Tonsil Cancer

Tonsil cancer is a type of head and neck cancer that originates in the tonsils, which are part of the lymphatic system. This cancer is often associated with risk factors such as smoking, heavy alcohol use, and certain viral infections, including the human papillomavirus (HPV). 

Tonsil cancer can present symptoms such as a persistent sore throat, difficulty swallowing, and unexplained weight loss. These symptoms are often mistaken for less serious conditions, which can delay diagnosis. Regular check-ups and awareness of the risk factors are essential in reducing the likelihood of late-stage diagnosis, where treatment options may become more complex and less effective.

What is Tonsil Cancer? 

Tonsil cancer occurs when tonsil cells begin to grow uncontrollably and form a malignant tumor. Doctors may call this form of cancer tonsil carcinoma. Tonsils are the two pieces of flesh on either side of the back of the throat. The tonsils contain white blood cells, which help fight infections. At one time, tonsillectomy—surgical removal of the tonsils—was a common operation in children who had frequent infections in these tissues. Other treatments are available today, though the procedure is still performed occasionally, including for treatment of sleep-related breathing disorders, as well as for some cases of tonsil cancer.

Tonsil cancer occurs when abnormal cell growth in the tonsils leads to the formation of a malignant tumor, often referred to as cancer of the tonsil. While peritonsillar abscess is a different condition that involves a collection of pus beside the tonsil, it can sometimes be mistaken for tonsil cancer due to similar symptoms like a sore throat and difficulty swallowing. The treatment options for tonsil cancer may include surgery, radiation therapy, and chemotherapy, depending on the stage and spread of the disease.

What is the First Sign of Tonsil Cancer? 

One of the first signs a doctor will look for in diagnosing tonsil cancer is enlargement of one tonsil. (If both tonsils are enlarged, cancer is less likely to be the cause.) Other signs and symptoms of tonsil cancer include: 

• Chronic sore throat 
• Hoarse voice 
• A lump in the neck or throat 
• Pain or difficulty when swallowing 
• Blood in the saliva 
• Bad breath 
• Pain in the ear or jaw 

In addition to the first signs of tonsil cancer, such as the enlargement of one tonsil, it is important to differentiate it from a tonsil abscess, which can present similar symptoms like a sore throat and difficulty swallowing. As tonsil cancer progresses, the stages of the disease may reveal more severe symptoms, including persistent pain in the ear or jaw and the presence of a lump in the neck or throat. Early diagnosis and understanding the stages are crucial for effective treatment and better prognosis.

How Common is Tonsil Cancer? 

Tonsil cancer is the most common form of oropharyngeal cancer, which affects the mouth and throat and represented 2.8% of all cancers diagnosed in the United States in 2022. The National Cancer Institute estimates that about 54,000 Americans were diagnosed with oropharyngeal cancer in 2022; slightly less than one quarter of all these cancers occur in the tonsils. Population studies indicate that tonsil cancer is becoming more common in the United States and some other countries. This increase is attributed to cases of tonsil cancer that are associated with infection with the human papilloma virus (HPV; see below). While tonsil cancer was once associated primarily with certain lifestyle choices, in many parts of the world, HPV infection is now the primary cause. For instance, in Western Europe, 93% of tonsil cancer cases are linked to HPV infections, according to one study.  

Tonsil cancer is increasingly recognized as a significant health issue, especially in relation to the growing prevalence of HPV-related cases. While traditionally associated with lifestyle factors such as smoking and alcohol consumption, the rise in cancer on tonsil cases linked to HPV infection has been notable in many regions, including Western Europe, where a study found that 93% of cases were connected to the virus. It is important to distinguish these cases from conditions like abscess of the tonsil, which, although painful and requiring medical attention, does not carry the same risks as malignancies. The increase in HPV-related tonsil cancer highlights the importance of public health initiatives focused on vaccination and early detection.

Does Tonsil Cancer Spread Quickly? 

Tonsil cancer is often diagnosed at an advanced stage. Cancer that has reached advanced stages tends to spread aggressively. For this reason, seeing your doctor at the earliest sign or symptom of tonsil cancer is essential.  

Tonsil cancer is often diagnosed at an advanced stage, which significantly complicates treatment and increases the risk of aggressive spread to other parts of the body. This underscores the importance of early detection and prompt medical consultation at the first sign of symptoms. While tonsil stones are generally benign and caused by the accumulation of debris in the crevices of the tonsils, there is a misconception that tonsil stones can cause cancer. However, there is no scientific evidence directly linking tonsil stones to cancer development. Despite this, the dangers of tonsil stones should not be entirely dismissed, as they can lead to chronic inflammation or infection, which may increase the risk of other complications. Nonetheless, tonsil stones themselves are not a cancer risk, but maintaining oral hygiene and monitoring any unusual symptoms is critical for overall throat health.

What Causes Tonsil Cancer? 

Doctors have identified several risk factors that make a person more likely to develop tonsil cancer. They include: 

• Prior infection with HPV, a common sexually transmitted disease.  
• Smoking and other forms of tobacco use 
• Heavy consumption of alcohol 

Having the HPV infection does not guarantee that you will develop tonsil cancer, but you should speak to your doctor about screening for this and other forms of cancer. Likewise, smoking and heavy consumption of alcohol will not necessarily cause tonsil cancer, but both are unhealthy habits—and curbing both of them will have other significant and long-lasting benefits in terms of lowering your risk for many other diseases.  

