Cancer of the throat – oropharyngeal cancer – very often starts off as a sore throat that goes on and on, or a lump in the throat and coughing up blood. It was usually caused by smoking or alcohol, but HPV, the virus behind cervical cancer, is now thought to be at the root of 70% cases.
Treatment has to be radical and can be harrowing, but Mayo Clinic researchers appear to have an answer in a newer, gentler approach.
The standard treatment involves surgery, chemotherapy and X-ray therapy. But the pioneering regime means patients may be able to have less radiation therapy without an increasing risk of the cancer spreading.
“We found that decreasing the amount of radiation therapy after a minimally invasive robotic surgery improved the quality of life of patients with HPV-related oropharyngeal cancer while delivering excellent cure rates,” says Dr Eric Moore, a Mayo Clinic otolaryngologist.
“In essence, we found exactly the right amount of treatment to deliver without over-treating these patients.”
In the study, Dr Moore and his colleagues looked at 79 patients with HPV-related tonsil and tongue cancer who were treated at the Mayo Clinic with surgery and two weeks of radiation therapy. They compared them to a group of 115 patients with the same cancer treated with surgery, then the standard six weeks of radiation therapy.
Dr Moore and his colleagues found no decrease in survival, or cancer recurrence, in the patients who received only two weeks of radiation therapy compared to the group that received six weeks. He says that by decreasing the amount of radiation therapy after minimally invasive robotic surgery, physicians were able to improve the quality of life of patients and achieve excellent cure rates.
Dr Moore says the Mayo Clinic now offers dose de-escalation radiation therapy to appropriately selected patients with HPV-related cancers of the tonsils and tongue.
“This approach shortens the treatment time for by several weeks and reduces side effects without sacrificing effectiveness,” he adds.
For patients having the usual treatment for throat cancer Dr Moore’s approach is a welcome advance. It significantly reduces the impact of the usual severe regime patients have to follow to overcome their cancer and prevent spread. Moreover, it lessens the side effects.
Because the oropharynx helps with breathing, eating and talking, patients need help adjusting to the side effects of the cancer and its treatment from a team of specialists.