Oropharyngeal Cancer

Oropharyngeal cancer targets the oropharynx—soft palate, tonsils, base of tongue, and pharyngeal walls—with squamous cell carcinoma predominant. HPV-related cases surge in younger nonsmokers, while traditional risks dominate elsewhere; it often spreads to neck nodes early. Five-year survival reaches 70-80% for HPV-positive early stages.?

Causes and Risk Factors

HPV-16 infection drives 70% of U.S. cases via oral transmission; tobacco (smoking/chewing) and alcohol synergize for non-HPV types. Betel quid, poor immunity, and chronic irritation elevate risk; genetic factors like p16 expression improve HPV prognosis.?

Symptoms

Persistent sore throat, odynophagia, dysphagia, otalgia, hoarseness, and neck lumps are hallmarks. Other signs include weight loss, trismus, foul breath, voice changes, and blood-tinged saliva.?

Diagnosis and Staging

Exam reveals asymmetric tonsils or masses; biopsy confirms HPV status via p16/HPV testing. CT/MRI/PET scans stage via TNM: Stage I (T1N0), up to IV (metastatic).?

Treatment Options

Early: transoral robotic surgery or radiation; advanced: chemoradiation (cisplatin), de-escalation for HPV+. Immunotherapy (pembrolizumab) for recurrent; speech/swallow rehab essential post-therapy.