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Tonsil cancer occurs when abnormal cells in the tonsils grow uncontrollably, resulting in the formation of tumors or lesions. The tonsils, which are two oval-shaped pads in the back of the mouth, play a role in the body’s immune system. Tonsil cancer is the most common type of oropharyngeal cancer, and its occurrence is often associated with infection by the human papillomavirus (HPV). However, it can also be caused by excessive alcohol consumption and tobacco use.
Symptoms of tonsil cancer include difficulty swallowing and a feeling of having something stuck in the throat. Unfortunately, tonsil cancer is often diagnosed at a late stage when it has already spread to nearby areas, such as the neck’s lymph nodes. It’s important to note that one can develop tonsil cancer even after having their tonsils removed.
Treatment options for tonsil cancer typically involve surgery, radiation therapy, and chemotherapy.
Symptoms
Symptoms commonly associated with tonsil cancer are as follows:
- Difficulty in swallowing, speaking, or chewing.
- A feeling of having an obstruction or object stuck in the back of the throat.
- Blood in the saliva.
- Pain and swelling in the neck.
- Ear pain.
- Presence of a persistent sore or ulcer at the back of the mouth that does not heal.
- Jaw stiffness
- Persistent bad breath (halitosis).
If you notice any persistent signs and symptoms that concern you, it is advisable to schedule an appointment with your doctor or dentist.
Causes
Tonsil cancer occurs when the DNA of healthy cells in the tonsils undergoes changes, leading to uncontrolled growth and survival of these cells. This abnormal cell growth forms a tumor that can spread to other parts of the body. While the exact cause of this process is still not fully understood, recent research has shown that the human papillomavirus (HPV) plays a significant role in the development of tonsil cancer. Tonsil cancer cases associated with HPV are typically diagnosed at a younger age and generally have better treatment outcomes. Additionally, tobacco use and heavy alcohol consumption have been linked to tonsil cancer, and individuals with compromised immune systems, such as organ transplant recipients and those with HIV, are also at a higher risk of developing the disease.
Risk factors
Tonsil cancer can occur to anyone at any age. Several factors may contribute to one’s risk of acquiring it, such as:
- Age: People over the age of 50 have a higher risk of developing tonsil cancer.
- Gender: People who are male at birth are three to four times more likely to acquire the disorder than people who are assigned female at birth.
- Tobacco use: Smoking or heavy use of tobacco products of any kind may increase the risk of tonsil cancer.
- Alcohol consumption: Excessive consumption of alcoholic beverages may contribute to one’s risk.
- Human papillomavirus (HPV): Exposure to HPV infection can contribute to the risk of tonsil cancer.
Diagnosis
The diagnosis of tonsil cancer involves a thorough examination of the tonsils to determine the size and location of the tumor, as well as checking for any signs of spread to the throat, neck, ears, and nose. This examination may involve the doctor using their hands to feel for swollen lymph nodes in the neck. In certain cases, the healthcare provider may visually observe tonsil cancer lesions in the form of sores, but not all warning signs may be readily apparent. If any irregularities are detected, further tests are typically recommended by the healthcare provider to gather more information and investigate the condition, including:
- Imaging tests: These tests, such as computed tomography (CT) scans, positron emission tomography (PET) scans, and magnetic resonance imaging (MRI), are used to determine if the cancer has invaded nearby structures or other areas of your body.
- Biopsy: To confirm your diagnosis, your healthcare provider may perform an incisional biopsy of the tonsil or a fine needle aspiration biopsy of a lump in the neck. During this procedure, the suspicious cells are sampled from the mouth using a small knife or cells are suctioned from the lump in the neck with a thin needle. Next, the cells are closely examined under a microscope.
- Blood tests: While blood tests aren’t used to diagnose tonsil cancer, they can be helpful in evaluating your overall health prior to treatment.
The doctor utilizes information from specific procedures to assign a stage to the cancer. Tonsil cancer stages span from 0 to IV, with the initial stages denoting a small cancer that may be contained within the tonsil or have extended to a few nearby lymph nodes. Advanced stages indicate a more extensive cancer that has spread to numerous lymph nodes or other regions of the body.
Treatment
The choice of tonsil cancer treatment depends on factors such as the size, stage, and HPV status of the cancer, as well as the patient’s overall health and personal preferences. Treatment options for tonsil cancer may include surgery, radiation therapy, or a combination of chemotherapy and radiation therapy.
Medical researchers are currently investigating the possibility of using lower doses of radiation and chemotherapy for individuals with HPV-related tonsil cancer. This alternative treatment approach aims to reduce side effects and early studies suggest that it may be just as effective as higher doses.
- Surgery: The primary objective of surgery for tonsil cancer is to remove the cancerous tissue as much as possible. It can be utilized for all stages of tonsil cancer. In cases where radiation therapy and chemotherapy fail to eradicate the tumor, surgery may be recommended. Additionally, if the cancer has spread to nearby lymph nodes, a neck dissection might be necessary.
- Transoral robotic surgery (TORS): Is an advanced surgical procedure that effectively treats hard-to-access areas in the back of the throat. It is commonly used for early stage tonsil cancer. The utilization of robotic technology in TORS offers several advantages, including reduced surgery duration, shorter hospital stay, and improved swallowing function.
- Radiation therapy: Involves the use of high-energy radiation beams to target and eliminate cancer cells. In the case of early stage tonsil cancer, radiation therapy can be employed to shrink the tumor. Furthermore, it may be used after surgery to eradicate any remaining cancer cells.
- Chemotherapy: Involves the administration of cancer-fighting drugs, either orally or through intravenous means. It is often combined with radiation therapy in the treatment of tonsil cancer. In cases where other treatments are not feasible, chemotherapy may be used to slow down tumor growth and alleviate symptoms.
- Rehabilitation: Plays a crucial role in the recovery process after surgery or radiation therapy. Rehabilitation specialists, including speech therapists, swallowing therapists, dietitians, physical therapists, and occupational therapists, assist in the necessary rehabilitation for patients.
