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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. </p></div><div class="iconblock clearfix whole_rhythm no_top_margin bk_noprnt"><a class="img_link icnblk_img" title="Table of Contents Page" href="/books/n/pdqcis/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-pdqcis-lrg.png" alt="Cover of PDQ Cancer Information Summaries" height="100px" width="80px" /></a><div class="icnblk_cntnt eight_col"><h2>PDQ Cancer Information Summaries [Internet].</h2><a data-jig="ncbitoggler" href="#__NBK65871_dtls__">Show details</a><div style="display:none" class="ui-widget" id="__NBK65871_dtls__"><div>Bethesda (MD): <a href="http://www.cancer.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Cancer Institute (US)</a>; 2002-.</div></div><div class="half_rhythm"></div><div class="bk_noprnt"><form method="get" action="/books/n/pdqcis/" id="bk_srch"><div class="bk_search"><label for="bk_term" class="offscreen_noflow">Search term</label><input type="text" title="Search this book" id="bk_term" name="term" value="" data-jig="ncbiclearbutton" /> <input type="submit" class="jig-ncbibutton" value="Search this book" submit="false" style="padding: 0.1em 0.4em;" /></div></form></div></div></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK65871_"><span class="title" itemprop="name">Oropharyngeal Cancer Treatment (Adult) (PDQ®)</span></h1><div class="subtitle whole_rhythm">Patient Version</div><p class="contrib-group"><span itemprop="author">PDQ Adult Treatment Editorial Board</span>.</p><p class="small">Published online: July 16, 2019.</p></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><div id="_abs_rndgid_" itemprop="description"><p id="CDR0000258025__205">This PDQ cancer information summary has current information about the treatment of adult oropharyngeal cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p><p id="CDR0000258025__206">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change. The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Adult Treatment Editorial Board.</p></div><div id="CDR0000258025__1"><h2 id="_CDR0000258025__1_">General Information About Oropharyngeal Cancer</h2><div id="CDR0000258025__1.kp" class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000258025__2">Oropharyngeal cancer is a disease in which malignant (cancer)
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cells form in the tissues of the oropharynx.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258025__6">Smoking or being infected with human papillomavirus can increase the risk
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of oropharyngeal cancer. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000258025__10">Signs and symptoms of oropharyngeal cancer include a lump in the neck and a sore throat. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000258025__14">Tests that examine the mouth and throat are used to help detect
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(find), diagnose, and stage oropharyngeal cancer.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258025__18">Certain factors affect prognosis (chance
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of recovery) and treatment options.</a></div></li></ul></div><div id="CDR0000258025__2"><h3>Oropharyngeal cancer is a disease in which malignant (cancer)
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cells form in the tissues of the oropharynx.</h3><p id="CDR0000258025__203">The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046024/" class="def">oropharynx</a> is the middle part of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046061/" class="def">pharynx</a> (throat), behind the mouth. The pharynx is a hollow tube about 5 inches long that starts
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behind the nose and ends where the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046623/" class="def">trachea</a> (windpipe) and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046408/" class="def">esophagus</a> (tube from the throat to
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the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046604/" class="def">stomach</a>) begin. Air and food pass
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through the pharynx on the way to the trachea or the esophagus. </p><div id="CDR0000258025__217" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Anatomy%20of%20the%20pharynx%20(throat)&p=BOOKS&id=544180_CDR0000713970.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65871.14/bin/CDR0000713970.jpg" alt="Anatomy of the pharynx; drawing shows the nasopharynx, oropharynx, and hypopharynx. Also shown are the nasal cavity, oral cavity, hyoid bone, larynx, esophagus, and trachea." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Anatomy of the pharynx (throat). The pharynx is a hollow tube that starts behind the nose, goes down the neck, and ends at the top of the trachea and esophagus. The three parts of the pharynx are the nasopharynx, oropharynx, and hypopharynx.</p></div></div><p id="CDR0000258025__214">The oropharynx includes the following:</p><ul id="CDR0000258025__204"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000389466/" class="def">Soft palate</a>.</div></li><li class="half_rhythm"><div>Side and back walls of the throat.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046618/" class="def">Tonsils</a>.</div></li><li class="half_rhythm"><div>Back one-third of the tongue.</div></li></ul><div id="CDR0000258025__213" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Parts%20of%20the%20oropharynx&p=BOOKS&id=544180_CDR0000779437.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65871.14/bin/CDR0000779437.jpg" alt="Parts of the oropharynx; drawing shows the soft palate, side and back wall of the throat, tonsil, and the back third of the tongue." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Parts of the oropharynx. The oropharynx includes the soft palate, side and back wall of the throat, tonsils, and the back third of the tongue.</p></div></div><p id="CDR0000258025__187"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000446523/" class="def">Oropharyngeal cancer</a> is a type of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257519/" class="def">head and neck cancer</a>. Sometimes more than one <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> can occur in the oropharynx and in other parts of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000389464/" class="def">oral cavity</a>, nose, pharynx, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046026/" class="def">larynx</a> (voice box), trachea, or esophagus at the same time.</p><p id="CDR0000258025__5">Most oropharyngeal cancers
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are <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046595/" class="def">squamous cell carcinomas</a>. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046056/" class="def">Squamous cells</a> are the thin, flat
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> lining the inside of the oropharynx.</p><p id="CDR0000258025__215">See the following <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044271/" class="def">PDQ</a> summaries for more information about other types of head and neck cancers:</p><ul id="CDR0000258025__216"><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000258014/">Hypopharyngeal Cancer Treatment (Adult)</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000258017/">Lip and Oral Cavity Cancer Treatment (Adult)</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000593570/">Oral Cavity, Pharyngeal, and Laryngeal Cancer Prevention</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000593427/">Oral Cavity, Pharyngeal, and Laryngeal Cancer Screening</a></div></li></ul></div><div id="CDR0000258025__6"><h3>Smoking or being infected with human papillomavirus can increase the risk
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of oropharyngeal cancer. </h3><p id="CDR0000258025__8">Anything that increases your risk of getting a disease is called a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045873/" class="def">risk factor</a>. Having a risk factor does not mean that you will
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get cancer; not having risk factors doesn't mean that you will
