Oropharyngeal Cancer : Treatment

by National Cancer Institute

(Page 2 of 2)

Radiation therapy uses high-energy x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external radiation therapy) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes in the area where the cancer cells are found (internal radiation therapy). Fractionated radiation therapy is given in several smaller, equal doses over a period of several days. External radiation to the thyroid or the pituitary gland may change the way the thyroid gland works. The doctor may test the thyroid gland before and after therapy to make sure it is working properly. Giving drugs with the radiation therapy to make the cancer cells more sensitive to radiation (radiosensitization) is being tested in clinical trials. If smoking is stopped before radiation therapy is started, there is a better chance of surviving longer.

Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by a needle in the vein or muscle. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and can kill cancer cells throughout the body.

People with oropharyngeal cancer have a higher risk of getting other cancers in the head and neck area. Clinical trials of chemoprevention therapy are testing whether certain drugs can prevent second cancers from developing in the mouth, throat, windpipe, nose, or esophagus (the tube that connects the throat to the stomach).

Hyperthermia therapy (warming the body to kill cancer cells) is being tested in clinical trials. Hyperthermia therapy uses a special machine to heat the body for a certain period of time to kill cancer cells. Because cancer cells are often more sensitive to heat than normal cells, the cancer cells die and the cancer shrinks.

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. A doctor will consult with several kinds of doctors who can help determine the best treatment. Trained medical staff can also help patients recover from treatment and adjust to new ways of eating and talking. Plastic surgery, or help learning to eat and speak, may be needed if a large part of the oropharynx is taken out.

Treatment by stage

Treatment of cancer of the oropharynx depends on where the cancer is in the oropharynx; the stage of the disease; the effect of treatment on the patient's ability to talk, eat, and breathe normally; and the patient's age and overall health.

Standard treatment may be considered because of its effectiveness in patients in past studies, or participation in a clinical trial may be considered. Not all patients are cured with standard therapy and some standard treatments may have more side effects than are desired. For these reasons, clinical trials are designed to find better ways to treat cancer patients and are based on the most up-to-date information. Clinical trials are ongoing in many parts of the country for patients with cancer of the oropharynx. To learn more about clinical trials, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.

Stage I Oropharyngeal Cancer

Treatment may be one of the following

1. Radiation therapy or surgery.
2. A clinical trial of fractionated radiation therapy.

Stage II Oropharyngeal Cancer

Treatment will be surgery to remove the cancer or radiation therapy.

Stage III Oropharyngeal Cancer

Treatment may be one of the following:

1. Surgery to remove the cancer followed by radiation therapy with or without chemotherapy.
2. Radiation therapy alone (which may be fractionated radiation therapy), for cancer in the tonsils or base of the tongue.
3. Radiation therapy combined with chemotherapy.
4. A clinical trial of chemotherapy followed by surgery or radiation therapy.
5. A clinical trial of chemotherapy combined with radiation therapy for cancer that cannot be removed by surgery.
6. A clinical trial of new ways of giving radiation therapy.

Stage IV Oropharyngeal Cancer

If the cancer can be removed by surgery, treatment may be one of the following:

1. Surgery to remove the cancer followed by radiation therapy with or without chemotherapy.
2. Radiation therapy.
3. A clinical trial of chemotherapy combined with radiation therapy.
4. A clinical trial of new ways of giving radiation therapy.

If the cancer cannot be removed by surgery, treatment may be one of the following:

1. Radiation therapy with or without chemotherapy.
2. A clinical trial of chemotherapy followed by surgery or radiation therapy.
3. A clinical trial of chemotherapy with radiation therapy and drugs to make the cancer cells more sensitive to radiation therapy (radiosensitizers).
4. A clinical trial of chemotherapy and fractionated radiation therapy given at the same time.
5. A clinical trial of new ways of giving radiation therapy.
6. A clinical trial of hyperthermia therapy combined 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.

Recurrent Oropharyngeal Cancer

Treatment may be one of the following:

1. Surgery to remove the cancer.
2. Radiation therapy.
3. A clinical trial of chemotherapy.
4. A clinical trial of hyperthermia therapy plus 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.

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