Tonsil Cancer

Tonsil cancer typically attacks the palatine tonsils located at the back of the throat. The tonsils are essentially a filter for what we inhale and ingest and help protect us from infection.

Tobacco use and alcohol consumption have long been linked to various forms of oropharyngeal cancer, including tonsil cancer. New studies are also showing a significant connection between tonsil cancer and infection with human papillomavirus, also known as HPV.

Who is at Risk for Tonsil Cancer?

According to the Journal of Clinical Oncology, approximately 70 percent of tonsil cancer cases can be attributed to HPV infection. This makes HPV the leading cause of oral cancer. It is estimated that HPV will be responsible for more cases of oral cancer than cervical cancer by the year 2020. Other potential risk factors for tonsil cancer include:

• Being male
• Tobacco use
• Drinking excessive alcohol

What are the Symptoms of Tonsil Cancer?

In the early stages, tonsil cancer is often mistaken by the patient for a viral illness, such as a sore throat. Other potential symptoms include:

• A sore throat that does not resolve in 3 weeks
• Difficulty swallowing
• A sensation of a lump in your throat or neck
• Unexplained sores in the mouth and throat
• Persistent mouth pain
• Inflamed and swollen tonsils
• Blood-tinged saliva
• Ear pain
• Neck pain

How is Tonsil Cancer Diagnosed?

The process of diagnosing tonsil cancer begins with a thorough patient history and a targeted physical exam using a variety of techniques, including inspection and palpation. This is typically followed by various imaging and diagnostic tests to confirm the diagnosis and to rule out other potential causes of your symptoms, including:

• CT scan, possibly MRI, and PET scans
• Biopsy
• Endoscopy

What are the Treatment Options for Tonsil Cancer?

Following diagnosis, the UC Irvine tumor board will develop an individualized treatment plan based on the location, size, type, and depth of the tumor. The tumor board includes specialists in head and neck cancer, radiation therapy, medical oncology (chemotherapy specialists), radiologists and pathologists. All your imaging and pathology (biopsy slides) are reviewed as a group and a plan is established that best fits the individual patient. Treatment typically includes one or more of the following:

• Radiation therapy that targets cancer cells with high-energy rays in an effort to destroy the cells. Radiation therapy is most often used in combination with surgery, chemotherapy, or both. Advances in radiation therapy, such as intensity-modulated radiation therapy, have made this form of treatment much more accurate and target-specific, which helps limit radiation exposure and damage to surrounding tissue.
• Chemotherapy uses powerful oral or intravenous medications to slow and disrupt the growth of the cancer cells. Chemotherapy may be used to provide some relief from cancer symptoms and in situations where surgery is not an option. Chemotherapy is frequently used in conjunction with other therapies, including surgery and/or radiation therapy.
• Surgery alone may be effective in treating early-stage tonsil cancer where the tumor is still small and has not metastasized beyond the tonsils. It is also frequently part of the treatment plan for all stages of tonsil cancer. Advanced tumors may require a combination therapy of surgery, radiation, and chemotherapy.