Close

Oropharyngeal Cancer

If an adult in your life has oropharyngeal cancer, you may want to learn more about it. This page has information about oropharyngeal cancer, its types and what to expect.

First, you should understand what cancer is. Cancer is a disease caused by abnormal cells that grow too rapidly. Our bodies are made of cells so tiny you need a microscope to see them. Cancer cells don’t look or act like normal cells, and they don’t allow our normal cells to work properly. There are many different types of cancer that can grow anywhere in the body.1 Dahlstrom KR, Li G, Tortolero-Luna G, Wei Q, Sturgis EM. Differences in history of sexual behavior between patients with oropharyngeal squamous cell carcinoma and patients with squamous cell carcinoma at other head and neck sites. Head Neck. 2011 Jun;33(6):847-55.

The oropharynx is a part of the throat (along with the nasopharynx, hypopharynx and larynx). Therefore, this is another site that can be grouped into the general term “throat cancer.” The oropharynx includes the tonsils, base of the tongue, soft palate and oropharyngeal wall. While all oropharynx cancers are analyzed and treated in a similar way, there are some subtle differences.

Like with all head and neck cancers, oropharyngeal cancer is often seen in older men with a history of smoking and drinking. However, over the last 10 to 20 years, doctors and researchers have noticed that while incidences of most head and neck cancers have remained stable, oropharyngeal cancer incidences are increasing. Also, they have been seeing more oropharyngeal cancers in patients who are younger, healthier and non-smokers. In search for the answer to these strange observations, it seems that researchers have discovered a new disease: human papillomavirus (HPV)-associated oropharyngeal cancer. This is similar to HPV-associated cervical and ano-genital cancer. It is a sexually-transmitted virus associated with high numbers of lifetime oral sex partners.1 Dahlstrom KR, Li G, Tortolero-Luna G, Wei Q, Sturgis EM. Differences in history of sexual behavior between patients with oropharyngeal squamous cell carcinoma and patients with squamous cell carcinoma at other head and neck sites. Head Neck. 2011 Jun;33(6):847-55.

Researchers are still discovering many details about HPV-associated oropharyngeal cancers, but one thing is certain—they behave quite differently from oropharyngeal cancers not associated with HPV. As a general rule, these patients have a better prognosis (outcome) than patients with non-HPV-associated oropharyngeal cancer with current treatment strategies.2 Ang KK, Harris J, Wheeler R, Weber R, Rosenthal DI, Nguyen-Tân PF, Westra WH, Chung CH, Jordan RC, Lu C, Kim H, Axelrod R, Silverman CC, Redmond KP, Gillison ML. Human papillomavirus and survival of patients with oropharyngeal cancer. N Engl J Med. 2010 Jul 1;363(1):24-35. doi: 10.1056/NEJMoa0912217. Epub 2010 Jun 7., 3 Fakhry, C, Westra, WH, Li, S, Cmelak A. Improved survival of patients with human papillomavirus–positive head and neck squamous cell carcinoma in a prospective clinical trial. JNCI J Natl Cancer Inst. 2008;100(4):261-269. The question of whether we can treat these patients differently (for example, less aggressively to decrease side effects of treatment) but still maintain a good prognosis is currently being evaluated.1 Dahlstrom KR, Li G, Tortolero-Luna G, Wei Q, Sturgis EM. Differences in history of sexual behavior between patients with oropharyngeal squamous cell carcinoma and patients with squamous cell carcinoma at other head and neck sites. Head Neck. 2011 Jun;33(6):847-55.

04a_throat_overview CROP

The oropharynx includes a few parts (or subsites): the base of the tongue, the soft palate, the palatine tonsils, the tonsillar pillars and the pharyngeal walls.

