Oropharyngeal Cancer Survival Rate

What is Oropharyngeal Cancer?

Oropharyngeal cancer is a type of cancer where cancer cells divide abnormally into squamous cells in the oropharynx. Oropharynx is the middle of the pharynx, or throat, located behind the mouth. This important bodily organ measures about 5 inches -connecting the nose to where the trachea and esophagus begin. It's unfortunately difficult to avoid such cancer, as activities like smoking and being infected with human papillomavirus (HPV) can increase the risk of development.

Unfortunately, signs and symptoms aren't much better either; they often include lumps in the neck and a sore throat. To make matters worse, it's estimated by the American Cancer Society that as many as 54,540 were diagnosed with oropharyngeal cancer in the last year resulting in an estimated 11,580 deaths [¹].

The ICD-10 code for oropharyngeal cancer is C10.9, categorized as malignant neoplasm [²]. This is an international standardized code that is used by medical professionals for the identification of oropharyngeal cancer. The C09 indicates that malignant neoplasms, otherwise known as cancerous tumors, are located in specific areas of the oropharynx. These areas can include the tonsil, parts of the throat, or the back wall behind it [²].

What Are the Types of Oropharyngeal Cancer?

There are various types of oropharyngeal cancer. Of these, squamous cell carcinoma is the most common type.

The types of oropharyngeal cancer, along with their symptoms, are discussed below;

Squamous Cell Carcinoma

Squamous cell carcinoma is the most common type of oropharyngeal cancer, which affects more than nine out of every ten cases [³]. It typically develops in the delicate cells along the back wall of your throat, such as in your tonsils and at the base or on top of your tongue. These cells act as a protective barrier and line the oropharynx.

Symptoms of squamous cell carcinoma include;

Chronic sore throat.
Pain when swallowing.
A lump in the neck.

A plethora of research suggests that patients diagnosed with HPV-positive squamous cell carcinoma of the oropharynx may experience a better prognosis than those with HPV-negative cancers [⁴].

Furthermore, immunotherapy can be an effective treatment option for those affected by advanced or recurrent squamous cell carcinoma of the head and neck area, including the oropharynx [⁵]. Thankfully, there is hope on the horizon for many facing the burden of this aggressive type of cancer.

Lymphoma

As the name suggests, lymphoma originates from the lymphatic system—a core part of our immune systems that plays an essential role in combating diseases. This type of cancer occurs when there is a build-up of uncontrolled and unregulated DNA changes in cells in the lymphatic tissues. Oropharyngeal lymphoma mainly develops in the tonsils or other types of lymphoid tissues existing in the oropharynx area [⁶]

Symptoms of oropharyngeal lymphoma include;

Lump in the neck.
Sore throat.
Difficulty in swallowing.

Sarcoma

Sarcoma is a rare kind of cancer that can occur in the muscles, bones and soft tissues around the oropharynx.

Symptoms of sarcoma include;

Lump or swelling in the mouth.
Difficulty in swallowing.
Pain or numbness in the face.

Many studies recommend that immunity-boosting therapists can effectively treat sarcoma. But since it is one of the rare kinds of oropharyngeal cancer, more research is needed to explore what can be done for an effective treatment. New advancements, such as genetic testing and personalized medicine options, can also open innovative paths in sarcoma treatment with favorable patient results.

Adenocarcinoma

What Are the Signs and Symptoms of Oropharyngeal Cancer?

The symptoms of oropharyngeal cancer are asymptomatic in nature, meaning that they do not show any clear-cut symptoms, and a thorough visual examination of the mouth and throat area is necessary, including thorough checking of all its components such as the tongue, the floor of the mouth, soft palate and uvula, a peek at those hard-to-reach lingual aspects behind your molars and tonsillar pillars [⁵].

The symptoms of oropharyngeal cancer can include the following;

A persistent sore throat, also known as pharyngitis.
Acute pain when trying to swallow something, also known as dysphagia.
Difficulty when moving your tongue and opening your mouth, also known as trismus.
Voice changes.
Weightloss.
A lump in the neck.
A lump in the back of your throat.
Bloody coughing.
White patches on your tongue.

Oropharyngeal Cancer Diagnosis and Staging

How Is Oropharyngeal Cancer Diagnosed?

Because the cancer is located at the back of our throat, it somewhat stays undetected for a longer period, and various methods are tried to diagnose a person with oropharyngeal cancer. Some of them of discussed below;

Head & Neck Exam

If your doctor thinks you may be facing cancer, they'll send you to a specialist for further inspection. These experts come in the form of oral and maxillofacial surgeons, head & neck specialists, or ENT doctors. This doctor will take a complete scan of your head & neck and will pay special attention to your lymph nodes to check for any swelling and abnormal growth of cells.

This procedure includes the use of specialized fiber optic scopes. The process includes;

Indirect pharyngoscopy and laryngoscopy.
Direct (flexible) pharyngoscopy and laryngoscopy.

Panendoscopy

Panendoscopy is a diagnostic procedure done to detect if there are other instances of cancer in the esophagus or lung. It is also used when it is unclear where cancer originally started or if the lymph nodes at the neck's base hint at a potential abnormality. During this procedure, multiple types of endoscopes can be introduced through the nose and mouth to evaluate different areas such as the oral cavity, oropharynx, larynx, esophagus, and even trachea and bronchi in the lungs.

Biopsy

Another way to diagnose oral or oropharyngeal cancer is a biopsy - this procedure involves removing and studying small tissue samples from our body (suspected area). By pinpointing any suspicious activity, treatment can be started with greater certainty. Also, it is the only way to fully detect oropharyngeal cancer in the body [⁶].

