Oropharyngeal cancer

Oropharyngeal cancer is sometimes called oropharyngeal carcinoma. It is a type of head and neck cancer that develops in the oropharynx.

The oropharynx is the middle part of the throat behind the mouth. This area helps you speak and swallow. 'Oro' means mouth and the 'pharynx' is the throat. It includes the soft part of the roof of the mouth (soft palate), the base or the back of the tongue (the part you cannot see), the tonsils and the side walls of the throat.

The most common type of oropharyngeal cancer is squamous cell cancer. Squamous cell cancer of the oropharynx is one of the most common types of head and neck cancer.

The throat (pharynx)

The throat is also known as the pharynx. It is divided into 3 main parts:

Nasopharynx

This is the upper part of the pharynx, behind the nose. Cancer that develops here is called nasopharyngeal cancer or sometimes cancer of the post-nasal space.

Oropharynx

This is the middle part of the pharynx, behind the mouth. It includes the soft part of the roof of the mouth (soft palate), the base or the back of the tongue (the part you cannot see), the tonsils and the side walls of the throat. The most common places for oropharyngeal cancer to develop are on the tonsils and the base of the tongue, or rarely the back in the throat.

Hypopharynx

This is the lower part of the pharynx, behind the voice box. Cancers that develop here are called hypopharyngeal cancers.

We have separate information about cancer that develops in other areas of the throat such as the nasopharynx (nasopharyngeal) or hypopharynx.

The exact causes of oropharyngeal cancers are not known. But there are risk factors that can increase your chance of developing it.

The main risk factors for oropharyngeal cancer are:

• smoking or chewing tobacco or chewing betel quid, with or without tobacco
• regularly drinking large amounts of alcohol – the more years someone drinks for, the higher the risk.

Your risk of developing oropharyngeal cancer is higher if you do both.

Some cases of oropharyngeal cancer are linked to an infection called human papilloma virus (HPV). Oropharyngeal cancers linked to HPV often start in the tonsils or the base of the tongue.

HPVs are a group of common infections that can affect areas such as the inside of the mouth, the throat, genital area or anus. Some types of high-risk HPV can increase the risk of certain cancers. Most people have HPV at some time during their life. But most people with HPV in the mouth do not develop oropharyngeal cancer.

As with other cancers, oropharyngeal cancer is not infectious and cannot be passed on to other people.

We have more information about the causes and risk factors of head and neck cancer.

The results of the tests help your doctors find out more about the size and position of the cancer and whether it has spread. This is called staging. The most commonly used staging systems for oropharyngeal cancers are the TNM and number staging systems.

Some oropharyngeal cancers may also be given a grade. This is how the cancer cells look under the microscope. The grade of the cancer gives an idea how quickly the cancer may grow.

Oropharyngeal cancer and HPV

If oropharyngeal cancer contains human papilloma virus (HPV), it is called HPV positive oropharyngeal cancer. If there is no HPV, it is called HPV negative oropharyngeal cancer.

Doctors stage HPV positive oropharyngeal cancers differently to HPV negative oropharyngeal cancers. Your doctor can tell you the stage of oropharyngeal cancer you have.

HPV negative oropharyngeal cancers are graded in the same way as other head and neck cancers. Doctors do not grade HPV positive oropharyngeal cancers.

Knowing the stage and grade of oropharyngeal cancer and whether it is positive or negative for HPV helps your doctors plan the best treatment for you.

We have more information about staging and grading of head and neck cancer.

You have regular follow-up appointments after treatment with your specialist doctor. These may continue for several years. You may also have regular follow-up appointments with your multidisciplinary team (MDT), including a speech and language therapist (SLT), dietitian, restorative dentist and dental hygienist and sometimes a physiotherapist.

If you have any problems or notice new symptoms between appointments, let your doctor or nurse know as soon as possible.

Some treatment side effects may take a long time to improve after treatment finishes, or they may become permanent. These are called long-term effects. Other side effects can develop months or even years after treatment has finished. These are known as late effects. We have more information about long-term and long-term and late effects of head and neck cancer treatment.

Head and neck cancer and its treatment can sometimes have an effect on your sex life.

If you are worried about this, talk to your doctor or nurse. You can read about things that may help in our information on cancer and sex.

Some cancer treatments can also affect whether you can get pregnant or make someone pregnant. If you are worried about this, it is important to talk with your doctor before you start treatment.

We have more information about:

• fertility in women after treatment
• fertility in men after treatment.
• LGBTQ+ people and cancer treatment

Even if you already have a healthy lifestyle, you may choose to make some positive lifestyle changes during and after treatment. For example, if you smoke or drink alcohol, it is best to avoid smoking or reduce the amount of alcohol.

Eating well and keeping active can improve your health and well-being. It can also help your body recover. Your dietitian can help with any difficulties you might have with eating after treatment.

It may take several months to recover from treatment. It can be hard if treatment has changed your appearance, how you eat or drink, or your voice. This may also affect your body image but there are ways to help you to manage any changes.

You may still be coping with difficult feelings. Talking to your family and friends or health professionals about how you feel can help them know how to support your well-being.

There are also national support groups that you may find helpful:

• The Mouth Cancer Foundation
  The Mouth Cancer Foundation gives information and support to people affected by head and neck cancers.
• Changing Faces
  Changing Faces offers advice and information to anyone who is affected by a change in their appearance.
• The Swallows Head and Neck Cancer Support Group
  The Swallows offers a 24-hour support line to anyone affected by head and neck cancer.
• Salivary Gland Cancer UK
  Salivary Gland Cancer UK supports people with rare salivary gland cancers, such as adenoid cystic carcinoma, ACC, and unknown carcinoma.

Macmillan is also here to support you. If you would like to talk, you can:

• Call the Macmillan Support Line on 0808 808 00 00.
• Chat to our specialists online.
• Visit our head and neck cancer forum to talk with people who have been affected by head and neck cancer, share your experience, and ask an expert your questions.