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Tonsil cancer is the most common malignant neoplasm of the throat and mouth and accounts for 46% of all cancers in the area of ​​the mouth. What are the causes and symptoms of tonsil cancer and how is it treated?


  1. Tonsil cancer - risk factors
  2. Tonsil cancer - symptoms
  3. Tonsil cancer - diagnosis
  4. Tonsil cancer - treatment
  5. Tonsil cancer - prognosis

Tonsil canceraffects mainly men over 50 and is associated with, among others, smoking and alcohol abuse.

Tonsil cancer - risk factors

Tonsil cancer risk factors include:

  • over 50
  • male gender
  • smoking
  • alcohol abuse
  • human papillomavirus (HPV) infection

Tonsil cancer - symptoms

A common symptom is an obstruction in the throat when swallowing and a sore throat.

In the later stages of the disease it may occur:

  • szczękościsk
  • bad breath
  • excess saliva production
  • tumor in the neck area

Otalgia is also not uncommon. This is a symptom of earache that is not related to an underlying medical condition. This is due to the joint innervation of the head and neck area, so pain in other areas of the head, such as the palatine tonsil, moves to the ear.

During the medical examination, you can notice ulceration of the tonsil, its immobilization, asymmetrical enlargement of one of the tonsils, as well as an infiltration of the palate and throat.

Tonsil cancer has a tendency to rapidly form distant metastases. The most common metastases are in the cervical lymph nodes, causing a tumor in the neck area. Metastases can also occur in the lungs, liver and bones.

Tonsil cancer - diagnosis

In the case of diseases of the palatine tonsils, the inflammatory etiology is most often taken into account. If, after taking anti-inflammatory drugs, symptoms do notdisappear, diagnostics for neoplastic disease should be implemented.

The first stage is an ENT examination involving the magnification of the tonsils. In most cases, tonsil cancer is one-sided, and it is extremely rare for a cancer that affects both tonsils at the same time.

The ENT examination states:

  • ulcer
  • swelling
  • necrotic areas
  • asymmetrical magnification of one tonsil

Such an image in an ENT examination raises the suspicion of a tumor of the palatine tonsil.

The next diagnostic stage is taking a tumor sample and histopathological examination. 90% of palatine tonsil cancers are histopathologically squamous cell carcinomas.

If cancer is at an advanced stage, imaging tests should be performed - X-rays or computed tomography of the chest in order to exclude the presence of distant metastases.

Tonsil cancer - treatment

There are 3 basic treatments for tonsil cancer.

The first method is surgical treatment involving the removal of the palatine tonsil with a margin of he althy tissue. Sometimes the patient's condition requires the removal of the palatal arches and the root of the tongue.

This method, as a standalone treatment method, is used only in the case of low or medium clinical stage, without distant metastases.

Sometimes, in addition to the palatine tonsil, the surrounding lymph nodes are also removed. The scope and method of the operation, however, depends on the individual assessment of each case.

Another method used in the treatment of tonsil cancer is radiotherapy. Modern methods of treatment allow the use of high doses of radiation allowing the tumor size to be reduced while protecting the surrounding he althy tissues. Most often, such treatment takes about 7 weeks.

Chemotherapy for tonsil cancer can be used as a standalone treatment, but it is used in cases of tumor spread and distant metastases, or in the case of cancer recurrence.

Combination of chemotherapy with surgery or radiotherapy is much more common. At the start of treatment, chemotherapy is given to reduce the weight of the tumor, this is called treatment induction, followed by radiation therapy or surgery.

Tonsil cancer - prognosis

Prognosis is always judged on a case by case basis as it depends on the degreethe advancement and course of the disease.

The presence of distant metastases, infiltration of surrounding tissues, inoperability of the tumor or lymph node involvement, as well as general organism exhaustion significantly worsen the prognosis.

Overall, the effectiveness of the treatment is estimated at 30-40%, and in the case of distant metastases, this percentage decreases to 15%.

After the end of treatment, frequent check-ups are very important due to the high tendency for the tumor to recur.

In most centers treating tonsil cancer, it is assumed that a follow-up examination in the first year after treatment should be planned once a month, in the second year every 2 months, in the third year every 3 months, in subsequent years 2 times a year.

Due to the increased risk of developing another type of cancer of the head and neck area, as well as of the respiratory system, the patient should be under medical care throughout his life.

Tonsil cancer is a dangerous cancer with a rapid growth, so it is important to see a doctor quickly if you notice any disturbing symptoms, such as difficulty swallowing, persistent pain or hoarseness.

It is assumed that if the disturbing symptoms of the tonsils persist for about 10-14 days, you should see a doctor in order to start the diagnosis and implement the appropriate treatment.

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About the authorBow. Agnieszka MichalakA graduate of the First Faculty of Medicine at the Medical University of Lublin. Currently a doctor during postgraduate internship. In the future, she plans to start a specialization in pediatric hematooncology. She is particularly interested in paediatrics, hematology and oncology.

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