Oropharyngeal Cancer Staging

The TNM system is used to know the stage of cancer.

T stage: It covers the size and the extent of the primary tumor within the oral cavity or oropharynx/
N stage: It covers whether cancer has spread to any lymph nodes and on how many sides. It also covers its origin.
M stage: This refers to if cancer has spread to other distant organs like lungs.

Based on these factors, oropharyngeal cancer can be classified into several stages. [⁷].

Stage 0: At this stage, doctors refer to cancer as "carcinoma in situ" - a way of saying that it has only affected the surface layer and hasn't spread into deeper tissue.
Stage I: it is the earliest form, and it's generally localized to one convenient spot in the oropharynx.
Stage II: This stage means cancer has advanced beyond its initial location, now growing larger or infiltrating nearby lymph nodes.
Stage III: Cancer has advanced considerably, infiltrating surrounding tissue and reaching nearby lymph nodes.
Stage IV: Cancer has taken a toll on the body, infiltrating distant lymph nodes, lungs, liver, and bones.

When it comes to oropharyngeal cancer, the stakes are high. Medical professionals have to consider a few factors when it comes to knowing the cancer stage. These factors include the size of tumor, its location, and how it has impacted the lymph nodes.

Is Oropharyngeal Cancer Hereditary?

The information contained in DNA is paramount for human cells to be made. DNA is the chemical found in our cells that makes up our genes. This further implies that these genes control how our cells function and divide. We are told to look like our parents, not just visually but also due to them being a source of our obtaining DNA from them. Inheriting their DNA can even result in certain mutations within the trait we acquired from them [⁸]. If there is a family history of oral or oropharyngeal cancer in the family, inheriting these faulty genes can be a risk factor for developing oropharyngeal cancer.

As per recent studies, oral cancer isn't exclusively linked to bad habits like smoking, chewing tobacco, or alcohol consumption. In fact, family members who don't have any of these vices can still be at risk. So it seems that the predisposition for oral cancer is genetic. Studies show a clear correlation between early age onset and having relatives with the same disease – this leads us to believe there could very well be an inherited gene responsible for susceptibility [⁷].

Oropharyngeal Cancer Cancer Survival Rate

Unfortunately, thousands of adults around the globe get impacted by oral and oropharyngeal cancer each year; in 2022, 54,000 people were diagnosed with oral, throat, and lung cancer [⁹]. The unfortunate truth is that men are much more likely to contract it than women - at a rate twice as high.

85% of people have a 5-year survival rate if the cancer is identified early. However, 68% of people can still reach that 5-year mark if the disease has spread to nearby tissues or organs. Those diagnosed with oral or oropharyngeal cancers after it has spread far from where it originated have only a 40% 5-year survival rate [¹⁰].

Oropharyngeal Cancer Cancer Survival Rate Based on Age

Shockingly, this kind of cancer is the 8th most common kind of cancer among men. Proper diagnosis for this disease is central as some men are diagnosed with it significantly earlier than others. According to statistics, 63 years old is the average age that people get diagnosed. However, there have been cases in which early diagnosis occurs before 55 years old.

Oropharyngeal Cancer Treatment Options

When it comes to oropharyngeal cancer, the treatment a patient receives often depends on other key factors. These underlying details can range from the stage and location of cancer to the patient's overall health. Because of this variance, a few general treatment methods are commonly recommended for this type of cancer.

1. Surgery

Surgery helps combat oropharyngeal cancer. It does this by removing the cancerous tissue as well as some of the anatomically nearby lymph nodes. The extent of the surgery depends heavily on the size and location of a given tumor, as doctors don't want to risk non-cancerous parts of the body in the removal process.

2. Radiation Therapy

Radiation therapy is an effective treatment for cancer. By using high energy beams, radiation therapy is able to target and destroy malignant cancer cells. This kind of therapy may be used as the primary way of stopping the spread of cancer or in combination with other treatments, like surgery or chemotherapy.

3. Chemotherapy

Chemotherapy is a common form of treatment for cancer, with drugs being used to directly target and destroy malignant cells. It can be used in combination with radiation therapy and surgery.

Chemotherapy may be chosen as the primary treatment for advanced stages of recurrent cancers.

Clinical Trials for Oropharyngeal Cancer

2017-2023- Radiation Therapy With Durvalumab or Cetuximab in Treating Patients With Locoregionally Advanced Head and Neck Cancer Who Cannot Take Cisplatin - This trial explores the use of the immunotherapy drug durvalumab in combination with radiation therapy as a potential treatment for patients with head and neck squamous cell carcinoma, including oropharyngeal cancer. Durvalumab works by blocking PD-L1, which can also help cancer cells evade the immune system.

2017-2022- Study of Pembrolizumab (MK-3475) or Placebo With Chemoradiation in Participants With Locally Advanced Head and Neck Squamous Cell Carcinoma (MK-3475-412/KEYNOTE-412) -This trial investigates whether adding the immunotherapy drug pembrolizumab to standard chemoradiotherapy can improve outcomes for patients with locally advanced oropharyngeal squamous cell carcinoma. Pembrolizumab works by blocking a protein called PD-1, which can help cancer cells evade the immune system.

Conclusion

Takeaway

Oropharyngeal cancer is a serious disease. The prognosis for oropharyngeal cancer is difficult to predict as it largely depends on the stage at which its diagnosis is made. However, advances in medical technology have improved the odds of survival significantly. Treatments such as endoscopic resection, surgery, and radiation therapy are incredibly promising and may help to improve overall outcomes for those affected by this complex type of cancer.