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not get cancer. Talk with your doctor if you think you may be at risk.</p><p id="CDR0000258025__188">The most common risk factors for oropharyngeal cancer include the following:</p><ul id="CDR0000258025__9"><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000642021/" class="def">history</a> of smoking <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000748148/" class="def">cigarettes</a> for more than 10 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000306510/" class="def">pack years</a> and other <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000439432/" class="def">tobacco</a> use.</div></li><li class="half_rhythm"><div>Personal history of head and neck cancer.</div></li><li class="half_rhythm"><div>Heavy <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463134/" class="def">alcohol</a> use.</div></li><li class="half_rhythm"><div>Being <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045364/" class="def">infected</a> with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045714/" class="def">human papillomavirus</a> (HPV), especially HPV type 16. The number of cases of oropharyngeal cancers linked to HPV infection is increasing.</div></li><li class="half_rhythm"><div>Chewing <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000748134/" class="def">betel quid</a>, a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000450121/" class="def">stimulant</a> commonly used in parts of Asia.</div></li></ul></div><div id="CDR0000258025__10"><h3>Signs and symptoms of oropharyngeal cancer include a lump in the neck and a sore throat. </h3><p id="CDR0000258025__12">These and other <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750109/" class="def">signs</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> may be caused by oropharyngeal cancer or by other <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">conditions</a>. Check with your doctor if you have any of the following:</p><ul id="CDR0000258025__13"><li class="half_rhythm"><div>A sore throat that does not go away.</div></li><li class="half_rhythm"><div>Trouble swallowing.</div></li><li class="half_rhythm"><div>Trouble opening the mouth fully.</div></li><li class="half_rhythm"><div>Trouble moving the tongue.</div></li><li class="half_rhythm"><div>Weight loss for no known reason.</div></li><li class="half_rhythm"><div>Ear pain.</div></li><li class="half_rhythm"><div>A lump in the back of the mouth, throat, or neck.</div></li><li class="half_rhythm"><div>A white patch on the tongue or lining of the mouth that does not go away.</div></li><li class="half_rhythm"><div>Coughing up <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a>.</div></li></ul><p id="CDR0000258025__189">Sometimes oropharyngeal cancer does not cause early signs or symptoms.</p></div><div id="CDR0000258025__14"><h3>Tests that examine the mouth and throat are used to help detect
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(find), diagnose, and stage oropharyngeal cancer.</h3><p id="CDR0000258025__16">The following tests and procedures may be used:</p><ul id="CDR0000258025__17"><li class="half_rhythm"><div class="half_rhythm">
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<b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270871/" class="def">Physical exam</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000689078/" class="def">history</a></b>: An exam of the body to check general signs of health, including checking for signs of disease, such as swollen <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph
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nodes</a> in the neck or anything else that seems unusual. The medical doctor or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000389460/" class="def">dentist</a> does a complete exam of the mouth and neck and looks under the tongue and down the throat with a small,
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long-handled mirror to check for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044636/" class="def">abnormal</a> areas. An exam of the eyes may be done to check for vision problems that are caused by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000373935/" class="def">nerves</a> in the head and neck. A history of the patient’s health habits and past illnesses and treatments will also be taken.</div></li><li class="half_rhythm"><div class="half_rhythm"><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000742485/" class="def">PET-CT scan</a></b>: A procedure that combines the pictures from a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046218/" class="def">positron emission tomography</a> (PET) scan and a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045560/" class="def">computed tomography</a> (CT) scan. The PET and CT scans are done at the same time with the same machine. The combined scans give more detailed pictures of areas inside the body than either scan gives by itself. A PET-CT scan may be used to help <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnose</a> disease, such as cancer, plan treatment, or find out how well treatment is working.<dl id="CDR0000258025__199" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin"><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046033/" class="def">CT scan</a> (CAT scan)</b>: A procedure that makes a series of detailed pictures of areas inside the body, such as the head and neck, taken from different angles. The pictures are made by a computer linked to an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045944/" class="def">x-ray</a> machine. A dye is <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">vein</a> or swallowed to help the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organs</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissues</a> show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. </p></dd><dt>-</dt><dd><p class="no_top_margin"><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046140/" class="def">PET scan</a> (positron emission tomography scan)</b>: A procedure to find <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045772/" class="def">malignant</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> cells in the body. A small amount of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046550/" class="def">radioactive</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044033/" class="def">glucose</a> (sugar) is injected into a vein. The PET <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386220/" class="def">scanner</a> rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.</p></dd></dl></div></li><li class="half_rhythm"><div class="half_rhythm"><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045788/" class="def">MRI</a> (magnetic resonance imaging)</b>: A procedure that uses a magnet, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651209/" class="def">radio waves</a>, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).</div></li><li class="half_rhythm"><div class="half_rhythm"><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045164/" class="def">Biopsy</a></b>: The removal of cells or tissues so they can be viewed under a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638184/" class="def">microscope</a> by a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046244/" class="def">pathologist</a> to check for signs of cancer. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045691/" class="def">fine-needle biopsy</a> is usually done to remove a sample of tissue using a thin needle.</div><div class="half_rhythm">The following procedures may be used to remove samples of cells or tissue:<ul id="CDR0000258025__167"><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045678/" class="def">Endoscopy</a></b>: A procedure to look at organs and tissues inside the body to check for abnormal areas. An <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046428/" class="def">endoscope</a> is inserted through an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046353/" class="def">incision</a> (cut) in the skin or opening in the body, such as the mouth or nose. An endoscope is a thin, tube-like instrument with a light and a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000572035/" class="def">lens</a> for viewing. It may also have a tool to remove abnormal tissue or lymph node samples, which are checked under a microscope for signs of disease. The nose, throat, back of the tongue, esophagus, stomach, larynx, windpipe, and large airways will be checked. The type of endoscopy is named for the part of the body that is being examined. For example, pharyngoscopy is an exam to check the pharynx. </div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046321/" class="def">Laryngoscopy</a></b>: A procedure in which the doctor checks the larynx (voice box) with a mirror or a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046320/" class="def">laryngoscope</a> to check for abnormal areas.
