Soft palate cancer

Overview

Soft palate cancer is cancer that starts as a growth of cells on the soft palate. The soft palate is located on the upper part of the back of the mouth, behind the teeth.

Soft palate cancer most often begins in the thin, flat cells that line the inside of the mouth and throat, called squamous cells. When cancer starts in these cells it's called squamous cell carcinoma.

Soft palate cancer can cause changes in the look and feel of the tissue on the soft palate. These changes may include a lump or a sore that doesn't heal.

Soft palate cancer is considered a type of throat cancer. It is treated similarly to the way other types of throat cancers are treated. This may include a combination of surgery, radiation therapy and chemotherapy.

Symptoms

Signs and symptoms of soft palate cancer can include the following:

• Bleeding in the mouth.
• Difficulty swallowing.
• Difficulty speaking.
• Bad breath.
• Mouth pain.
• Sores in the mouth that won't heal.
• Loose teeth.
• Pain when swallowing.
• Weight loss.
• Ear pain.
• Swelling in the neck that may hurt.
• White patches in the mouth that won't go away.

When to see a doctor

Make an appointment with a doctor or other healthcare professional if you have any symptoms that worry you.

Causes

Soft palate cancer happens when cells on the soft palate develop changes in their DNA. A cell's DNA holds the instructions that tell a cell what to do. In healthy cells, the DNA gives instructions to grow and multiply at a set rate. The instructions tell the cells to die at a set time. In cancer cells, the changes give different instructions. The changes tell the cancer cells to make many more cells quickly. Cancer cells can keep living when healthy cells would die. This causes too many cells.

The cancer cells might form a mass called a tumor. The tumor can grow to invade and destroy healthy body tissue. In time, cancer cells can break away and spread to other parts of the body. When cancer spreads, it's called metastatic cancer.

It's not always clear what causes the DNA changes that lead to soft palate cancer. For some soft palate cancers, human papillomavirus is thought to have a part. HPV is a common virus that's transmitted through sexual contact. For most people, HPV doesn't cause any problems. For others, it causes changes in the cells that may one day lead to cancer.

Risk factors

Things that may increase the risk of soft palate cancer include:

Using tobacco

All forms of tobacco increase the risk of soft palate cancer. This includes cigarettes, cigars, pipes, chewing tobacco and snuff.

Drinking alcohol

Frequent and heavy drinking increases the risk of soft palate cancer. Using alcohol and tobacco together increases the risk even more.

Being exposed to human papillomavirus, also called HPV

HPV is a common virus that's passed through sexual contact. For most people, it causes no problems and goes away on its own. For others, it causes changes in the cells that can lead to many types of cancer, including soft palate cancer.

Having a weakened immune system

If the body's germ-fighting immune system is weakened by medicines or illness, there might be a higher risk of soft palate cancer. People with a weakened immune system include those taking medicines to control the immune system, such as after an organ transplant. Certain medical conditions, such as infection with HIV, also can weaken the immune system.

Prevention

Ways to reduce your risk of soft palate cancer include:

Don't use tobacco

If you don't use tobacco, don't start. If you currently use tobacco of any kind, talk with a healthcare professional about strategies to help you quit.

Limit alcohol intake

If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women and up to two drinks a day for men.

Ask about the HPV vaccine

Receiving a vaccination to prevent HPV infection may reduce your risk of HPV-related cancers, such as soft palate cancer. Ask your doctor or other healthcare professional whether an HIV vaccine is appropriate for you.

Have regular health and dental exams

During your appointments, your dentist, doctor or other healthcare professional can check your mouth for signs of cancer and precancerous changes.

Diagnosis

Tests and procedures used to diagnose soft palate cancer include:

Examining your mouth and neck

A healthcare professional uses a mirror or tiny camera to get a closer look at your soft palate. The health professional looks for lumps, sores, or other signs of cancer in the mouth and throat. The health professional also may feel the neck for swollen lymph nodes. When soft palate cancer spreads, it often goes to the lymph nodes first.

Removing a tissue sample for testing

Called a biopsy, this test involves taking a sample of cells from the mouth. There are different types of biopsies. A sample may be collected by cutting out a piece of the suspicious tissue or the entire area. Another type of biopsy uses a thin needle that's inserted directly into the suspicious area and collects a sample of cells.

The samples are sent to a lab for testing. In the lab, tests can show whether the cells are cancerous. Other tests give more information about the cancer cells, such as if they show signs of HPV.

Imaging tests

Imaging tests capture pictures of the body. The pictures can show the size and location of the cancer. Imaging tests used for soft palate cancer may include:

• X-ray.
• CT.
• MRI.
• Positron emission tomography, also called PET.

Treatment

Treatment for soft palate cancer often includes surgery followed by radiation, chemotherapy or both. Your healthcare team considers many factors when creating a treatment plan. These might include the cancer's location and how fast it's growing. The team also may look at whether the cancer has spread to other parts of your body and the results of tests on the cancer cells. Your care team also considers your age and your overall health.

Surgery to remove the cancer

During surgery for soft palate cancer, the surgeon removes the cancer and some of the healthy tissue around it. This ensures that all the cancer cells are removed.

Sometimes surgery causes trouble with speaking and swallowing. Physical therapy and other rehabilitation services can help you cope with these changes.

Surgery to remove lymph nodes in the neck

When soft palate cancer spreads, it often goes to the lymph nodes in the neck first. If there are signs that the cancer has spread to the lymph nodes, you might need surgery to remove some lymph nodes, called a neck dissection. Even if there are no signs of cancer in the lymph nodes, you may have some of them removed as a precaution. Removing the lymph nodes removes the cancer and helps your healthcare team decide if you need other treatments.

