Oropharyngeal (Tonsil) Cancer

The oropharynx:

The oropharynx is the middle part of the throat that's in the back of the mouth.  It includes the soft palate, the back and sides of the throat, the back of the tongue, and the tonsils.

Oropharyngeal cancer, also called tonsil cancer, includes any cancer that originates in the oropharynx.

How Common is it?

According to the American Cancer Society, about 54,000 people are diagnosed with oropharyngeal cancer each year. Oropharyngeal cancer is relatively rare, accounting for only 3% of all head and neck cancers. However, it is on the rise, with cases increasing by 2-3% each year. Oropharyngeal cancer is about three times more common in men than women.

Generally, uncontrolled cell division and multiplication of abnormal cells is what causes cancer.

Damage to cells in the oropharynx can cause cancer.

The vast majority of oropharyngeal cancers are caused by HPV (human papillomavirus). HPV is a sexually transmitted infection that is passed from person to person through skin-to-skin contact. There are more than 150 types of HPV, with some posing more of a cancer risk than others.

Alcohol consumption and smoking are also leading causes of oropharynx cancer.

While anyone can develop oropharyngeal cancer, there are certain factors that can increase your risk:

• HPV infection is the leading cause of oropharyngeal cancer. Having multiple sexual partners or starting sex at an early age increases your risk of HPV infection.

• Smoking cigarettes, cigars, or pipes, and using other forms of tobacco such as chewing tobacco or snuff.

• Heavy alcohol use.

• Eating an unhealthy diet that’s low in fruits and vegetables h

• Poor mouth Care.

• Exposure to certain chemicals.

• A history of certain other cancers, such as Hodgkin's lymphoma, or throat cancer.

• Older age.

The symptoms of oropharyngeal cancer can vary depending on the size and location of the tumor. In general, symptoms may include:

• A sore throat that doesn't go away

• Painful swallowing

• Changes in your voice, such as hoarseness

• A lump in your neck

• Weight loss

• Ear pain

• Trouble breathing

If you experience any of these symptoms, it's important to see a doctor right away. Oropharyngeal cancer is often found at an early stage through routine cancer screenings. However, the earlier the cancer is caught, the better the chances are for successful treatment.

If your doctor suspects you have oropharyngeal cancer, they will likely order one or more of the following tests:

• A physical exam. This will help your doctor to look for any lumps or other abnormalities in your neck and head.

• A biopsy. During a biopsy, a small sample of tissue is taken from the suspicious area and examined under a microscope for signs of cancer.

• An MRI or CT scan. These imaging tests can help to show the size and location of any tumors.

• A PET scan. A PET scan uses special dye that helps to show areas of active cancer in the body.

You won’t know for sure if the tumor is cancer until after surgery.

Cancer Staging

 Testing can help determine the stage of the cancer. The stage is how much and how far the cancer has spread (metastasized) in your body. It’s one of the most important things to know when deciding how to treat cancer.

Once your cancer is staged, your healthcare provider will talk with you about what the stage means for your treatment. Be sure to ask your healthcare provider to explain the stage of your cancer to you in a way you can understand.

The treatment for oropharyngeal cancer will vary depending on the stage of the cancer, the location of the tumor, and your overall health. Treatment options may include:

• TORS (Transoral Robotic Surgery). TORS is a minimally invasive surgery to remove cancerous tumors in the throat.

• Surgery. Surgery is the most common treatment for oropharyngeal cancer. The type of surgery will depend on the size and location of the tumor.

• Radiation therapy. Radiation therapy uses high-energy beams to kill cancer cells. It can be used alone or in combination with surgery.

• Chemotherapy. Chemotherapy uses drugs to kill cancer cells. It can be used alone or in combination with radiation therapy.

Is oropharyngeal cancer curable?

The short answer is yes, oropharyngeal cancer is curable. However, the treatment for oropharyngeal cancer will vary depending on the stage of the cancer, the location of the tumor, and your overall health. The earlier a cancer diagnosis is found, the more curable that cancer will be, therefore it is important to have recommended routine screenings in line with your individual risk factors.

There are a few things you can do to help lower your risk of oropharyngeal cancer:

• Get vaccinated against HPV. The HPV vaccine is recommended for both boys and girls starting at age 11 or 12.

• Don't smoke or use any tobacco. If you do smoke, quitting is the best way to reduce your risk of cancer.

• Limit alcohol consumption. Drinking alcohol increases your risk of cancer. If you choose to drink, do so in moderation.

• Eat a healthy diet. Eating plenty of fruits and vegetables can help to lower your risk of cancer.

• Practice good oral hygiene. Get regular dental care. Brush and floss your teeth regularly and see your dentist for regular checkups.

Many people feel worried, depressed, and stressed when dealing with a cancer diagnosis. Getting treatment for cancer can be hard on your mind and body as well. 

It’s important to continue talking with your healthcare team about any problems or concerns you may have. Work together to ease the effect of cancer and its symptoms on your daily life. The University of Cincinnati Cancer Center offers supportive services and programs for your cancer journey – explore them here. 

Here are some additional tips:

• Talk with your family or friends.

• Ask your healthcare team or social worker for help.

• Speak with a counselor.

• Talk with a spiritual advisor, such as a minister or rabbi.

• Ask your healthcare team about medicines for depression or anxiety.

• Keep socially active.

• Join a cancer support group.

Cancer treatment is also hard on the body. To help yourself stay healthier, try to:

• Eat a healthy diet, with as many protein foods as possible.

• Drink plenty of water, fruit juices, and other liquids.

• Keep physically active.

• Rest as much as needed.

• Talk with your healthcare team about ways to manage treatment side effects.

• Take your medicines as directed by your team.

Call your provider immediately if you experience any of the following:

• New symptoms or symptoms that get worse.

• Signs of an infection, such as a fever.

• Side effects of treatment that affect your daily function or don't get better with treatment.

Ask your healthcare provider what signs to watch for, and when to call. Know how to get help after office hours and on weekends and holidays.

What is the survival rate for oropharyngeal (tonsil) cancer?

Prognosis, or survival, is different for each person and may also depend on the quality of care a person will receive. It is best to ask your Head & Neck Cancer specialist about this information for you specifically.

The University of Cincinnati Cancer Center is the  region's only adult academic health system , meaning we are best equipped to care for you or your loved one who is dealing with an oropharyngeal cancer diagnosis.

With access to innovative treatment technologies like Transoral Robotic Surgery (TORS) powered by fellowship trained head and neck cancer physicians, a life-saving second opinion is just a phone call away.