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A laryngoscope is a thin, tube-like instrument with a light and a lens for viewing the inside of the throat and voice box. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer.</div></li></ul></div><div class="half_rhythm">If cancer is found, the following test may be done to study the cancer cells:<ul id="CDR0000258025__192"><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000752848/" class="def">HPV test</a> (human papillomavirus test)</b>: A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046590/" class="def">laboratory test</a> used to check the sample of tissue for certain types of HPV infection. This test is done because oropharyngeal cancer can be caused by HPV. </div></li></ul></div></li></ul></div><div id="CDR0000258025__18"><h3>Certain factors affect prognosis (chance
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of recovery) and treatment options.</h3><p id="CDR0000258025__20">The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045849/" class="def">prognosis</a> (chance of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454708/" class="def">recovery</a>) depends on
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the following: </p><ul id="CDR0000258025__118"><li class="half_rhythm"><div> Whether the patient has HPV infection of the oropharynx.</div></li><li class="half_rhythm"><div>Whether the patient has a history of smoking cigarettes for ten or more pack years. </div></li><li class="half_rhythm"><div> The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the cancer.</div></li><li class="half_rhythm"><div> The number and size of lymph nodes with cancer.</div></li></ul><p id="CDR0000258025__168">Oropharyngeal tumors related to HPV infection have a better prognosis and are less likely to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recur</a> than tumors not linked to HPV infection.</p><p id="CDR0000258025__119">Treatment options depend on the following:</p><ul id="CDR0000258025__120"><li class="half_rhythm"><div>The stage of the cancer.</div></li><li class="half_rhythm"><div>Keeping the patient's ability to speak and swallow as normal as possible.</div></li><li class="half_rhythm"><div>The patient's general health.</div></li></ul><p id="CDR0000258025__173">Patients with oropharyngeal cancer have an increased risk of another cancer in the head or neck. This risk is increased in patients who continue to smoke or drink alcohol after treatment.</p><p id="CDR0000258025__200">See the PDQ summary <a href="/books/n/pdqcis/CDR0000062889/">Cigarette Smoking: Health Risks and How to Quit</a> for more information.</p></div></div><div id="CDR0000258025__22"><h2 id="_CDR0000258025__22_">Stages of Oropharyngeal Cancer</h2><div id="CDR0000258025__22.kp" class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000258025__23">After oropharyngeal cancer has been diagnosed, tests
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are done to find out if cancer cells have spread within the oropharynx or to
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other parts of the body. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000258025__135">There are three ways that cancer spreads in the body.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258025__163">Cancer may spread from where it began to other parts of the body.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258025__27">The following stages are used for oropharyngeal
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cancer:</a></div><ul><li class="half_rhythm"><div><a href="#CDR0000258025__29">Stage 0 (Carcinoma in Situ)</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258025__32">Stage I</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258025__35">Stage II</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258025__38">Stage III</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258025__148">Stage IV</a></div></li></ul></li></ul></div><div id="CDR0000258025__23"><h3>After oropharyngeal cancer has been diagnosed, tests
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are done to find out if cancer cells have spread within the oropharynx or to
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other parts of the body. </h3><p id="CDR0000258025__25">The process used to find out if <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> has spread within the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046024/" class="def">oropharynx</a> or
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to other parts of the body is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046597/" class="def">staging</a>. The information gathered from the staging
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process determines the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the
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disease. It is important to know the stage in order to plan treatment. The results of some of the <a href="#CDR0000258025__14">tests</a> used to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnose</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000446523/" class="def">oropharyngeal cancer</a> are often used to stage the disease.</p></div><div id="CDR0000258025__135"><h3>There are three ways that cancer spreads in the body.</h3><p id="CDR0000258025__135_69">Cancer can spread through <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a>, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045764/" class="def">lymph system</a>, and the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a>:</p><ul id="CDR0000258025__135_70"><li class="half_rhythm"><div>Tissue. The cancer spreads from where it began by growing into nearby areas.
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</div></li><li class="half_rhythm"><div>Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000269462/" class="def">lymph vessels</a> to other parts of the body.
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</div></li><li class="half_rhythm"><div>Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045020/" class="def">blood vessels</a> to other parts of the body.
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</div></li></ul></div><div id="CDR0000258025__163"><h3>Cancer may spread from where it began to other parts of the body.</h3><p id="CDR0000258025__163_66">When cancer spreads to another part of the body, it is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046710/" class="def">metastasis</a>. Cancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> break away from where they began (the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045847/" class="def">primary tumor</a>) and travel through the lymph system or blood.</p><ul id="CDR0000258025__163_67"><li class="half_rhythm"><div>Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044058/" class="def">metastatic</a> tumor) in another part of the body.</div></li><li class="half_rhythm"><div>Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.</div></li></ul><p id="CDR0000258025__165">The metastatic tumor is the same type of cancer as the primary tumor. For example, if oropharyngeal cancer spreads to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lung</a>, the cancer cells in the lung are actually oropharyngeal cancer cells. The disease is metastatic oropharyngeal cancer, not lung cancer.</p><div id="CDR0000258025__218" class="box"><h3><span class="title">metastasis: how cancer spreads</span></h3><div class="caption"><p>Many cancer deaths are caused when cancer moves from the original tumor and spreads to other tissues and organs. This is called metastatic cancer. This animation shows how cancer cells travel from the place in the body where they first formed to other parts of the body.</p></div><p><a href="https://www.youtube.com/watch?v=fQwar_-QdiQ" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">YouTube</a></p></div></div><div id="CDR0000258025__27"><h3>The following stages are used for oropharyngeal
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cancer:</h3><div id="CDR0000258025__29"><h4>Stage 0 (Carcinoma in Situ)</h4><p id="CDR0000258025__31">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000535775/" class="def">stage 0</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044636/" class="def">abnormal</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> are found in the lining of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046024/" class="def">oropharynx</a>.