To get to the lymph nodes, the surgeon makes a cut in the neck and removes the lymph nodes through the opening. The lymph nodes are tested for cancer. If cancer is found in the lymph nodes, other treatment might be needed to kill any cancer cells that are left. Options might include radiation or radiation combined with chemotherapy.

Sometimes it's possible to remove only a few lymph nodes for testing. This is called a sentinel node biopsy. It involves removing the lymph nodes to which cancer is most likely to spread. The lymph nodes are tested for cancer. If there's no cancer detected, it's likely that the cancer hasn't spread. Sentinel node biopsy isn't an option for everyone with soft palate cancer. It's only used in certain situations.

Reconstructive surgery

Reconstructive surgery may be used for people who had parts of their face, jaw or neck taken out during surgery. Healthy bone or tissue may be taken from other parts of the body and used to fill gaps. This tissue can replace part of the lip, tongue, palate or jaw, face, throat, or skin. Reconstructive surgery is sometimes done at the same time as surgery to remove the cancer. This may depend on the size and location of the cancer.

Radiation therapy

Radiation therapy uses powerful energy beams to kill cancer cells. The energy can come from X-rays, protons or other sources. During radiation therapy, a machine directs beams of energy to specific points on the body to kill the cancer cells.

Radiation might be used after surgery to kill any cancer cells that remain. Sometimes radiation is done at the same time as chemotherapy. If you can't have surgery or don't want surgery, radiation might be used instead.

Chemotherapy

Chemotherapy uses strong medicines to kill cancer cells. Chemotherapy may be used after surgery to kill any remaining cells. Sometimes chemotherapy is done at the same time as radiation therapy because it makes the radiation work better.

Targeted therapy

Targeted therapy uses medicines that attack specific chemicals in the cancer cells. By blocking these chemicals, targeted treatments can cause cancer cells to die. Targeted therapy is used to treat soft palate cancer that spreads to other parts of the body or comes back after treatment.

Immunotherapy

Immunotherapy is a treatment with medicine that helps your body's immune system kill cancer cells. Your immune system fights off diseases by attacking germs and other cells that shouldn't be in your body. Cancer cells survive by hiding from the immune system. Immunotherapy helps the immune system cells find and kill the cancer cells. Immunotherapy might be used when the cancer spreads to other parts of the body and other treatments haven't helped.

Therapy to help with recovery

Treatment for advanced soft palate cancer can impact your ability to speak and eat. Working with a skilled rehabilitation team can help you cope with changes that result from cancer treatment.

Coping and support

People who are facing a serious illness often say they feel worried about the future. With time, you'll find ways to cope the feelings brought on by a cancer diagnosis. Until you find what works for you, you may find comfort in these strategies:

Ask questions about soft palate cancer

Write down questions you have about your cancer. Ask these questions at your next appointment. Also ask your healthcare team for reliable sources where you can get more information.

Knowing more about your cancer and your treatment options may help you feel more confident in making decisions about your care.

Stay connected to friends and family

You may find comfort in the support of a caring group of your friends and family.

Your cancer diagnosis can be stressful for friends and family too. Try to keep them involved in your life.

Your friends and family will likely ask if there's anything they can do to help you. Think of tasks you might like help with, such as caring for your home if you have to stay in the hospital or just listening when you want to talk.

Find someone to talk with

Find someone you can talk to who has experience helping people facing a life-threatening illness. Ask your healthcare team to suggest a counselor or medical social worker you can talk with. You might find it helpful to talk with other cancer survivors through support groups. Contact the American Cancer Society or ask your healthcare team about local or online support groups.

Preparing for an appointment

Make an appointment with a doctor or other healthcare professional if you have any symptoms that worry you.

If you have soft palate cancer, you may be referred to a doctor who specializes in diseases of the face, mouth, teeth, jaws, salivary glands and neck. This doctor is called an oral and maxillofacial surgeon. You also may be referred to a doctor who specializes in diseases that affect the ears, nose and throat. This doctor is called an ENT specialist or otolaryngologist.

Because appointments can be brief it's a good idea to be prepared. Here's some information to help you get ready.

What you can do

• Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to do in advance, such as restrict your diet.
• Write down symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
• Write down key personal information, including major stresses or recent life changes.
• Make a list of all medicines, vitamins or supplements you're taking and the doses.
• Take a family member or friend along. Sometimes it can be difficult to remember all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot.
• Write down questions to ask your healthcare team.

Your time with your healthcare team is limited, so preparing a list of questions can help you make the most of your time together. List your questions from most important to least important in case time runs out. For soft palate cancer, some basic questions to ask include:

• What is the stage of my cancer?
• What other tests do I need?
• What are my treatment options?
• Is there one treatment that's best for my type and stage of cancer?
• What are the potential side effects for each treatment?
• Should I seek a second opinion? Can you give me names of specialists you recommend?
• Am I eligible for clinical trials?
• Are there brochures or other printed material that I can take with me? What websites do you recommend?
• What will determine whether I should plan for a follow-up visit?

What to expect from your doctor

You are likely to be asked a number of questions. Being ready to answer them may allow time later to cover points you want to address. You may be asked:

• When did you begin experiencing symptoms?
• Have your symptoms been continuous or occasional?
• How severe are your symptoms?
• What, if anything, seems to improve your symptoms?
• What, if anything, appears to worsen your symptoms?