Tonsil Cancer

Tonsil cancer is a type of cancer that develops in the cells of tonsils. Tonsils are two oval shaped pads that are situated on the back of oral cavity often termed as secondary lymphatic organs.

Cancer of tonsils often causes difficulty in swallowing. It is often diagnosed in advanced stages where it has already spread to the surrounding tissues such as tongue and the surrounding lymph nodes.

Treatment includes surgery and radiation therapy is recommended in some cases.

Signs and symptoms of tonsil cancer can be very similar to other conditions like hyperplasia (Increase in number of cells). They include:

• Pain in tonsils
• Nausea
• Vomiting
• Difficulty in swallowing
• Difficulty in speaking
• Increase in size of tonsils excessively and CNS disorder like insomnia.

Common causes of tonsil cancer are:

• excessive use of tobacco,
• harmful ionizing radiation,
• smoking,
• alcohol consumption,
• drug abuse,
• some genetic factors may be involved.

Special tests and procedures are used to diagnose tonsil cancer. They include:

• Physical examination- The doctor will examine the oral cavity and surrounding tissue for signs and symptoms. A small flexible mirror is used to examine the physical properties of tonsils.
• Imaging tests- To understand size, shape and spreading of cancer in oral cavity doctors recommend imaging test like Computerized Tomography (CT), Magnetic Resonance Imaging (MRI) and Positron Emission Tomography (PET).
• Biopsy- A tissue sample of cancer is taken for further laboratory investigation.

Treatment of tonsil cancer that hasn’t spread to surrounding tissue include combination of radiation therapy followed by chemotherapy or surgery.

In Surgery, the goal is to remove the cancer tissue along with some healthy tissue surrounding it to prevent further spreading. Surgery can be used in all stages of tonsil cancer but most effective in early stages. Depending on size, type, location and depth of cancer, the following surgical procedures are recommended:

• Trans Oral Surgery- surgeons remove most of the tumors through mouth and it does not require lengthy reconstruction and rehabilitation of the throat. Cutting tools and lasers are used to remove the cancer.
• Trans Oral Robotic Surgery- this provides more precise access to cancer and is safe, effective and enables faster recovery.
• Open Surgery- in case of large cancers or cancers that have spread in neck, surgeons make an incision in neck to remove the cancer.
• Reconstructive Surgery- this is used in case of advanced cancer which has spread to face jaw and neck. ENT experts work together to restore appearance of face jaw and neck after removal of cancer. In radiation therapy, high powered x-rays are used to kill cancer cells.

This is mostly used in early or advanced tonsil cancer. In some cases, highly advanced radiation therapy known as intensity- modulated therapy is used which targets accurately tumor cells.

In Chemotherapy, special drugs are used which target either dividing cells or cells in rest.

Preventive measures for tonsil cancer include:

• Avoiding tobacco
• Alcohol
• Smoking
• Proper nutrition and avoiding drug abuse.

Treatment of tonsil cancer may affect swallowing and speech. Special rehabilitation centers are available to help cope and recover the situation.

Specialists like physical therapists, occupational therapists and dietitians work together to achieve goal. Doctor may recommend tube feeding. People who heavily use tobacco should join nicotine dependence center to stop its usage.

There are several risks and complications associated with tonsil cancer.

Smoking, tobacco, alcohol and drug abuse are risk factors of tonsil cancer. Genetic predisposition also plays an important role.

Complications include:

• Spreading of the cancer to surrounding tissues
• Depletion of immunity
• Acquiring numerous infections
• Difficulty in swallowing
• Difficulty in speech and in some severe cases even death may occur.