While some think this is a rare cancer, mouth cancers will be newly diagnosed in about 132 new individuals each day in the US alone, and a person dies from oral cancer every hour of every day. The oropharynx is one of the most common sites of head and neck cancer in the United States. It is estimated that 11,000-13,000 new cases of oropharyngeal cancer are diagnosed in the United States each year. The vast majority of these tumors are squamous cell carcinoma, a cancer which arises from squamous epithelial cells which line the upper aerodigestive tract. Males are more than four times as likely as females to develop oropharyngeal squamous cell carcinoma (OPSCC), with an overall annual risk of 6.2 per 100,000 men compared to 1.4 cases per 100,000 women. Incidence in the U.S. is highest among white and black men, and lower among Hispanics, Native Americans and Asians/ Pacific Islanders. Despite decreasing rates of tobacco and alcohol use, the rates of oropharyngeal cancer have trended steadily upward for the last decade. This is primarily due to the increase in cancers related to infection with the human papilloma virus (HPV). The time lag between an oral HPV infection and the development of HPV-related oropharyngeal cancer is estimated at between 15 and 30 years. Unfortunately, at this time, the majority are found as late stage cancers, and this accounts for the very high death rate of about 43% at five years from diagnosis (for all stages and etiologies combined at time of diagnosis), and high treatment related morbidity in survivors. This course is designed to review the pathophysiology of oropharyngeal cancer and emerging trends in cancer management.
- Identify the most common etiologies of oral cancer and its incidence within the population.
- Review the basic histology of the oral mucosa and the changes that occur with premalignant and malignant lesions and their patterns of occurrence.
- Review current treatment recommendations and clinical outcomes.
- Review the principles and the complications from radiotherapy.
- Discuss the developing role of immunotherapy in the management of late-stage tumors.