Exploring Oropharyngeal Cancer: An In-Depth Overview [Part Two]
Detection, Diagnosis, and Treatment of Oropharyngeal Cancer
In the first part of our oropharyngeal cancer series, we explored what this condition is, its various types, and its causes and risk factors. Now, we move forward to discuss the critical aspects of detection, diagnosis and treatment of oropharyngeal cancer.
Timely identification and intervention are key to improving outcomes for individuals facing this challenging disease.
Symptoms of Oropharyngeal Cancer
Recognizing the Symptoms
Oropharyngeal cancer often begins silently, with subtle, easily overlooked symptoms. However, being vigilant about your health and being aware of the potential warning signs can make all the difference.
Common symptoms may include:
- Sore Throat (Pharyngitis): Persistent or unexplained sore throat, especially if accompanied by pain when swallowing, should not be ignored.
- Lump In The Neck: The development of a lump or swelling in the neck can be indicative of cancerous growth in the oropharynx.
- Difficulty Swallowing (Dysphagia): If you experience persistent difficulty swallowing, it’s essential to seek medical attention.
- Coughing Up Blood (Hemoptysis): Coughing up blood can be a symptom, therefore seek medical evaluation for a proper diagnosis.
- Ear Pain: Unexplained ear pain, particularly when it’s one-sided, can be a symptom
- Voice Changes: Hoarseness or changes in your voice that persist over time should be evaluated.
- Trouble opening up your mouth fully (trismus) or moving your tongue.
- Unexplained Weight Loss: Sudden and unexplained weight loss can sometimes be associated with advanced oropharyngeal cancer.
- A white patch on your tongue or lining of your mouth that doesn’t go away.
Diagnosis and Tests
The Importance of Early Detection
Early detection of oropharyngeal cancer significantly improves treatment outcomes. The point is; that the earlier the detection, the better and easier.
If you notice any of the above symptoms, it is crucial to consult with a healthcare professional, preferably an otolaryngologist (ear, nose, and throat specialist). They can perform a thorough examination and recommend further tests if necessary.
How do healthcare providers diagnose oropharyngeal cancer?
Your healthcare provider will inquire about your symptoms and medical background, including any history of head and neck cancer or prior radiation therapy to those areas. Lifestyle questions, such as past or current tobacco use, will also be asked.
A thorough physical examination of your mouth, throat, and neck, along with signs of abnormal lumps, will be conducted. Furthermore, your provider may use mirrors, lights, or a fiberoptic scope to inspect the interior of your mouth and throat.
Diagnostic Tests
- Endoscopy: An endoscopy is a procedure in which a flexible tube with a camera (endoscope) is used to examine the oropharynx closely. This allows the healthcare provider to assess the site and extent of the tumour.
- Biopsy: A biopsy is the gold standard for diagnosing oropharyngeal cancer. During a biopsy, a small tissue sample is collected from the suspicious area and examined under the microscope by a pathologist. It will be checked for any signs of cancer and/or HPV.
They may do the following imaging tests:
- Magnetic Resonance Imaging (MRI) Scan: This scan is supposed to give detailed images of your body and the suspicious area, especially the soft tissues. This includes the base of your tongue and tonsils. It can also be used to check the tumour size.
- Computed Tomography (CT) Scan: It combines a series of X-ray images taken from different angles around your body and uses computer processing to create cross-sectional images (slices) of the bones, blood vessels and soft tissues inside your body. It can also be used to check the tumour size and where it has spread.
Are there stages of oropharyngeal cancer?
Yes, there are. Oropharyngeal cancer is categorized into four stages, ranging from Stage I to Stage IV.
These stages can differ based on various factors, such as the presence of HPV-related oropharyngeal cancer, tumour size, and the extent of the cancer’s spread to nearby lymph nodes or distant parts of the body.
Indeed, healthcare professionals utilize cancer staging systems to formulate treatment strategies and predict probable results based on the stage the patient is in.
Treatment Options and Management
Multidisciplinary Approach
The treatment of oropharyngeal cancer often involves a multidisciplinary team of healthcare professionals, including otolaryngologists, oncologists, radiation oncologists, and pathologists.
The choice of treatment depends on several factors, including the stage of cancer, the type of cancer, and the patient’s overall health. Their ultimate goal is to remove the cancer cells without limiting your ability to speak and swallow as you normally would.
Treatment Modalities
Surgery
Surgical removal of the tumour is a common approach, especially for early-stage oropharyngeal cancer. Depending on the size and location of the tumour, the surgery may involve removing part or all of the affected tissue, such as the tonsils or part of the throat.
The type of surgery that doctors may use is called transoral robotic surgery.
