After diagnosing a patient with oropharyngeal cancer, a doctor will need to determine what type of cancer it is, the grade of the tumor, and the stage of the cancer. Doctors often establish a preliminary disease stage based on physical exam as well as findings on imaging that help to identify the spread of disease. In patients who undergo surgery, a more well-defined disease stage is determined based on pathology after surgery. It is also important to know if it is associated with HPV (human papillomavirus). This can be determined from a biopsy by running some special tests, including looking for DNA of the virus or looking for certain proteins, such as P16, related to the virus.
Type
The most common type of oropharyngeal cancer is squamous cell carcinoma. Squamous cell carcinoma is a cancer that starts from abnormal cells in the oropharynx. Squamous cell carcinoma can be divided into two main types related to the human papillomavirus (HPV):
- HPV positive
- HPV negative
Additionally, oropharyngeal cancer can be grouped based on whether or not it expresses a tumour suppressor protein known as p16.
Less common types of oropharyngeal cancer
- Salivary gland cancers: There are minor salivary glands located under the lining of the throat. This is why cancers that we typically see in salivary glands can appear in this region and they include diagnoses such as mucoepidermoid carcinoma, adenocarcinoma, and adenoid cystic carcinoma, to name a few. See our section on salivary gland cancer for more information.
- Lymphoma: The throat is lined with lymphoid cells. Some major sites of lymphoid tissue include the adenoids in the nasopharynx (part of the throat behind the nose) and tonsils in the oropharynx. This is why lymphoma might appear as a lump in the throat area.
- Mucosal melanoma: These cancers come from skin cells, known as melanocytes, that give skin its color. In rare cases, melanoma can be found in the lining of the oropharynx.
- Sarcomas, such as chondrosarcoma, liposarcoma and synovial sarcoma.
- Malignant fibrous histiocytoma.
- Peripheral Neuroectodermal Tumor (PNET).
- Cancer spread from another site.