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These abnormal cells may become <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> and spread into nearby normal <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a>. Stage 0 is also called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046488/" class="def">carcinoma in
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situ</a>.</p><div id="CDR0000258025__127" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Tumor%20sizes%20are%20often%20measured%20in%20centimeters%20(cm)%20or%20inches&p=BOOKS&id=544180_CDR0000415526.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65871.14/bin/CDR0000415526.jpg" alt="Drawing shows different sizes of a tumor in centimeters (cm) compared to the size of a pea (1 cm), a peanut (2 cm), a grape (3 cm), a walnut (4 cm), a lime (5 cm), an egg (6 cm), a peach (7 cm), and a grapefruit (10 cm). Also shown is a 10-cm ruler and a 4-inch ruler." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Tumor sizes are often measured in centimeters (cm) or inches. Common food items that can be used to show tumor size in cm include: a pea (1 cm), a peanut (2 cm), a grape (3 cm), a walnut (4 cm), a lime (5 cm or 2 inches), an egg (6 cm), a peach (7 cm), and a grapefruit (10 cm or 4 inches).</p></div></div></div><div id="CDR0000258025__32"><h4>Stage I</h4><p id="CDR0000258025__34">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046097/" class="def">stage I</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> has formed and is
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2 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000354457/" class="def">centimeters</a> or smaller and is found in the
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046024/" class="def">oropharynx</a> only.</p></div><div id="CDR0000258025__35"><h4>Stage II</h4><p id="CDR0000258025__37">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046098/" class="def">stage II</a>, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> is larger than 2 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000354457/" class="def">centimeters</a> but not larger than 4 centimeters and is found in the
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046024/" class="def">oropharynx</a> only. </p></div><div id="CDR0000258025__38"><h4>Stage III</h4><p id="CDR0000258025__155">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046099/" class="def">stage III</a>, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> is either:</p><ul id="CDR0000258025__146"><li class="half_rhythm"><div>4 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000354457/" class="def">centimeters</a> or smaller; cancer has spread to one <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph node</a> on the same side of the neck as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> and the lymph node is 3 centimeters or smaller; or</div></li><li class="half_rhythm"><div>larger than 4 centimeters or has spread to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046421/" class="def">epiglottis</a> (the flap that covers the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046623/" class="def">trachea</a> during swallowing). Cancer may 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.</div></li></ul></div><div id="CDR0000258025__148"><h4>Stage IV</h4><p id="CDR0000258025__150"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046100/" class="def">Stage IV</a> is divided
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into stage IVA, IVB, and IVC:</p><ul id="CDR0000258025__151"><li class="half_rhythm"><div>In stage IVA, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>:<dl id="CDR0000258025__152" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">has spread to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046026/" class="def">larynx</a>, front part of the roof of the mouth, lower jaw, or muscles that move the tongue or are used for chewing. Cancer may have spread to one <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph node</a> on the same side of the neck as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> and the lymph node is 3 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000354457/" class="def">centimeters</a> or smaller; or</p></dd><dt>-</dt><dd><p class="no_top_margin">has spread to one lymph node on the same side of the neck as the tumor (the lymph node is larger than 3 centimeters but not larger than 6 centimeters) or to more than one lymph node anywhere in the neck (the lymph nodes are 6 centimeters or smaller), and one of the following is true:<ul id="CDR0000258025__153"><li class="half_rhythm"><div>tumor in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046024/" class="def">oropharynx</a> is any size and may have spread to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046421/" class="def">epiglottis</a> (the flap that covers the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046623/" class="def">trachea</a> during swallowing); or</div></li><li class="half_rhythm"><div> 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.</div></li></ul></p></dd></dl></div></li><li class="half_rhythm"><div>In stage IVB, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a>:<dl id="CDR0000258025__154" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">surrounds the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000396786/" class="def">carotid artery</a> or has spread to the muscle that opens the jaw, the bone attached to the muscles that move the jaw, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046025/" class="def">nasopharynx</a>, or base of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000763008/" class="def">skull</a>. Cancer may have spread to one or more <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a> which can be any size; or</p></dd><dt>-</dt><dd><p class="no_top_margin">may be any size and has spread to one or more lymph nodes that are larger than 6 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000354457/" class="def">centimeters</a>.</p></dd></dl></div></li><li class="half_rhythm"><div>In stage IVC, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> may be any size and has spread beyond the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046024/" class="def">oropharynx</a> to
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other parts of the body, such as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lung</a>, bone, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046312/" class="def">liver</a>.</div></li></ul></div></div></div><div id="CDR0000258025__46"><h2 id="_CDR0000258025__46_">Recurrent Oropharyngeal Cancer</h2><p id="CDR0000258025__47"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045862/" class="def">Recurrent</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000446523/" class="def">oropharyngeal
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cancer</a> is <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> that has <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurred</a>
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(come back) after it has been treated. The cancer may come
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back in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046024/" class="def">oropharynx</a> or in other
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parts of the body. </p></div><div id="CDR0000258025__48"><h2 id="_CDR0000258025__48_">Treatment Option Overview</h2><div id="CDR0000258025__48.kp" class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000258025__49">There are different types of treatment for patients with oropharyngeal
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cancer. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000258025__53">Patients with oropharyngeal cancer should have their treatment planned by a team of doctors with expertise in treating head and neck cancer.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258025__57">Four types of standard treatment are used:</a></div><ul><li class="half_rhythm"><div><a href="#CDR0000258025__59">Surgery </a></div></li><li class="half_rhythm"><div><a href="#CDR0000258025__62">Radiation therapy
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</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258025__156">Chemotherapy </a></div></li><li class="half_rhythm"><div><a href="#CDR0000258025__183">Targeted therapy</a></div></li></ul></li><li class="half_rhythm"><div><a href="#CDR0000258025__66">New types of treatment are being tested in clinical
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trials. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000258025__219">Treatment for oropharyngeal cancer may cause side effects.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258025__137">Patients may want to think about taking part in a clinical trial.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258025__139">Patients can enter clinical trials before, during, or after starting their cancer treatment.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258025__141">Follow-up tests may be needed.</a></div></li></ul></div><div id="CDR0000258025__49"><h3>There are different types of treatment for patients with oropharyngeal
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cancer. </h3><p id="CDR0000258025__51">Different types of treatment are available for patients with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000446523/" class="def">oropharyngeal
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cancer</a>. Some treatments are <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard</a>
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(the currently used treatment), and some are being tested in
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trials</a>. A
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treatment clinical trial is a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651211/" class="def">research study</a> meant to help improve current
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treatments or obtain information on new treatments for patients with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>.