Transoral Robotic Surgery
Transoral Robotic Surgery (TORS) represents a minimally invasive approach for the removal of challenging oropharyngeal cancers situated within your mouth.
This form of surgery negates the necessity for a sizable neck incision or jaw separation. It also doesn’t need the insertion of a tracheostomy breathing tube.
Other advantages include;
- Reduced hospitalization duration post-surgery
- Quick recovery
- Minimized impact on neighbouring tissues and the muscles that help you talk and swallow
- Fewer long-term issues with swallowing and speech.
Side Effects of Transoral Robotic Surgery
- Abnormal bleeding (haemorrhage)
- Difficulty swallowing and breathing
- Aspiration (food or liquid might enter your lungs)
- Difficulty chewing food
- Permanent loss of voice or difficulty talking
- Changes to your facial appearance.
- Respiratory compromise, a condition in which your lungs can’t take in enough oxygen.
Some people might also need additional treatment, like speech therapy or nutritional therapy to manage the surgery’s side effects.
Radiation Therapy
Radiation therapy uses high-energy beams to target and kill cancer cells. It can be used alone or in combination with surgery or chemotherapy.
Chemotherapy
Chemotherapy, stand-alone or along with radiation therapy may be administered by your healthcare provider. This combination therapy might be used when you can’t undergo surgery, that is when your tumours are too large.
Chemotherapy might also be administered in the following cases;
- Treating oropharyngeal cancer that has metastasized to distant parts of your body
- Reducing the size of tumours prior to surgical removal
- Eliminating any residual cancer cells that persist post-surgery
Side Effects of Chemotherapy and Radiation Therapy
- May affect your ability to speak (because radiation therapy might damage healthy cells in the throat and make it hard for you either speak or swallow)
- You might also need speech therapy to address issues with speaking and swallowing.
Targeted Therapy
Targeted therapies involve using synthetic monoclonal antibodies, which are naturally occurring proteins within your immune system. Targeted therapy works by blocking a protein that cancer cells rely on to divide, grow and spread.
Side Effects of Targeted Therapy
The side effects may vary from person to person based on their circumstances. However, the common side effects include;
- Infections that cause fever
- Skin Rashes and Itching
- Dizziness
- Dry Mouth and Indigestion
- Changes to skin and nails.
Immunotherapy
Immunotherapy is a medical treatment that is used for people whose oropharyngeal cancer has returned or has spread. This form of therapy acts as the first line of defence and activates the body’s natural defences to recognize and attack cancer cells.
This can be administered through vaccines, antibodies, or inhibitors. The best news is that immunotherapy has shown promising results for most cancer patients and is becoming increasingly popular.
So, go check with your healthcare provider whether immunotherapy is the right treatment option for you. If so, get started right away!
Side Effects of Immunotherapy
The side effects are mild. Some include;
- Fatigue
- Itchy Rash
- Diarrhea
- Nausea and Vomiting
Coping Strategies and Support
A cancer diagnosis can be emotionally and physically challenging. Coping with the side effects of treatment, such as difficulty swallowing or changes in speech, can be especially tough.
Supportive care, including working with speech therapists and nutritionists, can help patients manage these challenges.
Looking Ahead
In this part of our series on oropharyngeal cancer, we’ve explored the critical aspects of detection, diagnosis, and treatment.
Early detection through recognizing symptoms and seeking prompt medical attention is key to improving outcomes. Treatment approaches are tailored to each individual’s unique situation, emphasizing a multidisciplinary approach and personalized care.
In Part 3 of our series, we will delve into the prognosis, prevention, and recent advances in the field of oropharyngeal cancer. Understanding the journey ahead and the latest developments in cancer research is essential for patients and their loved ones facing this disease.
Stay tuned for Part 3!!
References
— Oropharyngeal Cancer: What is it, Symptoms, Stages, Prognosis. (n.d.). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/12180-oropharyngeal-cancer
— Oropharyngeal Cancer Treatment (Adult) (PDQ®)–Patient Version — NCI. (2021, October 15). www.cancer.gov. https://www.cancer.gov/types/head-and-neck/patient/adult/oropharyngeal-treatment-pdq
— Oropharyngeal Cancer: Symptoms, Survival Rate & More. (2021, July 7). City of Hope. https://www.cancercenter.com/cancer-types/head-and-neck-cancer/types/oropharyngeal-cancer
— Oropharyngeal Cancer. (n.d.). Www.hopkinsmedicine.org. https://www.hopkinsmedicine.org/health/conditions-and-diseases/oropharyngeal-cancer
— Oropharyngeal Cancer: Symptoms, Diagnosis and Treatment. (n.d.). Yale Medicine. https://www.yalemedicine.org/conditions/oropharyngeal-cancer
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