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Oropharyngeal cancer is a rare form of throat cancer that forms in the oropharynx in the middle portion of the throat (pharynx). Most oropharyngeal cancers develop as squamous cell carcinomas (cancers arising from the squamous cells in the tissues that line the pharynx), however in rare cases they can develop as other types.

The pharynx/throat is a hollow tube that consists of three main portions: the nasopharynx, the oropharynx, and the hypopharynx. The nasopharynx is located at the uppermost portion of the throat, behind the nose and above the soft palate (muscle in the mouth preventing food from entering the nasal passages). The middle portion of the throat, the oropharynx, is the area from the soft palate and tongue to the back of the mouth, including the tonsils. The oropharynx acts as a passage of air from the nose and mouth to the lungs, and pushes food and drink from the mouth to the oesophagus. The last portion of the throat is the hypopharynx, which functions as a guide for food into the oesophagus and not into the larynx and lungs. 

Oropharyngeal cancer is more common in males, and is generally diagnosed over the age of 60. However, anyone can develop this disease.


If oropharyngeal cancer is detected, it will be staged and graded based on size, metastasis (whether the cancer has spread to other parts of the body) and how the cancer cells look under the microscope. Staging and grading helps your doctors determine the best treatment for you.

Cancers can be staged using the TNM staging system:

  • T (tumour) indicates the size and depth of the tumour.
  • N (nodes) indicates whether the cancer has spread to nearby lymph nodes.
  • M (metastasis) indicates whether the cancer has spread to other parts of the body.

This system can also be used in combination with a numerical value, from stage 0-IV:

  • Stage 0: this stage describes cancer cells in the place of origin (or ‘in situ’) that have not spread to nearby tissue.
  • Stage I: cancer cells have begun to spread to nearby tissue. It is not deeply embedded into nearby tissue and had not spread to lymph nodes. This stage is also known as early-stage cancer.
  • Stage II: cancer cells have grown deeper into nearby tissue. Lymph nodes may or may not be affected. This is also known as localised cancer.
  • Stage III: the cancer has become larger and has grown deeper into nearby tissue. Lymph nodes are generally affected at this stage. This is also known as localised cancer.
  • Stage IV: the cancer has spread to other tissues and organs in the body. This is also known as advanced or metastatic cancer.

Cancers can also be graded based on the rate of growth and how likely they are to spread:

  • Grade I: cancer cells present as slightly abnormal and are usually slow growing. This is also known as a low-grade tumour.
  • Grade II: cancer cells present as abnormal and grow faster than grade-I tumours. This is also known as an intermediate-grade tumour. 
  • Grade III: cancer cells present as very abnormal and grow quickly. This is also known as a high-grade tumour. 

Once your tumour has been staged and graded, your doctor may recommend genetic testing, which analyses your tumour DNA and can help determine which treatment has the greatest chance of success. They will then discuss the most appropriate treatment option for you.

Treatment is dependent on several factors, including location, stage of disease and overall health. 

Treatment options for oropharyngeal cancer may include: 

  • Surgery, potentially including:
    • Trans-oral robotic surgery (TORS) (a minimally invasive procedure that can remove the cancer with a robotic system or laser surgery without making any external incisions).
    • Neck dissection (removal of affected lymph nodes of the neck).
    • Mandibulotomy (a more extensive surgery involving cutting the jawbone to allow better access to the back of the throat, before a jaw reconstruction with titanium plates). 
    • Free flap reconstructive surgery (may be required in patients who have had a large amount of tissue removed. Skin is taken from another part of the body and grafted to cover the throat).
    • Tracheostomy (a tube inserted into your trachea (windpipe) to help you breathe after surgery). 
    • Feeding tubes (tubes are inserted via an incision (gastronomy or PEG tube) or through the nose (nasogastric tube) to help feed you after surgery).
  • Radiation therapy.
  • Chemotherapy.
  • Clinical trials.
  • Palliative care.

For more information on the treatment options, please refer to the Rare Cancers Australia Treatment Options page.

Risk factors

While the cause of oropharyngeal cancer remains unknown, these factors may increase your risk in developing oropharyngeal cancer:

  • Having been infected with the human papillomavirus (HPV). 
  • Having a history of smoking and/or excessive alcohol intake.

Not everyone with these risk factors will develop the disease, and some people who have the disease may have none of these risk factors. See your general practitioner (GP) if you are concerned.

Early symptoms

The symptoms of oropharyngeal cancers may include:

  • A persistent sore throat.
  • Throat sores/ulcers.
  • A lump in the throat and/or the neck.
  • Difficulties swallowing food or moving the tongue.
  • Difficulties opening the mouth.
  • Difficulties breathing.
  • Unexplained noisy breathing.
  • Unexplained ear pain.
  • Coughing up blood.
  • Changes in the voice.
  • Unexplained weight loss.

Not everyone with the symptoms above will have cancer, but see your general practitioner (GP) if you are concerned.


If your doctor suspects you have oropharyngeal cancer, they will order a range of diagnostic tests to confirm the diagnosis, and refer you to a specialist for treatment.

Physical examination 

Your doctor will collect your overall medical history, as well as your lifestyle/health habits current symptoms. Following this, they may examine your body to check for any abnormalities. More specifically, they will feel your neck to see if there are any swollen lymph nodes, which are indicative of infection. 

Imaging & blood tests

The doctor will take images of your body using magnetic resonance imaging (MRI), a computed tomography scan (CT scan), and/or positron emission tomography (PET scan), depending on where it is suspected the cancer is. The doctor may also look at other parts of the body and looks for signs of metastasis. Additionally, a blood test may be taken to assess your overall health and help guide treatment decisions.

Nasoendoscopy & biopsy

A Nasoendoscopy is a day procedure often used to examine the nasal cavity and throat. To look for oropharyncancer, the doctor will place a long, thin tube with a light and a camera attached (endoscope) into your nose to check for any abnormalities.

Once the location(s) of the cancer has been identified, the doctor will perform a biopsy to remove a section of tissue using a needle. The tissue sample will then be analysed for cancer cells. This can be done by a fine needle aspiration (FNA), or a core needle biopsy (CNB).

Prognosis (Certain factors affect the prognosis and treatment options)

While it is not possible to predict the exact course of the disease, your doctor may be able to give you a general idea based on the rate and depth of tumour growth, susceptibility to treatment, age, overall fitness, and medical history. Generally, early-stage oroopharyngeal cancers have a better prognosis and survival rates. However, if the cancer is advanced and has spread, the prognosis may not be as good and there may be a higher risk of cancer recurrence. It is very important to discuss your individual circumstances with your doctor to better understand your prognosis. 


Some references are to overseas websites. There may be references to drugs and clinical trials that are not available here in Australia.