Tonsil Cancer

What is tonsil cancer?

Tonsil cancer occurs when abnormal cells in your tonsils grow out of control, forming tumors or lesions. Tonsil cancer is the most common form of oropharyngeal cancer. You don’t have to have tonsils to get tonsil cancer. Even if you’ve had a tonsillectomy, you can still develop cancer in the tissue that’s left behind.

Who does tonsil cancer affect?

Tonsil cancer can develop at any age, but it’s more common in people over the age of 50. People assigned male at birth (AMAB) are three to four times more likely than people assigned female at birth (AFAB) to develop the condition. Additionally, white people are slightly more likely than Black people to be diagnosed with tonsil cancer.

How common is tonsil cancer?

According to the American Cancer Society, there’s a 1 in 60 chance that males will develop tonsil cancer in their lifetime. For females, there is a 1 in 140 chance. There has been a recent upsurge in tonsil cancer cases due to the increasing prevalence of HPV-related cancers.

Tonsil cancer vs cyst: What’s the difference?

In most cases, tonsil cancer doesn’t involve the formation of cysts. However, tonsil cancer can cause some of the same symptoms as tonsil cysts, including difficulty swallowing and feeling like there’s something stuck in the back of your throat.

What are signs of tonsil cancer?

Some of the most common tonsil cancer symptoms include:

• Lump in the neck.
• A sore or ulcer in the back of the mouth that won’t heal.
• Blood in your saliva.
• Mouth pain.
• One tonsil that’s larger than the other.
• A sore throat that won’t go away.
• Ear pain.
• Difficulty swallowing, speaking or chewing.
• Bad breath (halitosis).

Can you feel tonsil cancer?

Some people with tonsil cancer describe feeling as though something is stuck in their throats. You may also have pain in the mouth, throat or ears. However, symptoms are different for everyone, so the warning signs may not always be obvious.

What causes tonsil cancer?

Experts know that tonsil cancer develops when healthy cells undergo DNA mutations. However, they’re not exactly sure what causes this process to begin with. Research in recent years confirms that HPV (human papilloma virus) plays a significant role in the development of tonsil cancer. Cases that are caused by HPV are typically diagnosed at a younger age and generally respond better to treatment.

In addition, tonsil cancer has been linked to tobacco use and heavy alcohol consumption. People with decreased immunity — such as organ transplant recipients and individuals with HIV — are also more likely to develop tonsil cancer.

How is tonsil cancer diagnosed?

Your healthcare provider will perform a comprehensive examination of your tonsils to assess the size and location of the tumor. They'll also check your throat, neck, ears and nose to determine if the cancer has spread.

Can a doctor see tonsil cancer?

In some cases, yes. Tonsil cancer lesions may appear as sores. Sometimes the signs aren’t so obvious, though. So, if your provider finds anything suspicious, they will likely order more tests.

What tests will be done to diagnose tonsil cancer?

Your healthcare provider may recommend:

• Imaging tests. These tests can tell your provider if the cancer has invaded nearby structures or other areas of your body. Common imaging tests include CT (computed tomography) scans, PET scans and magnetic resonance imaging (MRI).
• Biopsy. To confirm your diagnosis, your healthcare provider may perform an incisional biopsy of the tonsil or a fine needle aspiration biopsy of a lump in the neck. During this procedure, the suspicious cells are sampled from the mouth using a small knife or cells are suctioned from the lump in the neck with a thin needle. Next, the cells are closely examined under a microscope.
• Blood tests. While blood tests aren’t used to diagnose tonsil cancer, they can be helpful in evaluating your overall health prior to treatment.

How is tonsil cancer treated?