41_1_tonsil

19b_oropharynx

  • Tonsils: These are the ball shaped structures at the back and on the sides of the throat. They can cause younger people problems such as infections and snoring. They are made of lymphoid tissue (tissue with infection-fighting cells). One of the most common surgeries in the U.S. is removal of tonsils when they get large in children and cause snoring and sleeping problems. They can also be removed if they often get infected. Interestingly, removing the tonsils does not seem to increase the chance of getting infections (you have a lot of back-up systems to fight infections in the body). In general, each of the tonsils should be about the same size (though in some people they are slightly different in size). Structures related to the tonsils include:
    • Anterior tonsil pillar: This is the fold of tissue just in front of the tonsil. It is also called the palatoglossus because it extends from the soft palate above, down to the tongue.
    • Posterior tonsil pillar: This is the fold of tissue just behind the tonsil. It is also called the palatopharyngeus because it extends from the soft palate above, to the pharyngeal wall on the back.
    • Glossotonsillar sulcus: This is the bottom part of the palatine tonsil where it blends into the lingual tonsil tissue. It is basically an area between the tonsil and the base of the tongue.
    • Tonsillar fossa:This is the “pocket” in which the tonsils sit. It is made up of the anterior and posterior tonsillar pillar.
  • Base of the tongue: This is part of the tongue, but it is considered part of the oropharynx, NOT the oral cavity (mouth). Everything behind a line of taste buds on the tongue (circumvallate papilla) is the base of the tongue. The base of the tongue can’t be seen by looking in the mouth. It can only be seen with a mirror in the mouth or a camera passed through the nose. Also, tumors here can be felt by sliding a finger back along the tongue. The base of the tongue is made up of lymphoid tissue, a mucosal lining and deep muscles of the tongue.
  • Soft palate: This part of the oropharynx can be seen in most people just by looking inside the mouth. It is the part of the roof of the mouth behind the hard palate (part of the oral cavity or mouth). The uvula (the dangly bit of tissue in the back of the mouth) is part of the soft palate. The soft palate is made up of many muscles and moves up and down as you breath and eat. Above and behind the soft palate is the nasopharynx; when the soft palate moves up, it closes the connection between the oropharynx and nasopharynx and prevents food and liquids from going up into the nose.
  • Pharyngeal walls: This is basically the back and side walls of the oropharynx. If you look straight back into your mouth, stick out your tongue and say “ahhhh,” a doctor might be able to see the posterior (back) pharyngeal wall. Behind the posterior pharyngeal wall is the spine.

Navigating oropharyngeal cancers

To learn more about a particular type of oropharyngeal cancer, choose an article below.

Soft Palate Cancer

This article discusses soft palate cancer, or cancer of the roof of the mouth behind the hard palate, in detail.

Tongue Base Cancer

This article discusses tongue base cancer, or cancer of the back of the tongue (the part inside the throat), in detail.

Tonsil Cancer

This article discusses tonsil cancer in detail.


References

1 Dahlstrom KR, Li G, Tortolero-Luna G, Wei Q, Sturgis EM. Differences in history of sexual behavior between patients with oropharyngeal squamous cell carcinoma and patients with squamous cell carcinoma at other head and neck sites. Head Neck. 2011 Jun;33(6):847-55.

2 Ang KK, Harris J, Wheeler R, Weber R, Rosenthal DI, Nguyen-Tân PF, Westra WH, Chung CH, Jordan RC, Lu C, Kim H, Axelrod R, Silverman CC, Redmond KP, Gillison ML. Human papillomavirus and survival of patients with oropharyngeal cancer. N Engl J Med. 2010 Jul 1;363(1):24-35. doi: 10.1056/NEJMoa0912217. Epub 2010 Jun 7.

3 Fakhry, C, Westra, WH, Li, S, Cmelak A. Improved survival of patients with human papillomavirus–positive head and neck squamous cell carcinoma in a prospective clinical trial. JNCI J Natl Cancer Inst. 2008;100(4):261-269.

Important: Privacy Update

Your privacy and the protection of your personal information is important to the THANC (Thyroid, Head and Neck Cancer) Foundation and the Head & Neck Cancer Guide (HNCG). For this reason, we have updated our privacy policy to align with the GDPR (General Data Protection Regulation).

Please click below to see an updated privacy policy that describes how we collect and use your personal information and respect your privacy.

Privacy Policy