Oropharyngeal cancer

What is oropharyngeal cancer

Oropharyngeal cancer is a type of head and neck cancer that affects the oropharynx – the middle part of the throat. This includes the back of the tongue, tonsils, soft palate, and the walls of the throat.

What causes it

Several risk factors are linked to oropharyngeal cancer:

• Human papillomavirus (HPV), particularly HPV-16.
• Smoking or chewing tobacco.
• Heavy alcohol consumption.
• A weakened immune system.
• Age (more common in people over 40).
• Being male (higher risk than females).

Symptoms

• Persistent sore throat.
• Difficulty swallowing.
• A lump in the neck.
• Pain in the ear or jaw.
• Hoarseness or voice changes.
• Unexplained weight loss.
• A sore or ulcer in the mouth or throat that doesn’t heal.

Diagnosis

If oropharyngeal cancer is suspected, your doctor may arrange:

• Examination by an ENT specialist.
• Nasendoscopy (camera through the nose to view the throat).
• Biopsy (removing tissue for analysis).
• Imaging tests such as MRI, CT, or PET scans to assess spread.

Treatment options

Treatment depends on the stage, location, and whether the cancer is HPV-positive. It may include:

• Surgery: removal of the cancer, sometimes through the mouth, with or without surgery to the neck lymph nodes. Robotic surgery is an option for selected cases.
• Radiotherapy: high-energy beams used to destroy cancer cells.
• Chemotherapy: medicines that kill cancer cells or enhance radiotherapy.
• Targeted therapy or immunotherapy: in some advanced or recurrent cases.

A multidisciplinary team will help choose the best treatment plan.

Side effects and recovery

Treatment can cause side effects such as:

• Difficulty swallowing or speaking.
• Dry mouth.
• Taste changes.
• Fatigue.
• Skin or throat soreness.

Rehabilitation support, including speech and swallowing therapy, is often needed.

Follow-up and outlook

• Regular follow-up appointments will monitor for recurrence and manage any long-term effects.
• HPV-positive cancers generally have a better prognosis than HPV-negative ones.
• Early diagnosis improves outcomes, so it’s important to seek help promptly if symptoms persist.

Symptoms that need assessment

See your GP or dentist promptly for a persistent neck lump, unexplained swallowing difficulty, or throat symptoms or an ulcer lasting more than 3 weeks. These symptoms often have other causes, but should be checked.

Seek urgent help if you cannot swallow fluids or saliva. Call 999 for severe breathing difficulty or major bleeding.

Support during treatment

Your team may include a specialist nurse, dietitian, speech and language therapist and dental team. Assessment of swallowing, nutrition and dental health helps plan treatment and recovery.

HPV is common and can remain in the body for many years. An HPV-related cancer does not show when the infection was acquired.