There are a few different options. Treatment depends on the size and location of your tumor and whether or not it has spread to other parts of your body. Possible options include:

• Transoral robotic surgery (TORS): This surgical procedure uses sophisticated technology to treat hard-to-reach areas in the back of the throat. TORS is a treatment option for early stage tonsil cancer. Benefits include of using the robotic system are reduced surgery time, shorter hospital stay and improved swallowing function.
• Radiation therapy. This method uses high-energy radiation beams to target and kill cancer cells. Early stage tonsil cancer can be treated with radiation therapy in an effort to shrink the tumor. Radiation therapy may also be used following surgery to kill any remaining cancer cells.
• Chemotherapy. These cancer-killing drugs may be given orally or intravenously. Chemotherapy is often used in combination with radiation therapy. It may also be used to help slow tumor growth and ease symptoms when other treatments aren’t possible.
• Surgery. If radiation therapy and chemotherapy aren’t successful in destroying the tumor, surgery may be recommended. A neck dissection may also be necessary if the cancer has spread to the nearby lymph nodes.

What are common side effects of radiation therapy for tonsil cancer?

Radiation therapy is commonly used to treat cancers of the head and neck. There are possible short-term side effects, including:

• Hoarseness.
• Dry mouth.
• Skin changes, much like a sunburn, in the treated area.
• Loss of taste.
• Difficulty swallowing.
• Soreness or discoloration in the mouth and throat.
• Open sores in the mouth and throat.
• Fatigue.

How long does it take to recover from tonsil cancer treatment?

Recovery times depend on several factors, including the severity of your condition and your own body’s healing capacity. People who undergo TORS for tonsil cancer usually experience the fastest recovery, which typically takes a few weeks.

It usually takes several weeks to complete a course of radiation therapy or chemotherapy for tonsil cancer. And it may be several months before you start feeling like yourself again.

How can I reduce my risk for tonsil cancer?

There are several things you can do to reduce your risk for tonsil cancer:

• Don’t smoke or use tobacco products of any kind.
• Take steps to protect yourself from HPV. This includes getting tested, practicing safe sex and getting the HPV vaccine.
• Undergo routine oral cancer screenings, which help detect tonsil cancer early on.

What can I expect if I have tonsil cancer?

If you’ve been diagnosed with tonsil cancer, you’ll work with a team of healthcare professionals. They will talk with you about your symptoms and discuss your treatment options with you in detail.

Does tonsil cancer spread quickly?

Like most cancers, high-grade tumors tend to spread more quickly than low-grade ones. That’s why it’s so important to see your healthcare provider at the very first sign of trouble.

Is tonsil cancer fatal?

Statistically, tonsil cancer isn’t likely to be fatal. As with most cancers, treatment is most successful when the condition is detected and treated in the early stages. Tonsil cancer that’s related to HPV has an overall survival rate of 85% to 90%. That means that 8.5 to 9 people out of 10 who are diagnosed with tonsil cancer are still alive in five years. Survival rates are estimates only, and they’re based on people who have been diagnosed with tonsil cancer in the past. They can’t tell you how successful your treatment will be or how long you will live. To learn more about survival rates, ask your healthcare provider.

When should I see my healthcare provider?

If you experience symptoms — such as a sore in the back of your mouth, a persistent sore throat or blood in your saliva — for longer than three weeks, call and make an appointment with your healthcare provider. If you’re currently undergoing treatment for tonsil cancer, inform your provider if you notice any new symptoms. They can help ease your discomfort and improve your quality of life.

What questions should I ask my healthcare provider?

If you’ve been diagnosed with tonsil cancer, here are some questions to consider asking your healthcare provider:

• Has my tonsil cancer spread?
• What are my treatment options?
• Will I be able to work and do normal activities during my treatment?
• How long will treatment take?
• What resources are available to me?

A note from Cleveland Clinic

Cancer is a scary word that can bring about feelings of fear, anxiety and uncertainty. But it’s important to know that there are advanced treatment options that can successfully treat tonsil cancer, especially when it’s caught during the early stages. If you’ve been diagnosed with tonsil cancer, consider joining a support group. Talking with others who are going through the same thing can provide emotional and mental support throughout your healthcare journey.