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Tonsil Cancer: Signs, Symptoms and Treatment

Cancer of the tonsils, which occurs in the oropharynx (the area just behind the back of the mouth) is an uncommon type of cancer, comprising only 1 percent of all cancer diagnoses every year. However, while uncommon, mortality rates for tonsil cancer are high. Of the roughly 8,000 cases of tonsil cancer diagnosed each year in the US, about 3,000 (nearly 40 percent) prove fatal.

Tonsil Cancer and the Oropharynx

Along with the tonsils, the oropharynx includes includes:

the back of the throat
the last third of the tongue
the ridges of tissue on either side of the tonsils
the soft palate
the tonsils.

As a result, cancerous cells can propagate in any or all of these regions.

Tonsil Cancer Risk Factors

The single greatest risk factor for tonsil cancer is tobacco use, either in the form of cigarettes or chewing tobacco. Tonsil cancer rates increase the longer one used tobacco products. Similarly, frequent alcohol consumption increases the risk of tonsil cancer. When combined, alcohol and tobacco use increases the risk of tonsil cancer to twice that of using either substance alone.

Other risk factors for cancer of the tonsil include:

AIDS and other immune system diseases
a personal and/or family history of oral or oropharynx cancer
betal nut chewing (in Indian populations)
lack of oral hygiene
poor denture fit (causes gum irritation and traps food)
precancerous plaques (red or white areas of irritation in the mouth)
syphilis.

Statistically, men are more prone to cancer of the tonsils than women, and people of African descent have a higher risk than Caucasians. Additionally, people in lower economic brackets have a higher risk of tonsil cancer than those who are in more affluent groups.

Tonsil Cancer in Children

Tonsil cancer in children is, as a rule, rare: signs of tonsil cancer usually develop in people between the ages of 50 and 70.

Apparent signs of tonsil cancer in children are usually caused by infection, so antibiotics are administered before cancer is even considered. In the majority of cases, "tonsil cancer symptoms" in children can be traced to other causes.

Tonsil cancer takes decades to develop. Children who begin to smoke, drink or chew tobacco early in life put themselves at risk of developing tonsil cancer as adults.

Tonsil Cancer Symptoms

The first signs of tonsil cancer are often a sore throat and pain radiating from the cancerous tonsil to the ear. Mouth sores that do not heal are also possible tonsil cancer symptoms.

Other possible tonsil cancer symptoms include:

bleeding
difficulty chewing
difficulty speaking
difficulty swallowing
localized pain (often radiating to the ears)
problems with face, eye and jaw movements
swollen lymph nodes in the neck.

Tonsil Cancer Treatment

Tonsil cancer treatment depends on the size of the tumor and what stage of development the cancer has reached. Common treatments for tonsil cancer treatments include any combination of the following:

chemotherapy: Chemotherapy, which uses medication (as either pills or injections) to kill cancer cells, can help shrink tonsil cancer tumors prior to surgery. Tonsil cancer chemotherapy usually employs two medications: 5-flurouracil and cisplatin. Taken in combination, the two medications produce better results than either drug used independently.

Chemotherapy is not usually used alone when treating tonsil cancer. Research suggests, however, that a combination of chemotherapy and radiotherapy help treat advanced cancer of the tonsil by reducing the symptoms of this condition.
radiotherapy: Radiotherapy uses radioactive waves to kill cancer cells. Small cancerous growths can be successfully treated with radiation alone. Larger, more advanced cancer of the tonsils may require radiotherapy to shrink the tumor before surgery, followed by post-surgical radiotherapy to kill any remaining cancer cells.
surgery: Surgical removal of tonsil cancer removes the area of the throat containing the tumor. While small tonsil cancer tumors can be removed during day surgery with local anesthetic, larger tumors typically require a hospital stay. The larger the tumor, the more complicated tonsil cancer surgery becomes.

Once the procedure has been done, recovery may require the rebuilding of part of the soft palate and/or tongue may be required. Speech may be affected by tonsil cancer surgery. While this is often a temporary side effect, alterations in speech can be permanent.

Success rates for curing tonsil cancer vary. Approximately 50 percent of patients survive at least five years after diagnosis with proper treatment. After treatment, it is necessary to watch for a return of tonsil cancer symptoms: Signs of tonsil cancer reoccur in 25 percent of patients.

Resources

CancerAnswers (2007). Tongue base and tonsil cancer treatment information. Retrieved June 18, 2007 from the Cancer Answers Web site:
www.canceranswers.com/Tongue.Base.Tonsil.html.

Cancer Research UK (2006). Tonsil cancer. Retrieved June 18, 2007 from the Cancer Research UK Web site:
www.cancerhelp.org.uk/help/default.asp?page=5524.

Mayo Foundation for Medical Education and Research. (2007). Treatment of tonsil cancer at mayo clinic. Retrieved June 18, 2007 from the Mayo Clinic Web site:
www.mayoclinic.org/tonsil-cancer/.

Merck Manuals Online Medical Library. (2003). Tonsillar cancer. Retrieved June 18, 2007, from the Merck Manuals Online Medical Library Web site:
www.merck.com/mmhe/sec19/ch223/ch223e.html.

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