Tonsil Cancer: Symptoms, Diagnosis, Treatment, Prevention

Tonsil cancer is a common type of oropharyngeal cancer. It is a type of head and neck cancer that develops when cells begin to divide and grow abnormally in the tonsils. Tonsils are two oval-shaped glands located at the back of your throat. They are part of your body’s immune system and prevent pathogens from entering the body through the nose or mouth.

The incidence of tonsil cancer is rapidly increasing due to the rising prevalence of human papillomavirus (HPV)-induced malignancies. The prognosis of tonsil cancer can be significantly altered by the presence of HPV.

What are the risk factors of developing tonsil cancer?

Some of the known risk factors for tonsil cancer are:

Smoking or usage of tobacco products
Excessive alcohol consumption
HPV infection - there is evidence that tonsil cancer is related to the human papillomavirus (HPV), a common virus associated with sexually transmitted infections

What are the signs and symptoms of tonsil cancer?

Many individuals with tonsil cancer may not experience any symptoms even after being diagnosed. The main symptom of tonsil cancer is having a tonsil that is larger than the other. A prolonged sore throat is another typical symptom. It is also not uncommon to experience a lump in the neck as the first symptom.

Symptoms may also include:

A persistent sore throat
Ear pain
Difficulty swallowing (dysphagia)
A painless lump in your throat or neck
Blood in saliva
Unexplained weight loss

Having one or more of these symptoms does not mean you have tonsil cancer. Several non-cancerous problems cause the same symptoms.

However, it is important to see a specialist if you have a persistent tonsil infection that does not get better with antibiotics or unexplained ear pain that does not go away.

How do doctors diagnose tonsil cancer?

Diagnosis is made based on various investigations. Your doctor would first question your general health, symptoms, and conduct a thorough physical examination. An examination of your neck and throat would be the first step in diagnosing tonsil cancer. Blood tests may also be requested.

Nasendoscopy
- During the procedure, a small, flexible tube with a light and video camera at one end (endoscope) will be placed into one of your nostrils and then passed down the back of your throat. On a monitor, images captured by an endoscope are presented.
Biopsy
- If any abnormal areas are found, a sample of cells from the affected tonsil may be biopsied for lab testing to look for cancerous cells.
Imaging tests
- Imaging studies help determine the extent of cancer spread. Some of these tests include magnetic resonance imaging (MRI), ultrasound of the neck, positron emission tomography (PET), computed tomography (CT) scan, and a combination of PET-CT scan.

Learn more about the different types of screening and diagnostic procedures performed to diagnose tonsil cancer.

How is tonsil cancer treated?

The treatment of choice for tonsil cancer depends on the size and stage of the cancer. The key therapies used are surgery, chemotherapy, radiotherapy, and targeted therapy.

Surgery
- Endoscopic surgery used in early stages of tonsil cancer include transoral laser microsurgery (TLM) and transoral robotic surgery (TORS).
- Selective neck dissection involves the removal of lymph nodes in selected areas of your neck. These lymph node tissue samples are sent to the laboratory to be examined.
Chemotherapy
- Chemotherapy is a cancer treatment that employs potent cancer-killing medications.
- Chemotherapy can be given before surgery to shrink tumour size and after surgery to destroy the remaining cancer cells and to reduce the rate of spread of cancer.
- Chemotherapy can be given in combination with radiation therapy.
Radiation therapy (radiotherapy)
- Radiotherapy uses high-energy radiation to shrink tumours and destroy cancer cells and to relieve symptoms associated with advanced cancer.
- Radiotherapy can be given before surgery to shrink tumour size, reduce the rate of spread of cancer, and in combination with chemotherapy.
Targeted therapy
- Targeted therapies are medications aimed at inhibiting the progression of advanced tonsil cancer.
- Cetuximab is an example of targeted cancer medicine.
Immunotherapy
- This is an advanced procedure in which specific drugs boost the body’s natural immune system to fight cancer cells. The drugs that are used for this purpose are known as checkpoint inhibitors.
- Immunotherapy is mostly reserved for those with advanced tonsil cancer.

Learn more about the different types of treatment technologies to treat tonsil cancer.

What can I do to reduce the risk of developing tonsil cancer?

Following are some medically recommended tips and lifestyle changes to reduce the risk of developing tonsil cancer:

Stop smoking and avoid second-hand smoke. The best time to quit smoking is now! Talk to your doctor about the strategies available to quit smoking.
Stop usage of tobacco in any form.
Limit consumption of alcohol.
Get vaccinated against HPV and practise safe sex.
Regularly visit the dentist to check for any cancerous or pre-cancerous indications in your oral cavity.

Do I need to get screened for tonsil cancer?

There is no available routine screening test for oropharyngeal cancers. However, routine oral examinations by a dentist or doctor can identify pre-cancerous lesions and allow for prompt treatment. For those with a higher risk of developing these cancers, particularly those who regularly smoke or consume alcohol, it is advised that they self-examine their oral cavity every month.

Make an appointment at Pantai Hospitals

Early detection of tonsil cancer makes it easier to treat the disease with effective and appropriate treatment. A dedicated multidisciplinary team of specialists and oncologists at Pantai Hospitals is available for consultation to provide the best care and assistance to patients through screening, diagnosis, and treatment.

Get in touch with us to book an appointment today if you have any concerns or questions about tonsil cancer treatment options.

Pantai Hospitals have been accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.