Oropharyngeal Cancer Health Article

Definition

Oropharyngeal cancer is an uncontrolled growth of cells that begins in the oropharynx, the area at the back of the mouth.

Description

The oropharynx is the passageway at the back of the mouth. It connects the mouth to the esophagus (tube through which food passes) and to the pharynx (the channel for the flow of air into and out of the lungs). It takes its name from the way it ties the oral cavity (hence the oro) to the rest of the pharynx, one part of which extends toward the back of the nose (nasopharynx). The base of the tongue, the soft palate (the soft roof of the mouth, above the base of the tongue) and the tonsils are part of the oropharynx.

If the oropharynx is blocked or injured in any way, the condition presents a threat to life because it interferes with both eating and breathing. Thus, an obstruction caused by oropharyngeal cancer is in itself a problem. Oropharyngeal cancer also contributes to problems with chewing and talking because of the importance of the oropharynx in these activities. If the oropharyngeal cancer spreads to the bone, muscle, and soft tissue in the neck, there is a severe effect on the ability of the neck to support the head. In individuals with oropharyngeal cancer that has spread, surgical options might be limited.

Oropharyngeal cancer usually begins in the squamous cells of the epithelial tissue. The squamous cells are flat, and often layered. The epithelial tissue forms coverings for the surfaces of the body. Skin, for example, has an outer layer of epithelial tissue. Throughout the oropharynx there are some very small salivary glands and one of more of them sometimes becomes the site of tumor growth.

Many times cancer that begins in the oropharynx spreads to the base of the tongue. Oropharyngeal cancer can spread to the muscle and bone in the neck, and also to the soft tissue that fills the space around the muscle and bone.

Demographics

In the United States, about 4, 000 cases of oropharyngeal cancer are diagnosed each year. Most of the cancer is found in people who are more than 50 years old. A history of tobacco or alcohol use, especially heavy use, is typically linked to the diagnosis. Men are three to five times more likely to be diagnosed than women.

Some benign tumors arise in the oropharynx. Although they are benign, many studies suggest the growths indicate the person is at greater risk for a malignant tumor growth in the future.

Causes and symptoms

The cause of oropharyngeal cancer is not known; but the risk factors for oropharyngeal cancer are understood. Two important lifestyle choices increase the chance a person will be diagnosed with cancer of the oropharynx. They are tobacco/ cigarettes and alcohol consumption.

Anything that passes into the lungs or stomach through the nose and mouth, must move through the oropharynx. (Air moves through the nasopharynx to reach the oropharynx.) Long periods of exposure to substances such as tobacco byproducts and alcohol somehow trigger cells to begin uncontrolled growth, cancer. About 90 percent of all cancer of the oropharynx starts in a squamous cell.

Since tobacco and alcohol come into direct contact with the squamous cells of the oropharynx as they move through the cavity, they might change the genetic material (DNA) of cells. If a cell cannot repair damage to DNA, a cancerous growth can begin.

A serious interaction occurs between tobacco and alcohol. Individuals who smoke and drink alcoholic beverages are at much greater risk for oropharyngeal cancer. They have as much as 30 times or 40 times the normal risk. The estimate is difficult to make because not all individuals diagnosed are accurate in the statements they make to physicians about their use of these substances. Patients often say they used less tobacco or less alcohol than they actually did.

Viral infection increases the risk of oropharyngeal cancer. So does reduced immunity, which is a condition that may be caused by viral infection. Individuals with papilloma viruses, which are sexually transmitted, may also be at greater risk. Marijuana seems to be linked with oropharyngeal cancer too. Vitamin A deficiency, or specifically, the absence of the carotene (from fruits and vegetables) that the body uses to make vitamin A, might also be a contributing factor.

Symptoms of oropharyngeal cancer include:

• difficulty swallowing
• difficulty chewing
• change in voice
• loss of weight
• lump in the throat
• lump in the neck