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UT Southwestern Medical Center’s cancer experts offer exceptional care for people with oropharyngeal cancer and other complex head and neck cancers. We provide advanced services to diagnose and treat the disease, with supportive services to guide patients and their families through the treatment journey.

As the only National Cancer Institute (NCI)-designated comprehensive cancer center in North Texas, we deliver the best cancer care available today and push to discover new treatments. NCI designation means we offer patients the ability to participate in the broadest possible range of clinical trials, with access to potential therapies not available at other facilities.

Exceptional Care for Oropharyngeal Cancer

Cancer that develops in the upper throat (the oropharynx) is called oropharyngeal cancer, a type of head and neck cancer. The oropharynx is located just behind the mouth and includes the base of the tongue, the soft palate (the soft, back part of the roof of the mouth), and the tonsils. 

Most oropharyngeal cancers are squamous cell carcinomas, which form in the thin, flat cells that line the mouth and throat. These cells also form the top layer of skin and make up other parts of the body such as the esophagus and lungs.

At the Harold C. Simmons Comprehensive Cancer Center, we have teams of surgeons, doctors, nurses, and other providers who specialize in treating head and neck cancers. Our team for oropharyngeal cancer care includes otolaryngologists (ear, nose, and throat specialists), radiation and medical oncologists, oral and dental oncologists, physical and occupational therapists, and speech pathologists.

Causes and Risk Factors of Oropharyngeal Cancer

Although the specific causes of oropharyngeal cancer are not fully known, certain factors can increase the chance of developing it. Not everyone with risk factors will develop oropharyngeal cancer. Also, people without known risk factors can develop the disease. Risk factors include:

  • Tobacco use
  • Infection with human papillomavirus, a sexually transmitted virus
  • Heavy alcohol use
  • Betel nuts, a stimulant commonly used by people in Asia 

Patients can help prevent oropharyngeal cancer by avoiding these risk factors. Learn more about head and neck cancer awareness and prevention.

Symptoms of Oropharyngeal Cancer

Some people do not experience any symptoms, and some symptoms can occur with other conditions. Patients should see their doctors if they experience any of these symptoms and they don’t go away:

  • Pain or sores in the mouth that don’t go away
  • Lump or thickening in the cheek or neck
  • Changes in the voice, such as hoarseness
  • White or red patches on the gums, tongue, tonsils, or lining of the mouth
  • Difficulty moving the jaw or tongue, chewing, or swallowing
  • Teeth that are loose or painful
  • Jaw pain or swelling
  • Numbness in the mouth, such as the tongue
  • Sore throat or feeling of something being stuck in the throat
  • Unexplained weight loss

Stages of Oropharyngeal Cancer

Cancer staging is the process doctors use to determine how large a tumor is, whether cancer has spread, and, if so, how far. The stages of oropharyngeal cancer include:

Stage 0 (Carcinoma in Situ)

The lining of the oropharynx contains abnormal cells, which might become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ. 

Stage I: Cancer has formed

The cancer is 2 centimeters or smaller, and is found only in the oropharynx. 

Stage II

The cancer is larger than 2 centimeters but not larger than 4 centimeters and is found only in the oropharynx. 

Stage III

The cancer is either: 

  • 4 centimeters or smaller and has spread to one lymph node on the same side of the neck as the tumor, and the lymph node is 3 centimeters or smaller; or 
  • Larger than 4 centimeters or has spread to the epiglottis (the flap that covers the trachea during swallowing). Cancer might have spread to one lymph node on the same side of the neck as the tumor, and the lymph node is 3 centimeters or smaller. 
Stage IV: Divided into substages IVA, IVB, and IVC

In stage IVA, cancer: 

  • Has spread to the larynx, front part of the roof of the mouth, lower jaw, or muscles that move the tongue or are used for chewing. Cancer might have spread to one lymph node on the same side of the neck as the tumor, and the lymph node is 3 centimeters or smaller; or 
  • Has spread to one lymph node that measures between 3 and 6 centimeters on the same side of the neck as the tumor or to multiple lymph nodes that are 6 centimeters or smaller anywhere in the neck, and one of the following is true:
    - The tumor in the oropharynx is any size and might have spread to the epiglottis; or
    - The tumor has spread to the larynx, front part of the roof of the mouth, lower jaw, or muscles that move the tongue or are used for chewing. 

