Oncologist Questions Oncologist

A surgical question?

When cancer has been detected in a tonsil of a 53 year old that has spread to the lymph node...should they be removing the tonsil only? With plans to next insert a feeding tube and port to treat the lymph node with radiation? Should they be removing the lymph node as well, if in fact not before the tonsil? Furthermore, shouldn't they be aware of possibility of any additional mouth cancer before targeting the tonsil, in regard to the problematic excessive bleeding that could occur?

Male | 53 years old
Complaint duration: two weeks

2 Answers

Hello,

You are asking a very perceptive question. Tonsillar Cancer is generally treated aggressively by physicians with the goal of eradicating the cancer when it is diagnosed, with a secondary aim of preventing a recurrence. It is usually treated in a multidisciplinary manner. Unfortunately there is no randomized trial that dictates the best approach and treatment recommendations are patient and physician dependent.

Treatment approaches include surgery with or without lymph node dissections. This is done to control the primary area of the tumor. At times pre-operative chemotherapy can be used to shrink the primary tumor. Post-surgical therapy of radiation with or without chemotherapy is often used to sterilize the primary area where the cancer arose.

More information about treatment approaches can be obtained online at websites including www.cityofhope.org or www.mayoclinic.org. If you search on “Treatment of tonsil cancer” many references will be identified.

Your surgeon is apparently recommending surgical resection of the primary tumor without a lymph node dissection. It is, I think important, that you ask your surgeon this question. There is no definitive treatment approach that defines the primary treatment schedule for this type of cancer. All three types of treatment are effective in controlling this illness.

Good luck.
If the tonsil is the source, it's where the cancer originates. Lymph nodes are not always removed. For head and neck, it's if there are positive.