Tonsil cancer

Diagnosis

The diagnosis of tonsil cancer involves a thorough examination of the tonsils to determine the size and location of the tumor, as well as checking for any signs of spread to the throat, neck, ears, and nose. This examination may involve the doctor using their hands to feel for swollen lymph nodes in the neck. In certain cases, the healthcare provider may visually observe tonsil cancer lesions in the form of sores, but not all warning signs may be readily apparent. If any irregularities are detected, further tests are typically recommended by the healthcare provider to gather more information and investigate the condition, including:

• Imaging tests: These tests, such as computed tomography (CT) scans, positron emission tomography (PET) scans, and magnetic resonance imaging (MRI), are used to determine if the cancer has invaded nearby structures or other areas of your body.
• 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.

The doctor utilizes information from specific procedures to assign a stage to the cancer. Tonsil cancer stages span from 0 to IV, with the initial stages denoting a small cancer that may be contained within the tonsil or have extended to a few nearby lymph nodes. Advanced stages indicate a more extensive cancer that has spread to numerous lymph nodes or other regions of the body.

Treatment

The choice of tonsil cancer treatment depends on factors such as the size, stage, and HPV status of the cancer, as well as the patient’s overall health and personal preferences. Treatment options for tonsil cancer may include surgery, radiation therapy, or a combination of chemotherapy and radiation therapy.

Medical researchers are currently investigating the possibility of using lower doses of radiation and chemotherapy for individuals with HPV-related tonsil cancer. This alternative treatment approach aims to reduce side effects and early studies suggest that it may be just as effective as higher doses.

• Surgery: The primary objective of surgery for tonsil cancer is to remove the cancerous tissue as much as possible. It can be utilized for all stages of tonsil cancer. In cases where radiation therapy and chemotherapy fail to eradicate the tumor, surgery may be recommended. Additionally, if the cancer has spread to nearby lymph nodes, a neck dissection might be necessary.
• Transoral robotic surgery (TORS): Is an advanced surgical procedure that effectively treats hard-to-access areas in the back of the throat. It is commonly used for early stage tonsil cancer. The utilization of robotic technology in TORS offers several advantages, including reduced surgery duration, shorter hospital stay, and improved swallowing function.
• Radiation therapy: Involves the use of high-energy radiation beams to target and eliminate cancer cells. In the case of early stage tonsil cancer, radiation therapy can be employed to shrink the tumor. Furthermore, it may be used after surgery to eradicate any remaining cancer cells.
• Chemotherapy: Involves the administration of cancer-fighting drugs, either orally or through intravenous means. It is often combined with radiation therapy in the treatment of tonsil cancer. In cases where other treatments are not feasible, chemotherapy may be used to slow down tumor growth and alleviate symptoms.
• Rehabilitation: Plays a crucial role in the recovery process after surgery or radiation therapy. Rehabilitation specialists, including speech therapists, swallowing therapists, dietitians, physical therapists, and occupational therapists, assist in the necessary rehabilitation for patients.