Oropharyngeal Cancer: Let's learn about the symptoms, causes, and treatment in simple terms

You probably feel a little sore or scratchy in your throat sometimes, right? Usually, such things go away in two or three days. But have you ever thought that if you have a sore throat or a small lump in your neck that persists for weeks, it is not normal? At such times, we need to be a little careful. Today we are going to talk about a condition that can start with such symptoms, but we don't talk about it much, which is cancer that occurs in the middle part of the throat.

Simply put, what is Oropharyngeal Cancer?

This is a bit of a scientific name, but it's very simple to understand. Your throat, which is medically called the pharynx, is the middle part of it, which we call the oropharynx. To be precise, this area includes the back of your mouth, including your tonsils, the back of your tongue, and the soft palate. When cells in this area start to grow abnormally and out of control, it's called Oropharyngeal Cancer .

This falls into the category of head and neck cancer. Although there are treatments for this cancer, it can sometimes recur even after treatment is complete. Therefore, it is very important to be aware of this.

Be aware of these symptoms.

The symptoms of this cancer can sometimes be similar to those of a common throat infection, which is why many people ignore them at first. But if these symptoms persist, you should definitely see your doctor.

Why does this cancer develop? What are the main causes?

Several main causes of this cancer have been identified.

1. Human Papillomavirus (HPV)

The main and most common cause of Oropharyngeal Cancer today is HPV infection. Specifically, HPV type 16. When this virus enters our body, some of the proteins it produces interfere with the function of the genes that control the growth of cells in our mouth and throat. Simply put, this virus deactivates the 'brake' that controls the rate of cell division. Then the cells can divide uncontrollably and become cancerous tumors.

2. Tobacco use (Tobacco)

Smoking cigarettes, cigars, and chewing tobacco are also major causes of this cancer. The chemicals in tobacco damage the delicate cells in your throat. To repair these damaged cells, your body starts dividing cells faster than normal. When cells divide at such a fast rate, there is a greater chance of errors in the DNA copying of those cells. Those errors are what start cancer cells.

3. Alcohol

Drinking alcohol can damage the cells of the throat. In particular, alcohol weakens the ability of cells to repair their DNA when they are damaged. A person who drinks alcohol while smoking is at a very high risk of developing this cancer. Because when these two habits are combined, the damage to the cells doubles or triples.

How does the doctor diagnose this disease exactly?

When you see a doctor with the symptoms you mentioned above, he will first ask you about your symptoms, medical history, and your lifestyle (such as smoking and alcohol use).

Then, your mouth, throat, and neck will be examined carefully. Your neck will be checked for any lumps. Sometimes, a small mirror and light, or a thin, flexible tube with a camera attached (fiberoptic scope) may be inserted into your mouth to examine the inside of your throat.

What tests are performed?

If cancer is suspected after symptoms and an initial examination, your doctor will refer you for further testing.

• Endoscopic Biopsy: This is the most important test to confirm the disease. In this, a thin tube with a camera attached to it (endoscope) is passed down the throat and a very small piece of tissue is removed from the suspicious area. The tissue is then examined under a microscope in a laboratory to determine if there are cancer cells or the HPV virus.
• CT scan (Computed Tomography Scan): This scan can determine the size of the cancerous tumor and whether it has spread to surrounding tissues. Sometimes this can be done in conjunction with a PET scan.
• MRI Scan (Magnetic Resonance Imaging Scan): This can produce very clear images of the soft tissues of the body, such as the tonsils and base of the tongue. MRI is very helpful in getting an accurate understanding of the size and spread of the tumor.

What are the treatments for this?

Treatment for this cancer depends on many factors, including the stage of the cancer, the size of the tumor, the patient's HPV status, and their overall health. The main goal of treatment is to completely remove the cancer cells, with minimal damage to the ability to speak and swallow.

1. Surgery

If the cancer is small and has not spread, surgical removal of the tumor is the main treatment. Currently, a highly advanced, minimally invasive surgical technique called Transoral Robotic Surgery (TORS) is used for this.

What is Transoral Robotic Surgery (TORS)?

In this, the surgeon controls a robotic arm and goes inside the patient's mouth to remove tumors deep in the throat. This method eliminates the need to make a large incision in the neck or cut the jawbone as in the past.

2. Radiation Therapy and Chemotherapy

If the tumor is large, cannot be removed surgically, or if the cancer has spread, radiation therapy and chemotherapy are used together or separately.

• Before surgery: To make the tumor smaller and make surgery easier.
• After surgery: To destroy any remaining cancer cells.
• As the main treatment: in cases where surgery is not possible.

These treatments can also damage healthy tissues in the throat, which can lead to difficulty speaking and swallowing. You may need to seek the help of a speech therapist.

3. Targeted Therapy

This is a relatively new treatment. It involves giving drugs that target a specific protein that helps cancer cells grow, divide, and spread, and block its action. In simple terms, it's like cutting off the 'oil' that goes to the 'engine' of cancer cells.

4. Immunotherapy

This is also a very advanced treatment. What happens here is that your body's own immune system is stimulated, and through it, it is made to recognize and destroy cancer cells. Cancer cells sometimes 'hide' from our immune system. What this treatment does is remove that 'mask' and allow the immune cells to recognize the cancer.

What happens after treatment? What are the chances of recovery?

Oropharyngeal cancer is a treatable disease. However, there is a risk of recurrence after treatment. Therefore , regular follow-up visits are essential.

The prognosis depends on several factors:

• Early detection: As with any cancer, the sooner this is detected and treatment begins, the higher the chances of recovery.
• HPV status: Surprisingly, the survival rate of people who develop this cancer due to HPV infection is higher than those who develop the cancer due to factors other than HPV, such as smoking.
• Not smoking: Those who completely abstain from smoking during and after treatment have better results.

What should we do to survive this cancer?

Although this cancer cannot be prevented 100%, there are many things we can do to reduce the risk.

1. Avoid HPV infection: There is now a very effective vaccine for the HPV virus, the HPV vaccine. Talk to your doctor about getting this vaccine at a young age.

2. Quit smoking completely: If you are a smoker, try to quit today. If you need help, seek medical advice.

3. Limit your alcohol intake: If you drink alcohol, do so in moderation. Combining alcohol with smoking is very dangerous.

4. A healthy lifestyle: Eating a well-balanced diet and exercising regularly can keep your immune system strong.

5. Regular medical and dental checkups: Visit your doctor and dentist at least once a year to check your mouth and throat. This can help you detect any changes early.

When should I see the doctor? Do I need to go to ETU?

It is very important to follow your doctor's instructions and follow-up appointments carefully after treatment.

If you have undergone surgery and experience the following symptoms, go to the hospital's Emergency Department (ETU) immediately.

• Fever.
• Redness, swelling, or extreme pain at the surgical site.
• A pus-like fluid drains from the surgical wound.

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