Keterangan
Oropharyngeal cancer is a type of head and neck cancer in which cancer cells are found within an area of your throat called your oropharynx.More than 90% of oropharyngeal cancers are squamous cell carcinomas, which are cancers arising from the flat surface cells lining your mouth and throat. Often, oropharyngeal cancers are asymptomatic. Typically, the first sign is a lump in the neck. Other symptoms may include: Neck mass, Difficulty or pain with swallowing, Muffled voice, Ear pain, Throat pain or sore throat, Lump or mass in the back of the throat.
Ringkasan
- The oropharynx, situated between the oral cavity, hypopharynx, and nasopharynx, includes the soft palate, base of the tongue, and tonsils. While tobacco and alcohol are known risk factors for oropharyngeal cancer, human papillomavirus (HPV) is a significant etiological factor, accounting for approximately 70% of cases.
- The anatomical boundaries of the oropharynx are defined superiorly by the soft palate, anteriorly by the oral cavity, laterally by the palatine tonsils and arches, posteriorly by the second and third cervical vertebrae and prevertebral fascia, and inferiorly by the hyoid bone and vallecula. Lymphatic drainage from the oropharynx primarily targets levels 2, 3, and 4 of the neck, and bilateral drainage is common, especially for lesions involving the soft palate or base of the tongue.
- Common clinical features of oropharyngeal cancer include pain, a foreign body sensation, and dysphagia. Patients may also experience hemoptysis, weight loss, voice changes, and referred ear pain (otalgia). Diagnosis involves a comprehensive physical exam, fibro-optic endoscopy, and imaging, such as MRI, to determine the extent of the disease.
- The eighth edition of the American Joint Committee on Cancer (AJCC) manual divides oropharyngeal cancer staging into HPV-positive and HPV-negative categories. HPV-positive staging is simplified, primarily based on tumor size and nodal involvement. Conversely, HPV-negative staging considers tumor size, nodal involvement, and the presence of extracapsular nodal extension (ENE).
- The role of HPV status is significant for predicting prognosis, with HPV-positive cancers typically exhibiting better treatment responses. Treatment modalities range from single-modality approaches like surgery or radiation for early-stage disease to multi-modality approaches that combine surgery, radiation, chemotherapy, and immunotherapy for locally advanced cancer.
- Treatment selection depends on factors such as patient choice, tumor location, potential functional deficits, and the surgeon's expertise. Radiation with chemotherapy is a standard treatment for locally advanced oropharyngeal cancer. Drugs like cetuximab have shown promise when used in conjunction with radiation and chemotherapy. The decision between surgery and radiation aims to balance tumor control with functional preservation.
Contoh Sertifikat
Tentang Pembicara
Dr VIJAY KUMAR KONTHAM
Consultant Radiation Oncologist and Pain and Palliative Care PhysicianYashoda Hospitals
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