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When clinical trials show that a new treatment is better than the standard treatment, the new
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treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.</p></div><div id="CDR0000258025__53"><h3>Patients with oropharyngeal cancer should have their treatment planned by a team of doctors with expertise in treating head and neck cancer.</h3><p id="CDR0000258025__55">The patient's treatment will be overseen by a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046290/" class="def">medical oncologist</a>, a doctor who specializes in treating people with cancer. Because the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046024/" class="def">oropharynx</a>
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helps in breathing, eating, and talking, patients may need special help
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adjusting to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a> of the cancer and its treatment. The medical oncologist may refer the patient to other health professionals with special training in the treatment of patients with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257519/" class="def">head and neck cancer</a>. These may include the following <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000478785/" class="def">specialists</a>:</p><ul id="CDR0000258025__56"><li class="half_rhythm"><div>Head and neck <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044306/" class="def">surgeon</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046546/" class="def">Radiation oncologist</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046221/" class="def">Plastic surgeon</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000389460/" class="def">Dentist</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044661/" class="def">Dietitian</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044716/" class="def">Psychologist</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000318825/" class="def">Rehabilitation specialist</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044459/" class="def">Speech therapist</a>.</div></li></ul></div><div id="CDR0000258025__57"><h3>Four types of standard treatment are used:</h3><div id="CDR0000258025__59"><h4>Surgery </h4><p id="CDR0000258025__61"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> (removing the cancer in an operation) is a common
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treatment of all <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stages</a> of
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oropharyngeal cancer. A surgeon may remove the cancer and some of the healthy
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a> around the cancer. After
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the surgeon removes all the cancer that can be seen at the time of the
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surgery, some patients may be given <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a> after surgery to kill any cancer
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> that are left. Treatment given
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after the surgery, to lower the risk that the cancer will come back, is called
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045587/" class="def">adjuvant therapy</a>.</p><p id="CDR0000258025__182">New types of surgery, including <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000657867/" class="def">transoral robotic surgery</a>, are being studied for the treatment of oropharyngeal cancer. Transoral robotic surgery may be used to remove cancer from hard-to-reach areas of the mouth and throat. Cameras attached to a robot give a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045582/" class="def">3-dimensional</a> (3D) image that a surgeon can see. Using a computer, the surgeon guides very small tools at the ends of the robot arms to remove the cancer. This procedure may also be done using an endoscope.</p></div><div id="CDR0000258025__62"><h4>Radiation therapy
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</h4><p id="CDR0000258025__64">Radiation therapy is a cancer treatment that uses high-energy <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045944/" class="def">x-rays</a> or other types of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045072/" class="def">radiation</a> to kill cancer cells or keep them from growing. There are two types of radiation therapy:</p><ul id="CDR0000258025__209"><li class="half_rhythm"><div class="half_rhythm"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046686/" class="def">External radiation therapy</a> uses a machine outside the body to send radiation toward the cancer.<div id="CDR0000258025__207" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=External-beam%20radiation%20therapy%20of%20the%20head%20and%20neck&p=BOOKS&id=544180_CDR0000732667.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65871.14/bin/CDR0000732667.jpg" alt="External-beam radiation therapy of the head and neck; drawing shows a patient lying on a table under a machine that is used to aim high-energy radiation at the cancer. An inset shows a mesh mask that helps keep the patient's head and neck from moving during treatment. The mask has pieces of white tape with small ink marks on it. The ink marks are used to line up the radiation machine in the same position before each treatment." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>External-beam radiation therapy of the head and neck. A machine is used to aim high-energy radiation at the cancer. The machine can rotate around the patient, delivering radiation from many different angles to provide highly conformal treatment. A mesh mask helps keep the patient’s head and neck from moving during treatment. Small ink marks are put on the mask. The ink marks are used to line up the radiation machine in the same position before each treatment.</p></div></div></div><div class="half_rhythm">Certain ways of giving radiation therapy can help keep radiation from damaging nearby healthy <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a>. These types of radiation therapy include the following:<dl id="CDR0000258025__210" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000335073/" class="def"> Intensity-modulated radiation therapy</a> (IMRT): IMRT is a type of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045582/" class="def">3-dimensional</a> (3-D) radiation therapy that uses a computer to make pictures of the size and shape of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a>. Thin beams of radiation of different intensities (strengths) are aimed at the tumor from many angles.</p></dd><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386233/" class="def">Stereotactic body radiation therapy</a>: Stereotactic body radiation therapy is a type of external radiation therapy. Special equipment is used to place the patient in the same position for each radiation treatment. Once a day for several days, a radiation machine aims a larger than usual <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044664/" class="def">dose</a> of radiation directly at the tumor. By having the patient in the same position for each treatment, there is less damage to nearby healthy tissue. This procedure is also called stereotactic external-beam radiation therapy and stereotaxic radiation therapy.</p></dd></dl></div></li><li class="half_rhythm"><div class="half_rhythm"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046345/" class="def">Internal radiation therapy</a> uses a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046550/" class="def">radioactive</a> substance sealed in needles, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257219/" class="def">seeds</a>, wires, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045637/" class="def">catheters</a> that are placed directly into or near the cancer.</div></li></ul><p id="CDR0000258025__175">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000478743/" class="def">advanced</a> oropharyngeal cancer, dividing the daily dose of radiation into smaller-dose treatments improves the way the tumor <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044085/" class="def">responds</a> to treatment. This is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000484407/" class="def">hyperfractionated radiation therapy</a>.</p><p id="CDR0000258025__212">The way the radiation therapy is given depends on the type and stage of the cancer being treated. External radiation therapy is used to treat oropharyngeal cancer.</p><p id="CDR0000258025__65">Radiation therapy may work better in patients who have
