Summary

• Predominantly (90%) squamous cell carcinoma arising from base of tongue, soft palate, palatine tonsillar fossa and pillars, and lateral and posterior pharyngeal wall. Non-epithelial tumours, such as minor salivary gland carcinomas and sarcoma, are uncommon.
• Tobacco and alcohol abuse are the strongest predictors of developing oropharyngeal carcinoma. HPV infection is strongly implicated in people not exposed to smoking or alcohol. Betel nut chewing in developing countries is also a risk factor.
• Signs include sore throat, oral pain, dysphagia, weight loss, neck mass, and trismus.
• Patients should be referred to an ear, nose, and throat surgeon for histology diagnosis of cancer.
• Staging is through CT scan or MRI of the head and neck with contrast, followed by triple endoscopy under general anaesthesia. However, PET scan either alone or combined with CT scan has become an acceptable method.
• Treatment regimens vary depending on the stage of the cancer and involve surgery, chemotherapy, radiotherapy, and monoclonal antibodies. Patients should be managed by a multidisciplinary team to optimise outcome.