamins and the influence of pollutants such as paints containing nickel and chromium or asbestos. However, cigarette and alcohol consumption are classified as the greatest risk factors. A combination of both increases the risk of throat cancer considerably.
Oral cancer is three or four times more common in men than in women. Oropharyngeal carcinoma often occurs together with the Epstein-Barr virus. Other risk factors include a weakened immune system and poor oral hygiene.
Symptoms, Ailments & Signs
Oropharyngeal carcinoma usually does not initially show any typical symptoms. Noticeable symptoms only appear in the late stages of the insidious disease. This usually results in changes to the mucous membrane of the oral cavity. Taste changes and bleeding are also possible.
Not infrequently, the patient also suffers from bad breath, although his oral hygiene has not changed. Speaking and chewing can also cause pain that radiates towards the ear. The affected person also has problems swallowing.
In most cases, oropharyngeal carcinoma forms in the region of the tonsils (palatine tonsils). Sometimes the tumor spreads to the masticatory muscles. This leads to a painful jaw lock. Patients are then unable to fully open their mouth.
Diagnosis & course of disease
If there is a suspicion of oropharyngeal carcinoma, the attending physician carries out a mirror examination with a special laryngoscope. It may be necessary to use a very flexible endoscope to view the oropharynx more closely. When the entire throat area is checked, the patient is given intubation anesthesia.
Imaging procedures are used to assess the extent of the tumor and to plan subsequent treatment. This involves an ultrasound examination (sonography), computed tomography (CT) and magnetic resonance imaging (MRI). The doctor can use the ultrasound examination to determine whether the lymph nodes are affected.
CT and MRI are used to determine the extent of the tumor. In addition, they can be used to determine any infestation of the neck vessels. To clarify whether the oropharyngeal carcinoma has caused distant metastases, CT and X-ray images of the lungs are taken. The liver is also checked by sonography.
A scintigraphy is considered useful for clarifying metastases in the bones. The course of an oropharyngeal carcinoma depends on when the tumor is discovered. Late diagnosis is a common problem. In the early stages, the carcinoma is small, has not yet attacked neighboring structures and has not caused metastases, which means that a favorable prognosis can be made. However, if the growth of the tumor continues, this often leads to a negative course of the disease.
Complications
Because of the oropharyngeal carcinoma, those affected suffer from a tumor. In this disease, the tumor can also spread to other parts of the body and possibly lead to another tumor there. For this reason, life expectancy in the case of oropharyngeal carcinoma is significantly reduced. This is especially the case when the tumor is diagnosed and treated late.
In most cases, the diagnosis occurs relatively late, since the tumor initially does not cause any symptoms. However, those affected suffer from an altered sense of taste and also from changes in the oral mucosa. Furthermore, the oropharyngeal carcinoma can also lead to bad breath, which cannot be overcome with the help of care products. Those affected also suffer from ear pain.
If treatment is delayed, the tumor usually also spreads to the masticatory muscles, so that patients can no longer open their mouths as usual. Usually the tumor has to be removed. Due to the individual characteristics, it cannot be predicted whether this will lead to a positive course of the disease. It is also possible that the patient dies as a result of this cancer.
When should you go to the doctor?
Changes in the area of the mouth or throat are often signs of a disease. If there is swelling, tightness or pain in the mouth or throat, a doctor is needed. Irregularities in the chewing process or the vocalization must be examined and treated. If problems occur with existing dentures or braces, a doctor’s visit is necessary.
If the symptoms spread or increase in intensity, it is advisable to clarify the impairments. Research into the cause must be initiated so that a treatment plan can be drawn up. Since oropharyngeal carcinoma can have a fatal course without medical care, a doctor should be consulted as soon as the first discrepancies arise.
A loss of appetite, sensory disturbances or a decrease in body weight are further signs of the disease. Earaches, headaches, tilting of the head or tension are causes for concern. There is a need for action as soon as there are changes in the appearance of the skin or the mucous membranes.
If the jaws can no longer be moved as usual, if there is a loss of well-being or participation in social life, the observations should be discussed with a doctor. A general malaise, listlessness or sleep disorders are secondary disorders that can occur as a result of oropharyngeal carcinoma. A doctor’s visit is advisable so that a diagnosis can be made.