Tonsil cancer is influenced by several risk factors, including HPV infection, smoking, and heavy alcohol consumption. It’s important to distinguish between tonsil cancer and other conditions such as tonsil stones. While tonsil cancer stones is not a recognized medical term, some may mistakenly associate tonsil stones with cancer. However, tonsil cancer vs tonsil stones presents a clear difference: tonsil cancer is a malignant condition that requires medical treatment, whereas tonsil stones are benign accumulations of debris in the tonsils, often causing discomfort but not posing a cancer risk. Understanding these distinctions is crucial for recognizing the symptoms and seeking appropriate medical advice.

Is Tonsil Cancer Curable? 

Many patients with tonsil cancer respond well to treatment. In cancer, doctors use the five-year survival rate to estimate a patient’s prognosis. Among patients with tonsil cancer, those who are positive for HPV have a 71% five-year survival rate, meaning that 71 out 100 patients will be alive five years after diagnosis, according to one study. For patients whose tonsil cancer is not related to HPV, the five-year survival rate is lower, 46%. A patient with tonsil cancer is also more likely to be cured by treatment if he or she: 

• Does not smoke 
• Is relatively young 
• Had a small tumor 
• Did not have cancer that spread to lymph nodes 
• Does not have other significant health problems 
• Had a positive test for the presence of tumor-invading lymphocytes, which kill tumor cells

Many patients with tonsil cancer respond well to treatment, with survival rates varying depending on several factors. While tonsil stones are often a source of discomfort and bad breath, they are generally not considered harmful or related to cancer. However, it’s important to differentiate between benign conditions like tonsil stones and more serious diagnoses such as tonsil cancer. Factors like smoking, age, tumor size, and overall health also play a critical role in determining a patient’s prognosis and likelihood of successful treatment.

Are Tonsil Stones a Sign of Cancer? 

Tonsil stones are not a sign of cancer. A tonsil stone is a small lump that can form on a tonsil. They’re called “stones” because they feel firm and, in some cases, may be painful. Also called tonsilloliths, these formations are made of bacteria and food debris that get caught in the tonsils. While they can produce bad breath, tonsil stones do not cause cancer. Tonsil stones can often be removed with a water pick or swab, or by gargling. If they persist, a doctor may recommend a tonsillectomy (removal of the tonsils).

Tonsil stones are not an indication of cancer, and there is no evidence that they lead to cancer. It’s important to distinguish between tonsil stones or cancer when assessing symptoms. Tonsil stones, or tonsilloliths, are benign formations caused by the accumulation of debris and bacteria in the tonsils. 

In addition, squamous cell carcinoma in the tonsil is a type of cancer of the tonsils that requires medical attention and treatment. Despite concerns, tonsil stones cancer is not a medically recognized condition, and can tonsil stones cause cancer is a misconception. Tonsil stones do not transform into cancer; however, any persistent or unusual symptoms should be evaluated by a healthcare professional to rule out serious conditions.

How is Tonsil Cancer Diagnosed?

A doctor will begin by closely examining the tonsils, as well as the throat, neck, and other tissues. In some cases, a doctor may be able to see a lesion, or cancerous formation, on a tonsil. To confirm the diagnosis, the doctor will remove a small piece of tissue from the lesion, using either a scalpel or a fine needle (known as aspiration). This tissue is then sent to a lab, which will test it for the presence of cancer cells. Doctors also use imaging tests to determine where the cancer is and whether it has spread, such as computed tomography (CT) scans, magnetic resonance imaging (MRI) scans, and positron-emission tomography (PET) scans. Your doctor may also order blood tests as part of diagnosis of tonsil cancer.  

To diagnose tonsil cancer, a doctor will start with a thorough examination of the tonsils, throat, neck, and surrounding tissues. If a lesion or suspicious area is visible on the tonsil, the doctor may take a biopsy, either with a scalpel or through fine needle aspiration, to analyze the tissue for cancer cells. Imaging tests like CT scans, MRI scans, and PET scans help determine the extent and spread of the cancer. Blood tests may also be conducted as part of the diagnostic process. It’s important to note that while HPV infection is a known risk factor for tonsil cancer, tonsil stones are not related to cancer and do not indicate its presence.

How is Tonsil Cancer Treated? 

Doctors take a number of factors into consideration when planning a treatment regimen for tonsil cancer, including the patient’s age and overall health, the stage of the cancer, whether it has spread, and whether the cancer is related to HPV.  

Surgery: Early-stage tonsil cancer is usually treated with surgery. At many hospitals, new technology called transoral robotic surgery is used, which is associated with shorter hospital stays and improved post-surgical swallowing. During surgery, lymph nodes in the neck may also be removed to determine if cancer has migrated from the tonsils.  

Radiation therapy: This common cancer treatment uses beams of high energy to kill malignant cells. Radiation may be used before surgery to shrink the tumor or after to kill any remaining cancer cells.  

Chemotherapy: Another common cancer treatment, chemotherapy is the use of various drugs that directly attack and kill cancer cells. Chemotherapy is often combined with radiation for treatment of tonsil cancer.  

In addition to these treatment options, it is important to understand the differences between tonsil cancer and tonsil stones. While tonsil stones are harmless calcifications that can cause discomfort, they do not indicate cancer. On the other hand, tonsil SCC (squamous cell carcinoma) is a serious form of cancer that requires prompt medical attention and a tailored treatment plan. Some patients may also experience calcification on tonsils, which is typically benign and unrelated to cancer, but should still be monitored by a healthcare professional to rule out any potential complications. Recognizing these distinctions is crucial in ensuring proper diagnosis and treatment.