Oropharyngeal Cancer

General Information | Treatment Options | Additional Resources

Treatment
  • Overview
  • Standard Treatment
  • Clinical Trials
  • Treatment By Stage

There are different types of treatment for patients with oropharyngeal cancer.

Different types of treatment are available for patients with oropharyngeal cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

Patients with oropharyngeal cancer should have their treatment planned by a team of doctors with expertise in treating head and neck cancer.

The patient's treatment will be overseen by a medical oncologist, a doctor who specializes in treating people with cancer. Because the oropharynx helps in breathing, eating, and talking, patients may need special help adjusting to the side effects of the cancer and its treatment. The medical oncologist may refer the patient to other health professionals with special training in the treatment of patients with head and neck cancer. These may include the following specialists:

  • Head and neck surgeon.
  • Radiation oncologist.
  • Plastic surgeon.
  • Dentist.
  • Dietitian.
  • Psychologist.
  • Rehabilitation specialist.
  • Speech therapist.

Follow-up tests may be needed.

Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. This is sometimes called re-staging.

Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.

After treatment for oropharyngeal cancer, frequent and careful follow-up is important because of the risk of developing a second cancer in the head or neck.

 

Two types of standard treatment are used:

Surgery

Surgery (removing the cancer in an operation) is a common treatment of all stages of oropharyngeal cancer. A doctor may remove the cancer and some of the healthy tissue around the cancer. Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to increase the chances of a cure, is called adjuvant therapy.

Radiation therapy

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated. Fractionated radiation therapy divides the total dose of radiation therapy into several smaller, equal doses given over several days.

Radiation therapy may be more effective in patients who have stopped smoking before beginning treatment.

Radiation therapy to the thyroid or pituitary gland increases the risk of hypothyroidism (too little thyroid hormone). Thyroid function tests should be done before and after treatment.

New types of treatment are being tested in clinical trials.

This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI Web site.

Chemotherapy

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.

Radiosensitizers

Radiosensitizers are drugs that make tumor cells more sensitive to radiation therapy. Combining radiation therapy with radiosensitizers may kill more tumor cells.

Hyperthermia therapy

Hyperthermia therapy is a treatment in which body tissue is exposed to increased temperature to damage and kill cancer cells or to make cancer cells more sensitive to the effects of radiation and certain anticancer drugs.

Patients may want to think about taking part in a clinical trial.

For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.

Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.

Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.

Patients can enter clinical trials before, during, or after starting their cancer treatment.

Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.

Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's clinical trials database.

A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.

Stage I Oropharyngeal Cancer

Treatment of stage I oropharyngeal cancer may include the following:

  • Radiation therapy.
  • Surgery.
  • A clinical trial of fractionated radiation therapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage I oropharyngeal cancer.

Stage II Oropharyngeal Cancer

Treatment of stage II oropharyngeal cancer may include the following:

  • Radiation therapy (external radiation therapy and/or internal radiation therapy).
  • Surgery.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage II oropharyngeal cancer.

Stage III Oropharyngeal Cancer

Treatment of stage III oropharyngeal cancer may include the following:

  • Surgery followed by radiation therapy or by chemotherapy given at the same time as radiation therapy.
  • Radiation therapy (for patients with tongue or tonsil cancer).
  • Chemotherapy given at the same time as radiation therapy.
  • A clinical trial of chemotherapy followed by surgery or radiation therapy.
  • A clinical trial of chemotherapy given at the same time as radiation therapy.
  • A clinical trial of fractionated and/or internal radiation therapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage III oropharyngeal cancer.

Stage IV Oropharyngeal Cancer

Treatment of stage IV oropharyngeal cancer that can be treated by surgery may include the following:

  • Surgery followed by radiation therapy and chemotherapy.
  • Radiation therapy (for tonsil cancer).
  • A clinical trial of chemotherapy given at the same time as radiation therapy.
  • A clinical trial of fractionated and/or internal radiation therapy.

Treatment of stage IV oropharyngeal cancer that cannot be treated by surgery may include the following:

  • Radiation therapy with or without chemotherapy.
  • A clinical trial of chemotherapy with radiation therapy and/or radiosensitization.
  • A clinical trial of fractionated and/or internal radiation therapy.
  • A clinical trial of radiation therapy with or without chemotherapy.
  • A clinical trial of hyperthermia therapy with radiation therapy.

Following treatment, it is important to have careful head and neck examinations to look for recurrence. Check-ups will be done monthly in the first year, every 2 months in the second year, every 3 months in the third year, and every 6 months thereafter.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage IV oropharyngeal cancer.

Treatment Options for Recurrent Oropharyngeal Cancer

Treatment of recurrent oropharyngeal cancer may include the following:

  • Surgery if radiation therapy did not remove all the cancer.
  • Radiation therapy (if not previously used) or additional surgery if the first surgery did not remove all the cancer.
  • A clinical trial of chemotherapy.
  • A clinical trial of hyperthermia therapy with radiation therapy.

Following treatment, it is important to have careful head and neck examinations to look for recurrence. Check-ups will be done monthly in the first year, every 2 months in the second year, every 3 months in the third year, and every 6 months thereafter.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with recurrent oropharyngeal cancer.

Cancer information from the NCI PDQ service