Treatments for early stage oropharyngeal cancer

The following are treatment options for early stage (stages 1 and 2) oropharyngeal cancer. Your healthcare team will work with you to develop a treatment plan.

The main treatment for early stage oropharyngeal cancer is surgery or radiation therapy. Your healthcare team will suggest treatments based on your needs and the expected side effects of treatment, including its effect on your appearance and the ability to speak and swallow.

Surgery

Surgery is a main treatment for early stage oropharyngeal cancer. It is used to remove the tumour along with a margin of healthy tissue around it.

Depending on the size and location of the tumour, you may have one of the following types of surgery:

  • open surgical resection
  • transoral resection – transoral robotic surgery (TORS) or transoral laser microsurgery (TLM)
  • neck dissection to remove lymph nodes in the neck (cervical lymph nodes)

Radiation therapy

External radiation therapy is a main treatment for early stage oropharyngeal cancer. It may be given alone as the main treatment or after surgery to remove the tumour to reduce the risk of cancer coming back (called adjuvant radiation therapy).

Radiation is given to the tumour in the oropharynx and lymph nodes in the neck. Where the radiation is given depends on where the tumour started.

Cancer that starts in the tonsil rarely spreads to lymph nodes on both sides of the neck at an early stage. Radiation is given only to the tumour, tissue around the tumour and lymph nodes on the same side of the neck as the tumour.

Cancer that starts in the base of the tongue can spread to lymph nodes on both sides of the neck. Radiation is given to the primary tumour, tissue around the tumour and lymph nodes on both sides of the neck.

Cancer that starts in the soft palate can spread to lymph nodes on both sides of the neck. Radiation is given to the primary tumour, tissue around the tumour and lymph nodes on both sides of the neck.

Sometimes radiation therapy is combined with chemotherapy (chemoradiation), but chemoradiation is not usually used for early stage oropharyngeal cancer.

Clinical trials

Talk to your doctor about clinical trials open to people with oropharyngeal cancer in Canada. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.

Expert review and references

  • American Cancer Society. Treating Oral Cavity and Oropharyngeal Cancer. 2021.
  • Machiels JP, Leemans CR, & Golusinski W. Squamous cell carcinoma of the oral cavity, larynx, oropharynx and hypopharynx: EHNS-ESMO-ESTRO clinical practices guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 2020: 31(11): 146201475.
  • Mierzwa ML, Casper KA, Swiecicki PL. Oropharynx cancer. DeVita VT Jr, Lawrence TS, Rosenberg S. eds. DeVita Hellman and Rosenberg's Cancer: Principles and Practice of Oncology. 12th ed. Philadelphia, PA: Wolters Kluwer; 2023: Kindle version, chapter 26, https://read.amazon.ca/?asin=B0BG3DPT4Q&language=en-CA.
  • National Comprehensive Cancer Network . NCCN Clinical Practice Guidelines in Oncology: Head and Neck Cancer Version 2.2023 . 2023: https://www.nccn.org/guidelines/category_1.

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