Tonsil Cancer: Causes, Symptoms, Signs, Prognosis and Treatment

What is Tonsil Cancer?

Tonsil cancer is malignant abnormal cell growth in the tonsils. It is a form of oropharyngeal (related to the mouth and pharynx or throat) cancer.

About Tonsil Cancer

Your tonsils are the lymph nodes that sit at the back of your mouth. These form a crucial part of the germ-fighting mechanism of your body or immune system. 

Tonsils work as a protective shield that guards the entry of viruses, bacteria, and other pathogens that invade your body via the oropharyngeal route.

An HPV (human papillomavirus) infection, smoking, and drinking are more likely to put you at a higher risk of developing tonsil cancer. The NIH (National Institutes of Health) notes that around 93% of the Western European people with throat and mouth cancer also have human papillomavirus infection.

Tonsil cancer often makes swallowing difficult, and people with this condition are likely to feel there is something stuck in their throats. Although tonsil cancer is diagnosed late in most cases, like other types of cancers, early medical intervention increases treatment options and the likelihood of successful recovery.

What are the Symptoms of Tonsil Cancer?

Some people experience no signs and symptoms until cancer has already started spreading. And even if the symptoms surface, these are often similar to other conditions, such as tonsillitis or strep throat. Some common symptoms of tonsil cancer include the following:

• Difficulty swallowing
• Difficulty chewing
• Persistent sore throat and pain in the ear
• The appearance of red or white spots on the tonsils
• Problems consuming citrusy foods and drinks
• The formation of a lump in the throat or neck
• Losing weight without trying
• Stiffness in the jaw
• Saliva tinged with blood
• Pain in the back of your neck

When Do You Need Medical Help?

If the symptoms do not go away even after two weeks, you should contact doctor immediately.

Request an appointment at Apollo Hospitals

How Can You Prevent Tonsil Cancer?

You can minimize the risks of developing tonsil cancer by following the preventive measures given below: 

• Quit smoking and using tobacco: If you use tobacco (in any form) or smoke, stop it right away. If you find it hard to quit, get in touch with your doctor to discuss the strategies.
• Limit alcohol consumption: If you drink alcohol, make sure to do so in moderation. Men and women may drink up to two and one drink per day, respectively as the maximum .
• Pay regular visits to your dental clinic: Your dentist can help identify any precancerous changes in your mouth .
• Get vaccinated: Talk to your doctor and ask if an HPV vaccine is the right choice for you.

What are the Treatment Options for Tonsil Cancer?

1. Your doctor will ask you about your symptoms, medical history, and any possible risk factors before diagnosing the condition . Your doctor will also use tiny camera or a mirror to examine your mouth and the throat. The doctor may use his/her hands to feel the neck to check for enlarged lymph nodes.The doctor will remove an area of suspicious tissue and send the same to a laboratory for testing. The tissue sample will also be tested for HPV and cancer.
2. To better understand the size and to estimate if the cancer has spread beyond the tonsils, your physician may recommend imaging tests like computerized tomography (CT) scan, magnetic resonance imaging (MRI) scan and positron emission tomography (PET).

If the tests confirm tonsil cancer, the doctor will base the course of treatment based on two factors:

• The stage of cancer (the extent to which it has spread). 
• The grade or type of cancer (the speed of its growth). 

The treatment options for tonsil cancer include the following:

Surgery: Tonsil cancer surgery aims to remove the tumor or cancer as much as possible. Your doctor is likely to suggest surgery, regardless of the stage of tonsil cancer. This surgery is mainly transoral, where your doctor passes specialized medical devices through your mouth to access the affected area and remove the tumour  using lasers or cutting instruments.

In some cases, especially if the cancer is too large or has spread to the lymph nodes, your doctor is likely to make a prominent cut in the neck and do a more extensoive resection . In such scenarios, reconstructive surgery(s) and rehabilitation becomes necessary to restore normal functioning, including speaking, eating, swallowing, and chewing.

Radiation therapy: High-powered energy beams like protons or X-rays to destroy or shrink the cancer cells.

Your doctor is likely to use this therapy if:

• The cancer is limited to the tonsils.
• They cannot remove the cancer cells completely.
• There is a chance of cancer spreading to the lymph nodes.

Your doctor may also use radiation therapy along with chemotherapy to increase the effectiveness of the procedure.

Chemotherapy: This treatment procedure uses medications to destroy the cancer cells, reduce their size, or reduce the rate of spread. Although it kills the cancer cells, it also affects healthy cells leading to many side effects. Your doctor is likely to discuss this aspect of chemotherapy before the treatment starts.

Rehabilitative therapies: Your doctor may refer you to various rehabilitation specialists for speech, swallowing, occupational, and physical services so that you can get back to normal at the earliest. Your doctor may also recommend seeing a dietitian who will help you find an appropriate diet.

Conclusion

Although relatively rare, it is essential to be aware of the symptoms of tonsil cancer and make sure to visit your doctor as soon as you experience any symptom . Early detection can help your doctor provide you with the best and most appropriate course of treatment. 

Frequently Asked Questions (FAQs)

1. What are the stages of tonsil cancer?

There are four stages of tonsil cancer – Stage 0, Localized, Regional, and Disant.

• Stage 0: In this state, the tonsil cells undergo some changes. Although these cells are still precancerous, they cannot be calssified as cancer and do not spread.
• Localized or Stage 1: Cancer cells have developed on your tonsils in this stage. However, they have not yet spread.
• Regional Stage: In this stage, cancer has started spreading to the nearby tissues or lymph nodes, and in some cases, your epiglottis too. 
• Distant: In this stage, cancer happens to spread to other parts of the body, including the jawbone, liver, lungs, among others.

2. What are the causes of tonsil cancer?

Although the causes of tonsil cancer are not clear, according to the American Head and Neck Society (AHNS), certain risk factors increase the chances of developing tonsil cancer. They include the following:

• Pathogens: People who have HIV (human immunodeficiency virus) or HPV infection are at a higher risk of developing tonsil cancer.
• Environmental factors: If you smoke, consume tobacco, or drink alcohol heavily, it might put you at risk of tonsil cancer.

3. I have got big holes in my tonsils. Is that normal?

Holes in the tonsils, or tonsillar crypts, are a normal part of a person’s anatomy. However, these holes at the back of the throat can trap bacteria and become blocked with food particles, mucus, and other debris.