Tonsil cancer is part of a group of cancers that originate in the mouth and throat. These are known as oral and oropharyngeal cancers and are often grouped under head and neck cancers.
The tonsils are part of the immune system. They defend the body against bacteria and viruses that enter the mouth or throat.
If cancer is found at an early stage, there are usually more options available to treat it. This increases the chance of successful treatment and recovery.
What is tonsil cancer?
Symptoms of tonsil cancer may include a sore throat that lasts a long time, difficulty swallowing, a lump in the neck, and unexplained weightloss.
Tonsil cancer begins with cancerous cells or a tumor in the tonsils. It can still affect people who have had their tonsils removed, as some tissue is often left behind after surgery.
People who drink alcohol, smoke, or have human papillomavirus (HPV) have a greater risk of developing tonsil cancer.
The tonsils are found towards the back of the throat, one on either side. Each tonsil is made up of a collection of lymphoid tissue. This is tissue containing lymphocytes, which are cells that fight off disease.
Tonsils catch and destroy bacteria and viruses. They can change in size and often swell with blood to help trap germs, such as when someone has a cold.
Listed below are some of the symptoms that may indicate tonsil cancer:
- a white or red patch on the tonsil
- a sore throat that lasts for a long time
- the feeling of something in the throat that does not go away
- difficulty swallowing
- changes in a person's voice
- a lump in the neck
- unexplained weight loss
A person should see a doctor if any of these symptoms last for more than 2 weeks.
Causes and risk factors
Drinking alcohol and smoking are risk factors for tonsil cancer.
There is no definitive cause of tonsil cancer, but a person's age, genetics, and many environmental factors can influence whether cancer develops.
Risk factors for tonsil cancer include:
- smoking or using tobacco products
- drinking alcohol
- having HPV
When someone smokes a cigarette or drinks alcohol, the substance enters the mouth first. Tobacco and alcohol can harm the DNA or genetic coding in cells, and this damage is linked to cancer. Oropharyngeal and oral cancers happen when cells in the mouth or throat become cancerous.
HPV is a group of viruses that are spread by sexual contact. A significant number of cases of head and neck cancer are linked to HPV, but scientists are still not sure why.
A doctor will ask a person about their medical history, symptoms, and any known risk factors. They will conduct a physical examination by looking at the mouth and throat, and feeling for lumps or anything unusual.
If the doctor thinks there is a possibility of tonsil cancer, they will recommend that a person sees a specialist. A specialist may then do other tests and exams to check for cancer, including a biopsy.
A biopsy is a small sample of tissue taken from the affected area, in this case, the tonsils. The sample is examined under a microscope to look for cancer cells.
Imaging tests that can see inside the body are sometimes used to help determine the extent of the disease. These can check to see how far cancer may have spread or to look for a tumor.
The stage of the cancer depends on its severity and whether it has spread to other parts of the body. Knowing the stage can help doctors determine the best course of treatment.
The stages of tonsil cancer are:
- Stage 0: Also known as precancerous when some abnormal cells are present that could become cancer.
- Stage 1: There is a tumor of less than 2 centimeters (cm) that has not spread.
- Stage 2: There is a tumor of 2–4 cm that has not spread.
- Stage 3: The tumor is bigger than 4 cm and has spread to a surrounding lymph node.
- Stage 4: Cancer has spread to other areas of the mouth, throat, or body.
A biopsy may be taken to diagnose tonsil cancer.
Treatment for tonsil cancer varies and depends on the stage and where tumors are found. Cancer can be complex so different doctors, specialists, and health professionals are likely to be involved in a person's treatment.
Surgery to remove the tumor is usually the first treatment for cancer affecting the mouth and throat. It is likely that the tonsils will be removed if the cancer has not spread.
Surgery also removes some tissue around the tumor, even if it looks normal, to reduce the risk of any cancer cells being left behind.
Radiation therapy may be used to stop the growth of a tumor or to destroy cancer cells.
Chemotherapy uses medication to kill cancer cells, slow their spread, or shrink the size of a tumor to make it easier to operate. It is often used alongside radiation therapy for cancers of the mouth and throat.
New drugs called targeted therapy are being developed to target cancer cells in a precise and selective way. For this reason, targeted therapy may have fewer side effects than chemotherapy.
It is also vital that a person who has advanced cancer is supported to manage their pain. This is often known as palliative treatment and focuses on relieving symptoms and improving quality of life.
Tonsil cancer and its treatment make it hard to eat and drink normally. Some people may need a feeding tube that goes directly into the stomach through the skin to ensure a person is getting enough nutrition.
Tonsil cancer is relatively rare and living with a rare form of cancer can be particularly hard. Understanding the disease and getting information about the treatments available can make the process easier.
Finding cancer in its early stages often means that it is easier to treat. This improves the chances of recovery. Diagnosing tonsil cancer early is critical, and it can be clear that the tonsils are enlarged by looking at them or feeling the throat.
However, the tonsils can swell for many other reasons, including a common cold. Anyone worried about their symptoms should speak to a doctor.