Tonsil Cancer

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What is tonsil cancer?

Tonsil cancer is cancer that occurs in one of the three types of tonsils of the throat. It most commonly occurs in the palatine tonsils, which are located on either side of the throat, although it can also occur in the pharyngeal tonsils (also called adenoids), which are behind the nasal cavity, or in the lingual tonsils, which are at the back of the tongue.

Most tonsil cancers are squamous cell carcinomas, which arise in the lining tissues of the mouth, although it is possible for lymphoma (a type of immune system cancer) to develop in the tonsils. Smoking is the most common risk factor for squamous cell carcinomas of the tonsils. Alcohol is also a risk factor; the combination of smoking and alcohol use yields an even greater risk than using either substance alone.

Symptoms of tonsil cancer include a sore at the back of the throat that does not heal, or one tonsil that is bigger than the other. It may or may not be painful. Tonsil cancer is known to cause bleeding, bad breath, or altered taste. Larger cancers can interfere with eating, talking or breathing, and may make it difficult to open the mouth.

Radiation therapy or surgery can be effective in treating early tonsil cancer, and chemotherapy can be effective in treating more advanced tonsil cancer. Following surgery to remove cancerous tissue, reconstructive surgery can help restore structures that have been removed and rehabilitation can help you relearn how to eat, swallow or talk, if needed.

Some complications of tonsil cancer can be serious. Seek immediate medical care (call 911) for serious symptoms, such as uncontrolled or heavy bleeding or respiratory or breathing problems, such as shortness of breath, difficulty breathing, labored breathing, wheezing, not breathing, or choking. You have the best chance of curing tonsil cancer if you catch it early. Seek prompt medical care if you have bleeding in the throat, notice sores or lumps in the back of the throat, have difficulty eating, swallowing or speaking, or have any other symptoms that concern you.

What are the symptoms of tonsil cancer?

Tonsil cancer may start as a sore at the back of the throat that does not heal. Problems with eating, swallowing and talking may occur, and the sense of taste may be altered. Lymph nodes in the neck may be enlarged and unexplained weight loss may occur.

Common symptoms of tonsil cancer

Common symptoms of tonsil cancer include:

  • Altered sense of taste
  • Bad breath
  • Bleeding
  • Difference in tonsil size
  • Difficulty eating, swallowing or talking
  • Ear ache
  • Hoarseness
  • Lump or sore that does not go away
  • Sore throat
  • Swollen lymph nodes in the neck
  • Throat pain
  • Unexplained weight loss

Serious symptoms that might indicate a life-threatening condition

In some cases, tonsil cancer can be life threatening. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

  • Respiratory or breathing problems such as shortness of breath, difficulty breathing, labored breathing, wheezing, not breathing, or choking

  • Vomiting blood or black material resembling coffee grounds

What causes tonsil cancer?

Although the specific cause of tonsil cancer is not known, several risk factors have been identified, including tobacco use, which is the strongest single risk factor for developing tonsil cancer, and alcohol use. Infection by human papilloma virus plays an important role in the development of genetic changes that initiate the development of cancer.

What are the risk factors for tonsil cancer?

A number of factors increase the risk of developing tonsil cancer. Not all people with risk factors will get tonsil cancer. Risk factors for tonsil cancer include:

  • Age over 50 years

  • Alcohol abuse

  • Chewing betel quid (paan), a popular stimulant in Southeast Asia

  • Compromised immune system due to conditions such as HIV/AIDS, taking corticosteroids, or taking medications for organ transplant

  • Diets low in vegetables and fruits

  • Drinking mate, a tea-like stimulant popular in South America

  • Human papilloma virus (HPV) infection

  • Male gender

  • Smoking or use of other tobacco products

Reducing your risk of tonsil cancer

You may be able to lower your risk of tonsil cancer by:

  • Avoiding betel quid (paan)

  • Avoiding mate

  • Eating plenty of vegetables and fruits

  • Quitting use of tobacco products, including cigarettes and smokeless tobacco

  • Reducing your alcohol intake

How is tonsil cancer treated?

Treatment of tonsil cancer begins with seeking regular medical care throughout your life, including regular dental care. Regular medical care allows a health care professional to provide early screening tests. Regular medical care also provides an opportunity for your health care professional to promptly evaluate symptoms and your risks for developing tonsil cancer.

The goal of tonsil cancer treatment is to permanently cure the cancer or to bring about a complete remission of the disease. Remission means that there is no longer any sign of the disease in the body, although it may recur or relapse later.

Common treatments for tonsil cancer

Common treatments for tonsil cancer include:

  • Chemotherapy to attack cancer cells

  • Participation in a clinical trial that is testing promising new therapies and treatments for tonsil cancer

  • Radiation therapy to attack cancer cells

  • Surgery to remove the cancer and evaluate how far it has spread

  • Targeted therapy to attack cancer cells

Other treatments for tonsil cancer

Other therapies may be added to help with your general state of health and any side effects of treatment:

  • Antinausea medications if nausea occurs

  • Blood cell growth factors to increase the number of white blood cells if these get too low

  • Blood transfusions to temporarily replace blood components, such as red blood cells, that have dropped to low levels

  • Dietary counseling to help maintain strength and nutritional status

  • Pain medications as needed to increase comfort

  • Physical therapy to help with eating, swallowing or talking problems

  • Reconstructive surgery to restore structures that have been removed

Complementary treatments

Some complementary treatments may help some people to better deal with tonsil cancer and its treatments. These treatments, sometimes referred to as alternative therapies, are used in conjunction with traditional medical treatments. Complementary treatments are not meant to substitute for traditional medical care. Be sure to notify your doctor if you are consuming nutritional supplements or homeopathic (nonprescription) remedies as they may interact with the prescribed medical therapy.

Complementary treatments may include:

  • Acupuncture

  • Massage therapy

  • Nutritional dietary supplements, herbal remedies, tea beverages, and similar products

  • Yoga

Hospice care

In cases in which tonsil cancer has progressed to an advanced stage and has become unresponsive to treatment, the goal of treatment may shift away from curing the disease and focus on measures to keep a person comfortable and maximize the quality of life. Hospice care involves medically controlling pain and other symptoms while providing psychological and spiritual support as well as services to support the patient’s family.

What are the potential complications of tonsil cancer?

Complications of tonsil cancer can be serious, even life threatening in some cases. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of tonsil cancer include:

  • Adverse effects of tonsil cancer treatments
  • Decreased ability to eat, drink, talk or breathe
  • Hemorrhage (uncontrolled bleeding)
  • Recurring cancer after treatment
  • Spread of cancer into nearby structures
  • Spread of cancer to distant areas of the body
  • Spread of cancer to lymph nodes in the neck
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Jan 5
  1. Head and neck cancers. National Cancer Institute. http://www.cancer.gov/cancertopics/factsheet/Sites-Types/head-and-neck.
  2. Tonsil cancer. Cedars-Sinai. http://www.cedars-sinai.edu/Patients/Health-Conditions/Tonsil-Cancer.aspx.
  3. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin 2013; 63:11.
  4. Bessell A, Glenny AM, Furness S, et al. Interventions for the treatment of oral and oropharyngeal cancers: surgical treatment. Cochrane Database Syst Rev 2011; :CD006205.
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