Treatment of Oropharyngeal Cancer That Has Come Back After Initial Treatment
Clinical Scenario
When oropharyngeal cancer returns after prior treatment, it is called recurrent cancer. Recurrence can occur in three distinct patterns, each carrying different management implications:
Local — in or near the original site (mouth or throat)
Regional — in nearby lymph nodes
Distant — spread to other organs (e.g. lungs or bone)
Treatment Approach
Management is guided by the site of recurrence and the type of treatment used initially — options span surgical, radiation-based, and systemic approaches, used alone or in combination. The complete regimen and selection criteria are available in the full protocol.
References
- When cancer comes back after treatment, it's called recurrent cancer.
- Come back in or near the same place it first started (local)
- Come back in nearby lymph nodes (regional)
- Spread to other organs such as the lungs or bone (distant)
- If the cancer comes back in the same area and radiation therapy was used as the first treatment, surgery is often the next treatment if the cancer can be removed completely and the person is healthy enough for surgery.
- But internal radiation (brachytherapy) can often be used to control the cancer if it comes back in the place it started.
- If surgery was used first, more surgery, radiation therapy, chemo, the targeted drug cetuximab, immunotherapy, or a combination of these may be an option.
- If the cancer comes back in the lymph nodes in the neck, the nodes are often removed with surgery (lymph node dissection).
- This may be followed by radiation or chemoradiation.
- If the cancer comes back in a distant area, chemo (and/or cetuximab) is often used.
- Immunotherapy with or without chemo might be an option as well.
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