Tonsil Cancer

What causes tonsil cancer?

Men are diagnosed with tonsil cancer three to four times more often than women. People are generally diagnosed at age 50 or older, but it can develop at any age. The most significant risk factors for tonsil cancers are tobacco and alcohol use, including smokeless tobacco (snuff and betel nut).

Other potential causes include people with certain infections or decreased immunity, such as:

• Exposure to the human papilloma virus, especially strains 16 and 18.
• Organ transplant recipients
• People with human immunodeficiency virus disease

There are no accepted general risk factors or causes for lymphoma.

What are the symptoms of tonsil cancer?

The symptoms of tonsil cancer include:

• A sore in the back of the mouth that will not heal
• A tonsil that is larger on one side
• Blood in the saliva
• Mouth pain
• Difficulty chewing, swallowing or speaking
• Persistent sore throat
• Intolerance to eating or drinking citrus foods
• Severe ear pain
• Lump or pain in the neck
• Pain when swallowing
• Bad breath

How is tonsil cancer diagnosed?

A doctor will examine the inside of your mouth and back of your throat to check the location and size of the tumor. Examination of the ears, nose, throat and neck are needed to help determine if the tumor has spread.

The doctor may also order tests including:

• Blood tests.
• X-rays to determine if the tumor has spread to the lung.
• Fine needle aspiration biopsy. A thin needle is placed in the mouth. The cells are aspirated (suctioned) and then examined under a microscope to determine if the lump is cancerous.
• Imaging studies to determine if the tumor has invaded nearby tissues or other organs of the body. These may include:
  • Orthopantomography (Panorex). This is a panoramic X-ray of the upper and lower jaw. It shows a view from ear-to-ear and helps determine if a tumor has grown into the jaw bone.
  • Computerized tomography scan.
  • Magnetic resonance imaging.
  • Positron emission tomography (PET) scan. During a PET scan, a small amount of radioactive glucose (sugar) is injected into a vein. The scanner creates computerized pictures of the areas inside the body. Cancer cells absorb more radioactive glucose than normal cells so the tumor is highlighted on the pictures.

How is tonsil cancer treated?

Early-stage tonsil cancer is often treated with radiation therapy. A promising treatment called induction chemotherapy is also used to shrink the tonsil tumor. Advanced cancer cases usually require a combination of surgery, radiation and chemotherapy.

Surgery is used if chemotherapy and radiation do not destroy the tumor. If the lymph nodes in the neck are affected, a neck dissection may be needed to remove the nodes.

Radiation therapy frequently follows surgery. Chemotherapy may be used for palliative therapy (to help relieve symptoms and slow the tumor growth) if surgery is not possible.

Key points

• Cancer of the tonsils usually involves the palatine tonsils on the sides of the throat.
• Men are diagnosed with tonsil cancer three to four times more often than women.
• People are generally diagnosed at age 50 or older but it can develop at any age. The most significant risk factors for tonsil cancers are tobacco and alcohol use.
• Tonsil cancer may be treated by a combination of surgery, radiation and chemotherapy.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

Know how you can contact your provider if you have questions.

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