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stopped smoking before beginning treatment. </p><p id="CDR0000258025__125">If the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046036/" class="def">thyroid</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046229/" class="def">pituitary gland</a> are part of the radiation treatment area, the patient has an increased risk of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044547/" class="def">hypothyroidism</a> (too little <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044558/" class="def">thyroid hormone</a>). A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000688783/" class="def">blood test</a> to check the thyroid hormone level in the body should be done before and after treatment.</p></div><div id="CDR0000258025__156"><h4>Chemotherapy </h4><p id="CDR0000258025__157">Chemotherapy is a cancer treatment that uses <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000348921/" class="def">drugs</a> to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">vein</a> or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000301626/" class="def">systemic chemotherapy</a>). When chemotherapy is placed directly into the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046483/" class="def">cerebrospinal fluid</a>, an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organ</a>, or a body <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463703/" class="def">cavity</a> such as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a>, the drugs mainly affect cancer cells in those areas (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046559/" class="def">regional chemotherapy</a>). </p><p id="CDR0000258025__195">The way the chemotherapy is given depends on the type and stage of the cancer being treated. Systemic chemotherapy is used to treat oropharyngeal cancer.</p><p id="CDR0000258025__158">See <a href="https://www.cancer.gov/about-cancer/treatment/drugs/head-neck" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Head and Neck Cancer</a> for more information. (Oropharyngeal cancer is a type of head and neck cancer.)</p></div><div id="CDR0000258025__183"><h4>Targeted therapy</h4><p id="CDR0000258025__177"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">Targeted therapy</a> is a type of treatment that uses drugs or other substances to attack specific cancer cells. Targeted therapies usually cause less harm to normal cells than chemotherapy or radiation therapy do. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046066/" class="def">Monoclonal antibodies</a> are a type of targeted therapy being used in the treatment of oropharyngeal cancer.</p><p id="CDR0000258025__178">Monoclonal antibody <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044737/" class="def">therapy</a> is a cancer treatment that uses <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044918/" class="def">antibodies</a> made in the laboratory from a single type of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046356/" class="def">immune system</a> cell. These antibodies can identify substances on cancer cells or normal substances in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a> or tissues that may help cancer cells grow. The antibodies attach to the substances and kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045738/" class="def">infusion</a>. They may be used alone or to carry drugs, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046622/" class="def">toxins</a>, or radioactive material directly to cancer cells.</p><p id="CDR0000258025__184"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045467/" class="def">Cetuximab</a> is a type of monoclonal antibody that works by binding to a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046092/" class="def">protein</a> on the surface of the cancer cells and stops the cells from growing and dividing. It is used in the treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045862/" class="def">recurrent</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044058/" class="def">metastatic</a> oropharyngeal cancer.</p><p id="CDR0000258025__185">See <a href="https://www.cancer.gov/about-cancer/treatment/drugs/head-neck" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Head and Neck Cancer</a> for more information. (Oropharyngeal cancer is a type of head and neck cancer.)</p></div></div><div id="CDR0000258025__66"><h3>New types of treatment are being tested in clinical
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trials. </h3><p id="CDR0000258025__223">This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p><div id="CDR0000258025__224"><h4>Immunotherapy</h4><p id="CDR0000258025__226"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045729/" class="def">Immunotherapy</a> is a treatment that uses the patient’s <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046356/" class="def">immune system</a> to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body’s natural defenses against cancer.</p><p id="CDR0000258025__222">PD-1 inhibitors are a type of immunotherapy called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000772606/" class="def">immune checkpoint inhibitor</a> therapy. PD-1 is a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046092/" class="def">protein</a> on the surface of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044928/" class="def">T cells</a> that helps keep the body’s immune responses in check. When PD-1 attaches to another protein called PDL-1 on a cancer cell, it stops the T cell from killing the cancer cell. PD-1 inhibitors attach to PDL-1 and allow the T cells to kill cancer cells. </p><p id="CDR0000258025__227"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000764538/" class="def">Pembrolizumab</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000767747/" class="def">nivolumab</a> are types of PD-1 inhibitors being studied in the treatment of oropharnygeal cancer.</p><div id="CDR0000258025__1666" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Immune%20checkpoint%20inhibitor&p=BOOKS&id=544180_CDR0000774646.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65871.14/bin/CDR0000774646.jpg" alt="Immune checkpoint inhibitor; the panel on the left shows the binding of proteins PD-L1 (on the tumor cell) to PD-1 (on the T cell), which keeps T cells from killing tumor cells in the body. Also shown are a tumor cell antigen and T cell receptor. The panel on the right shows immune checkpoint inhibitors (anti-PD-L1 and anti-PD-1) blocking the binding of PD-L1 to PD-1, which allows the T cells to kill tumor cells." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Immune checkpoint inhibitor. Checkpoint proteins, such as PD-L1 on tumor cells and PD-1 on T cells, help keep immune responses in check. The binding of PD-L1 to PD-1 keeps T cells from killing tumor cells in the body (left panel). Blocking the binding of PD-L1 to PD-1 with an immune checkpoint inhibitor (anti-PD-L1 or anti-PD-1) allows the T cells to kill tumor cells (right panel).</p></div></div><div id="CDR0000258025__1667" class="box"><h3><span class="title">immune checkpoint inhibitors</span></h3><div class="caption"><p>Immunotherapy uses the body’s immune system to fight cancer. This animation explains one type of immunotherapy that uses immune checkpoint inhibitors to treat cancer.</p></div><p><a href="https://www.youtube.com/watch?v=GIUu239FWMg" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">YouTube</a></p></div></div></div><div id="CDR0000258025__219"><h3>Treatment for oropharyngeal cancer may cause side effects.</h3><p id="CDR0000258025__219_73">For information about <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a> caused by treatment for cancer, see our <a href="https://www.cancer.gov/about-cancer/treatment/side-effects" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Side Effects</a> page.