In stage IVB, the tumor: 

  • Surrounds the carotid artery or has spread to the muscle that opens the jaw, the bone attached to the muscles that move the jaw, the nasopharynx, or the base of the skull. Cancer might have spread to one or more lymph nodes that can be any size; or 
  • Can be any size and has spread to one or more lymph nodes that are larger than 6 centimeters. 

In stage IVC, the tumor can be any size and has spread beyond the oropharynx to other parts of the body, such as the lungs, bones, or liver. 

Diagnosis of Oropharyngeal Cancer

At UT Southwestern, our cancer experts conduct a thorough evaluation, which includes a:

  • Physical exam
  • Discussion of personal and family medical history
  • Discussion of symptoms and risk factors

To confirm a diagnosis, our doctors might recommend one or more tests, such as:

  • Laryngoscopy: We sometimes use a laryngoscope (a thin, flexible tube with a lighted camera), which is inserted through the nose or mouth, for a closer look into the throat. During the same procedure, we can use the scope to take tissue samples from any suspicious areas, if needed.
  • Barium swallow: The patient swallows liquid barium, a substance that shows up on X-rays, and then X-rays are taken. Barium swallows can show abnormalities in the mouth and throat and help determine the cause of painful swallowing.
  • Computed tomography (CT) scan: CT uses specialized X-rays with or without a contrast agent to produce cross-sectional, 3D images of the mouth and throat.
  • Magnetic resonance imaging (MRI) scan: MRI uses radio waves and a strong magnet, with or without a contrast agent, to produce detailed images of the mouth and throat. MRI can also show whether cancer has spread to lymph nodes in the neck.
  • Positron emission tomography (PET) scan: Using small amounts of radioactive materials and a special camera, PET scans produce highly detailed images that can detect cancerous cells.
  • Biopsy: Our doctors take a small tissue sample using a needle or a small brush to collect cells from a suspicious area. A pathologist analyzes the cells under a microscope for the presence of cancer and HPV infection.

Treatment for Oropharyngeal Cancer

Treatment options vary based on the stage of cancer, which includes its size, location, and whether it has spread. Surgery is often the first treatment we use for oropharyngeal cancer, especially for early-stage cancers, which are small and have not spread.

Our treatment options for oropharyngeal cancer include the following, sometimes in combination:

  • Surgery: Depending on the extent of the cancer, we can often remove tumors through the mouth (transoral), while other tumors require open surgery (using an incision).
  • Radiation therapyOur doctors often use radiation, treatment with high-energy waves such as X-rays, as the main treatment for small oropharyngeal cancers. Radiation therapy can destroy cancer cells left after surgery, and it can also treat inoperable tumors.
  • Chemotherapy: Anticancer medications work to destroy cancer cells and prevent them from spreading. We sometimes use chemotherapy before or during radiation therapy and/or surgery to destroy as many cancer cells as possible.
  • Chemoradiation: Chemotherapy given at the same time as radiation therapy is known as chemoradiation. For some oropharyngeal cancers, chemoradiation can be the main treatment.
  • Targeted therapy: Certain anticancer medications target a specific characteristic of a cancer cell, which can be detected through specialized testing. People whose cancers have these characteristics can be treated with targeted therapy, often in combination with radiation or chemotherapy.

For patients who are having radiation therapy for oropharyngeal cancer, we recommend having any necessary dental work done before treatment. Radiation treatment slows healing and can cause other side effects. Learn more about cancer and transplant dental care

At UT Southwestern’s Harold C. Simmons Comprehensive Cancer Center, patients have access to every available treatment option, delivered by the most experienced head and neck cancer specialists in Dallas. Find out more about all the options we offer for head and neck cancer treatment.

Support Services

We offer a variety of head and neck cancer support services for patients and their families, such as:

Clinical Trials

As a medical research institution, UT Southwestern frequently conducts head and neck cancer clinical trials, giving our patients access to the newest treatments. Patients should speak with their doctors about the availability of clinical trials.