Oropharyngeal Cancer Health Article

Diagnosis

Cells grow old and flake off regularly from epithelial tissues. The first step in diagnosing oropharyngeal cancer often makes use of the natural process. It is given the name exfoliative cytology. A physician scrapes cells from the part of the oropharynx where a cancer is suspected and smears them on a slide. The cells are then treated with chemicals so they can be studied with a microscope. If they do not appear normal, a biopsy, or a tissue sample from a deeper layer of cells, is taken for examination.

Different sorts of biopsies are used. An incision, or cut, is be made to obtain tissue. Or, a needle with a small diameter is inserted into the neck to obtain cells, especially if there is a lump in the neck.

Computed tomography (CT) and magnetic resonance imaging (MRI) scans are also used. They help determine whether the cancer has spread from the walls of the oropharynx. MRI offers a good way to examine the tonsils and the back of the tongue, which are soft tissues. CT is used as a way of studying the jaw, which is bone.

Many extremely specialized means of determining the condition of the oropharynx have been developed. One of them relies on the same sort of light wave technology that now powers much of the communications world, fiberoptics. A fiber (a bundle of glass fibers, actually) with a very small diameter is inserted in the oropharynx and the area is probed with light that is reflected on mirrors for interpretation. Lighting up the oropharynx with the high intensity, very low heat illumination of fiberoptics, a physician can get a good look at the cavity.

Another special way of getting a good look at the oropharynx involves studying it from within by inserting an endoscope into the oropharynx and then, weaving it through adjacent connecting structures. The structures include the trachea, the bronchi, the larynx and the esophagus. The patient is given an anesthetic, local or general, for this procedure. When several organs are examined at the same time, the procedure is called a panendoscopy. The tool used is generally named for the organ for which it is most closely designed. For example, there is a laryngoscope.

Because oropharyngeal cancer often spreads, bones near the oropharynx must be examined carefully. Some special types of equipment are used. A rotating x ray called panorex provides for close inspection of the jaw.

Oropharyngeal cancer also spreads to the esophagus, so physicians usually examine the esophagus when they diagnose oropharyngeal cancer. To do so, they ask the patient to drink a liquid containing barium, a chemical that can be seen on x rays. Then, they can x ray the esophagus and look for bulges or lumps that indicate cancer there.

Treatment team

Generally, physicians with special training in the organs of the throat take responsibility for the care of a patient with oropharyngeal cancer. They are called otolaryngologists or occasionally by a longer name, otorhinolaryngologists.

In abbreviation, otolaryngologists are usually labeled ENT (for Ear, Nose and Throat) specialists. An ENT specializing in cancer will probably lead the team. Some ENTs have a specialty in surgery. Some have a specialty in oncology. Some have a specialty in both.

Nurses, as well as a nutritionist, speech therapist and social worker will also be part of the team. Depending on the extent of the cancer when diagnosed, some surgery and treatments result in extensive changes in the throat, neck and jaw. The social worker, speech therapist and nutritionist are important in helping the patient cope with the changes caused by surgery and radiation treatment. If there is great alteration to the neck because of surgery, rehabilitation will also be part of the recovery process and a rehabilitation therapist a member of the team.