</p></div><div id="CDR0000258025__137"><h3>Patients may want to think about taking part in a clinical trial.</h3><p id="CDR0000258025__137_23">For some patients, taking part in a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard treatment</a>.</p><p id="CDR0000258025__137_24">Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.</p><p id="CDR0000258025__137_25">Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.</p></div><div id="CDR0000258025__139"><h3>Patients can enter clinical trials before, during, or after starting their cancer treatment.</h3><p id="CDR0000258025__139_29">Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurring</a> (coming back) or reduce the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a> of cancer treatment.</p><p id="CDR0000258025__139_30">Clinical trials are taking place in many parts of the country. Information about clinical trials supported by NCI can be found on NCI’s <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trials search</a> webpage. Clinical trials supported by other organizations can be found on the <a href="https://clinicaltrials.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">ClinicalTrials.gov</a> website.</p></div><div id="CDR0000258025__141"><h3>Follow-up tests may be needed.</h3><p id="CDR0000258025__141_33">Some of the tests that were done to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnose</a> the cancer or to find out the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.</p><p id="CDR0000258025__141_34">Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">condition</a> has changed or if the cancer has <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurred</a> (come back). These tests are sometimes called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044671/" class="def">follow-up</a> tests or check-ups.</p><p id="CDR0000258025__202">Following treatment, it is important to have careful head and neck exams to look for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750109/" class="def">signs</a> that the cancer has come back. Check-ups will be done every 6 to 12 weeks in the first year, every 3 months in the second year, every 3 to 4 months in the third year, and every 6 months thereafter. </p></div></div><div id="CDR0000258025__79"><h2 id="_CDR0000258025__79_">Treatment Options by Stage </h2><p id="CDR0000258025__201">For information about the treatments listed below, see the <a href="#CDR0000258025__57">Treatment Option Overview</a> section.</p><div id="CDR0000258025__80"><h3>Stage I and Stage II Oropharyngeal Cancer</h3><p id="CDR0000258025__81">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046097/" class="def">stage I</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046098/" class="def">stage II oropharyngeal cancer</a> may include the following:</p><ul id="CDR0000258025__82"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation
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therapy</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a>.</div></li></ul><p id="CDR0000258025__TrialSearch_80_19">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000258025__87"><h3>Stage III and Stage IV Oropharyngeal Cancer</h3><p id="CDR0000258025__88">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046099/" class="def">stage III oropharyngeal
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cancer</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046100/" class="def">stage IV oropharyngeal cancer</a> may include the following:</p><ul id="CDR0000258025__89"><li class="half_rhythm"><div>For patients with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045955/" class="def">locally advanced cancer</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a> followed by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a>. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">Chemotherapy</a> also may be given at the same time as radiation therapy.</div></li><li class="half_rhythm"><div>Radiation therapy alone for patients who cannot have chemotherapy. </div></li><li class="half_rhythm"><div>Chemotherapy given at the same time as
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radiation therapy.</div></li><li class="half_rhythm"><div>Chemotherapy followed by radiation therapy given at the same time as more chemotherapy.</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of chemotherapy followed by surgery or
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radiation therapy.</div></li><li class="half_rhythm"><div>A clinical trial of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">targeted therapy</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000767747/" class="def">nivolumab</a>) with chemotherapy given at the same time as radiation therapy in patients with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000478743/" class="def">advanced</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044386/" class="def">HPV</a>-<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044710/" class="def">positive</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000446523/" class="def">oropharyngeal cancer</a>.</div></li><li class="half_rhythm"><div>A clinical trial of radiation therapy with or without chemotherapy.</div></li><li class="half_rhythm"><div>A clinical trial of transoral surgery followed by standard- or low-dose radiation therapy with or without chemotherapy in patients with HPV-positive oropharyngeal cancer.</div></li></ul><p id="CDR0000258025__TrialSearch_87_19">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000258025__196"><h3>Recurrent and Metastatic Oropharyngeal Cancer</h3><p id="CDR0000258025__197">Treatment of oropharyngeal
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cancer that has <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurred</a> (come
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back) in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046024/" class="def">oropharynx</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046283/" class="def">metastasized</a> (spread to other
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parts of the body) may include the following:</p><ul id="CDR0000258025__198"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a>, if the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> does not <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044085/" class="def">respond</a> to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a>.</div></li><li class="half_rhythm"><div>Radiation therapy, if the tumor was not completely removed by surgery and previous radiation has not been given.</div></li><li class="half_rhythm"><div>Second surgery, if the tumor was not completely removed by the first surgery.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">Chemotherapy</a> for patients with recurrent <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> that cannot be removed by surgery.</div></li><li class="half_rhythm"><div>Radiation therapy given at the same time as chemotherapy.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386233/" class="def">Stereotactic body radiation therapy</a> given at the same time as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">targeted therapy</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045467/" class="def">cetuximab</a>).</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">Clinical trials</a> of targeted therapy, stereotactic body radiation therapy, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000484407/" class="def">hyperfractionated radiation therapy</a> given at the same time as chemotherapy.</div></li><li class="half_rhythm"><div>A clinical trial of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045729/" class="def">immunotherapy</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000767747/" class="def">nivolumab</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000764538/" class="def">pembrolizumab</a>).