Treatment & Therapy
If the oropharyngeal carcinoma is discovered at an early stage and the tumor is still small, the cancer can even be cured. Carcinomas of the tonsils are usually surgically removed. If the tumor is larger, radiation therapy is also necessary.
If the carcinoma is on the tongue or on the palate, high-dose radiation therapy is usually carried out. If the carcinoma has also affected neighboring structures such as the esophagus or thyroid gland, the affected areas are also surgically removed. However, complete removal of the tumor is considered problematic in such cases.
In most of those affected, the cervical lymph nodes are also completely removed, which is seen as an advantage because tumor settlements in the cervical lymph nodes cannot always be made visible. If the patient is in an advanced stage of the oropharyngeal carcinoma, a combination of radiotherapy and chemotherapy is carried out .
Doctors refer to this mixture as radiochemotherapy. The additional chemotherapy ensures a better effect of the treatment. The survival rate of patients older than 70 years is considered to be higher than that of young patients.
Outlook & Forecast
The prognosis for oropharyngeal carcinoma is quite variable. Essentially, the prospects in each case depend on the stage, form and cause as well as the metastatic behavior of the cancer.
Those affected whose oropharyngeal carcinoma was triggered by HP viruses have the best prognosis. Both chemotherapy and radiation have proven to be extremely effective for them. In these cases, no surgery is often necessary. Smokers, on the other hand, have significantly worse prospects. With early treatment, the five-year survival rate is 90 percent. In the second stage of the disease, it is 75 percent.
Patients who have had their oropharyngeal carcinoma surgically removed have the best prospects. In patients who have already developed further distant metastases, the five-year survival rate is between 35 and 75 percent.
Affected people who are only treated very late have very poor prospects. In these cases, only a combination of different therapeutic approaches proved to be successful. The age of the patient is also a crucial factor. Younger sufferers have significantly higher survival rates than older ones. The prospects for oropharyngeal carcinoma are particularly poor in patients over the age of 70. Compared to other types of cancer, the prognosis is relatively good in most cases.
Prevention
There are definitely ways to prevent oropharyngeal carcinoma. So it is advisable to avoid excessive consumption of cigarettes and alcohol. Even after long-term consumption, the risk of cancer can still be reduced. A complete renunciation of nicotine and alcohol is even better. Consistent oral hygiene and a healthy diet also play an important role. However, there is no special vaccination against viruses that promote oropharyngeal carcinoma.
Aftercare
Since oropharyngeal carcinoma is in many cases only recognized relatively late, those affected with this disease have only a few and usually only limited measures and options for aftercare. For this reason, the person affected by this disease should ideally see a doctor very early on, so that other complications or symptoms do not arise.
The treatment itself usually takes the form of a surgical procedure in which the tumor is removed. Regular checks and examinations by a doctor are also very important after such an operation in order to identify and remove further tumors at an early stage. Due to the lengthy treatment, those affected are sometimes dependent on psychological support, which can alleviate and prevent depression in particular.
In general, a healthy lifestyle should be strived for, while also paying attention to a balanced diet. The person concerned should refrain from alcohol and cigarettes. The oropharyngeal carcinoma may reduce the life expectancy of the patient, with the further course depending very much on the time of diagnosis.
You can do that yourself
To strengthen the organism, it is important to ensure a healthy and balanced diet. Harmful substances such as alcohol, nicotine or the use of drugs should be avoided. In particular, the person concerned should abstain from alcohol.
Since the disease is fatal in severe cases, an early medical consultation is necessary as soon as the first irregularities appear. During the treatment process, the instructions and specifications of the treating physician must be followed to avoid complications. Mental strength is important for coping with the overall situation. The psyche should be supported by relaxation and mental techniques. Yoga, meditation or autogenic training are helpful. In addition, psychotherapeutic treatment can be taken advantage of.
So that the immune system is strengthened, sleep hygiene and an adequate supply of oxygen are important in addition to an optimized food intake. The body must be able to regenerate well in order to be able to absorb the consequences of oropharyngeal carcinoma. Walks and exercise within the scope of physical possibilities are recommended. Many patients find an exchange with like-minded people helpful. In self-help groups or internet forums, contacts with other affected people can be established and maintained. Tips for dealing with the adversities in everyday life or mutual motivation take place via these channels.
