How Does Tonsil Cancer Develop? Symptoms and Treatment of Tonsil Cancer

We call the structures at the back of the throat "tonsils" in medical terminology and tonsil canceroften presents with signs and symptoms resembling other illnesses and is a rare cancer type. As with many cancers, some causes are unclear, but there are well-established risk factors such as HPV infection among these risks.

Tonsil cancer, head and neck cancersinclude it among their subgroups of oral and oropharyngeal (mouth and pharynx) cancers.

The tonsils are part of the immune system. They defend the body against bacteria and viruses entering the mouth or throat.

As with many cancers, tonsil cancer generally has more treatment options when found at an early stage. Early diagnosis increases the chances of successful treatment and recovery.

What Is Tonsil Cancer?

Tonsil cancer consists of tumors arising from cancerous transformation of tonsil cells. Because a small amount of tonsil tissue is often left after tonsillectomy, this cancer can also affect people whose tonsils have been removed.

People who drink alcohol, smoke or have human papillomavirus (HPV) infection have a higher risk of developing tonsil cancer.

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The tonsils are located on both sides toward the back of the throat. Each consists of a collection of lymphatic tissue. Tonsils contain lymphocytes, immune cells that fight infectious diseases.

The tonsils can swell during bacterial or viral upper respiratory infections.

What Are the Symptoms of Tonsil Cancer?

Tonsil cancer signs and symptomsmay include a persistent sore throat, difficulty swallowing, a neck lump and unexplained weight loss. Many complaints caused by tonsil cancer resemble those of beta infection , the name used for streptococcal bacterial infection.

Symptoms Suggesting Tonsil Cancer:

• a white or red patch/spot on the tonsil
• a persistent sore throat
• a feeling of something in the throat that will not go away
• difficulty swallowing
• changes in the person's voice
• a neck lump
• unexplained weight loss

A person should see a doctor if any of these symptoms lasts longer than 2 weeks.

Causes of Tonsil Cancer

Alcohol, tobacco and tobacco product use, and HPV infection are the main risk factors for tonsil cancer.

However, having these risk factors does not necessarily mean a person will develop tonsil cancer; indeed, it is a rare cancer. Age, genetics and many environmental factors may influence whether cancer develops. Nevertheless, as HPV infection becomes more common, among head and neck cancers, especially tongue, palate and tonsil cancer are becoming more frequent.

The mouth is the body's first point of contact with the toxic (harmful) substances in tobacco smoke and alcohol. Tobacco and alcohol damage DNA, the carrier of cells' genetic code and all their information, and this damage triggers many cancers.

HPV is a group of viruses spread through tissue contact — mostly sexual contact. A significant proportion of head and neck cancers are linked to HPV.

How Is Tonsil Cancer Diagnosed?

If tonsil cancer is suspected, the person is usually referred to an ENT (ear, nose and throat) specialist. The specialist may perform other tests and procedures, including biopsy, to check for cancer.

A biopsy is a small tissue sample from the affected area, namely the tonsils. A pathologist examines it under a microscope to look for cancer cells.

Radiological imaging testsare used to help determine the cancer stage (extent of spread). Determining the stage after biopsy is the most important step in selecting the best treatment.

The Stages of Tonsil Cancer Are

• Stage 0: Also known as precancer (a precancerous lesion), when some abnormal cells that could become cancer are present.
• Stage 1: The tumor is smaller than 2 cm and, to other tissues and organs, metastasis has not occurred.
• Stage 2: The tumor is 2–4 cm in size and has not metastasized.
• Stage 3: The tumor is larger than 4 cm and has spread to nearby lymph nodes.
• Stage 4: Cancer has spread to the mouth, throat or other parts of the body.

How Is Tonsil Cancer Treated?

The most important determinants of tonsil cancer treatment are the cancer stage and the patient's overall condition.

Surgical removal of the tumor is the main treatment for early-stage tonsil cancer. Radiotherapy is also used for this cancer type. For mouth and throat cancers, chemotherapy is generally used alongside radiation therapy.

Immunotherapy is a new treatment shown effective in head and neck cancers. In 2016, pembrolizumab and nivolumab received FDA approval for treating stage 4 or recurrent squamous cell head and neck cancers.

Relieving pain and supporting a person with advanced cancer in managing other difficulties is also vital. This is generally known as palliative treatment and focuses on relieving symptoms (complaints) and improving quality of life.

Tonsil cancer and its treatment commonly make eating and drinking difficult. If the patient cannot obtain adequate nutrition because of the cancer or treatment, they may need PEG (Percutaneous Endoscopic Gastrostomy), a feeding tube passing directly through the abdominal skin into the stomach.

Summary

Tonsil cancer is a rare cancer and should be followed and treated by a team experienced in head and neck cancers.

The main risk factors are alcohol, smoking and HPV infection.

Surgery, radiotherapy, chemotherapy and, very recently, immunotherapy have roles in its treatment.

As with many cancers, treatment is easier and outcomes more favorable at an early stage. However, tonsils can swell for many other reasons, including the common cold. Anyone with persistent symptoms who is concerned should consult a doctor.

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