</div></li></ul><p id="CDR0000258025__TrialSearch_196_19">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div></div><div id="CDR0000258025__128"><h2 id="_CDR0000258025__128_">To Learn More About Oropharyngeal Cancer</h2><p id="CDR0000258025__129">For more information from the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044266/" class="def">National Cancer Institute</a> about oropharyngeal cancer, see the following:</p><ul id="CDR0000258025__159"><li class="half_rhythm"><div><a href="https://www.cancer.gov/types/head-and-neck" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Head and Neck Cancer Home Page</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000593570/">Oral Cavity, Pharyngeal, and Laryngeal Cancer Prevention</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000593427/">Oral Cavity, Pharyngeal, and Laryngeal Cancer Screening</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000062871/">Oral Complications of Chemotherapy and Head/Neck Radiation</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-fact-sheet" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">HPV and Cancer</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/treatment/drugs/head-neck" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Head and Neck Cancer</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/types/head-and-neck/head-neck-fact-sheet" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Head and Neck Cancers</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/causes-prevention/risk/tobacco" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Tobacco</a> (includes help with quitting)</div></li></ul><p id="CDR0000258025__128_40">For general <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> information and other resources from the National Cancer Institute, see the following:</p><ul id="CDR0000258025__128_41"><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">About Cancer</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/diagnosis-staging/staging" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Staging</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/publications/patient-education/chemo-and-you" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Chemotherapy and You: Support for People With Cancer</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/publications/patient-education/radiation-therapy-and-you" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Radiation Therapy and You: Support for People With Cancer</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/coping" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Coping with Cancer</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/coping/questions" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Questions to Ask Your Doctor about Cancer</a></div></li><li class="half_rhythm"><div><a href="https://cancercontrol.cancer.gov/ocs/resources/survivors.html" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">For Survivors and Caregivers</a>
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</div></li></ul></div><div id="CDR0000258025__AboutThis_1"><h2 id="_CDR0000258025__AboutThis_1_">About This PDQ Summary</h2><div id="CDR0000258025__AboutThis_2"><h3>About PDQ</h3><p id="CDR0000258025__AboutThis_3">Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in <a href="https://www.cancer.gov/espanol/publicaciones/pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Spanish</a>.</p><p id="CDR0000258025__AboutThis_4">PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.</p></div><div id="CDR0000258025__AboutThis_5"><h3>Purpose of This Summary</h3><p id="CDR0000258025__AboutThis_6">This PDQ cancer information summary has current information about the treatment of adult oropharyngeal cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p></div><div id="CDR0000258025__AboutThis_7"><h3>Reviewers and Updates</h3><p id="CDR0000258025__AboutThis_8">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Updated") is the date of the most recent change.
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</p><p id="CDR0000258025__AboutThis_9">The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the <a href="https://www.cancer.gov/publications/pdq/editorial-boards/adult-treatment" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PDQ Adult Treatment Editorial Board</a>.
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</p></div><div id="CDR0000258025__AboutThis_10"><h3>Clinical Trial Information</h3><p id="CDR0000258025__AboutThis_11">A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
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</p><p id="CDR0000258025__AboutThis_12">Clinical trials can be found online at <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI's website</a>. For more information, call the <a href="https://www.cancer.gov/contact/contact-center" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Cancer Information Service</a> (CIS), NCI's contact center, at 1-800-4-CANCER (1-800-422-6237).
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</p></div><div id="CDR0000258025__AboutThis_13"><h3>Permission to Use This Summary</h3><p id="CDR0000258025__AboutThis_14">PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].”
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</p><p id="CDR0000258025__AboutThis_15">The best way to cite this PDQ summary is:</p><p id="CDR0000258025__AboutThis_21">PDQ® Adult Treatment Editorial Board. PDQ Oropharyngeal Cancer Treatment (Adult). Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: <a href="https://www.cancer.gov/types/head-and-neck/patient/adult/oropharyngeal-treatment-pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www.cancer.gov/types/head-and-neck/patient/adult/oropharyngeal-treatment-pdq</a>. Accessed <MM/DD/YYYY>. [PMID: 26389310]</p><p id="CDR0000258025__AboutThis_16">Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in <a href="https://visualsonline.cancer.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Visuals Online</a>. Visuals Online is a collection of more than 3,000 scientific images.
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</p></div><div id="CDR0000258025__AboutThis_17"><h3>Disclaimer</h3><p id="CDR0000258025__AboutThis_18">The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the <a href="https://www.cancer.gov/about-cancer/managing-care" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Managing Cancer Care</a> page.</p></div><div id="CDR0000258025__AboutThis_19"><h3>Contact Us</h3><p id="CDR0000258025__AboutThis_20">More information about contacting us or receiving help with the Cancer.gov website can be found on our <a href="https://www.cancer.gov/contact" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Contact Us for Help</a> page. Questions can also be submitted to Cancer.gov through the website’s <a href="https://www.cancer.gov/contact/email-us" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">E-mail Us</a>.</p></div></div></div></div>
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<div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Views</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PDF_download" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK65871.14/?report=reader">PubReader</a></li><li><a href="/books/NBK65871.14/?report=printable">Print View</a></li><li><a data-jig="ncbidialog" href="#_ncbi_dlg_citbx_NBK65871" data-jigconfig="width:400,modal:true">Cite this Page</a><div id="_ncbi_dlg_citbx_NBK65871" style="display:none" title="Cite this Page"><div class="bk_tt">PDQ Adult Treatment Editorial Board. Oropharyngeal Cancer Treatment (Adult) (PDQ®): Patient Version. 2019 Jul 16. In: PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. <span class="bk_cite_avail"></span></div></div></li><li><a href="#" class="toggle-glossary-link" title="Enable/disable links to the glossary">Disable Glossary Links</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Version History</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter shutter_closed" title="Show/hide content" remembercollapsed="true" pgsec_name="version_history" id="Shutter"></a></div><div class="portlet_content" style="display: none;"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><span class="bk_col_itm"><a href="/books/NBK65871.20/">NBK65871.20</a></span> April 26, 2024</li><li><span class="bk_col_itm"><a href="/books/NBK65871.19/">NBK65871.19</a></span> May 10, 2023</li><li><span class="bk_col_itm"><a href="/books/NBK65871.18/">NBK65871.18</a></span> 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