http://www.cancerresearchuk.

org/about-cancer/cancers-in-general/cancer-questions/tonsil-cancer
Tonsil cancer
This page is about tonsil cancer. There is detailed information about this type of cancer in
the mouth and oropharyngeal cancer section. On this page you can find information about
What tonsil cancer is
Risk factors for tonsil cancer
Treatment for tonsil cancer


What tonsil cancer is
Cancer of the tonsil is one of the head and neck cancers. It develops in the part of the throat
just behind your mouth, called the oropharynx (pronounced oar-o-far-rinks). The
oropharynx includes
The back third of your tongue
The soft area at the back of the roof of the mouth (the soft palate)
The tonsils and two ridges of tissue in front of and behind the tonsils
The back wall of your throat
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Risk factors for tonsil cancer
The main risk factors for developing this type of cancer are smoking and regularly drinking a
lot of alcohol. If you smoke and drink a lot together, you increase your risk even further.
Cancer of the tonsil has been linked to a virus called human papilloma virus (HPV). There are
a number of different types of HPV. Some cause warts on the genital area or skin. Other
types increase the risk of some types of cancer including cancer of the cervix, vagina, vulva,
penis and anus. Researchers have found that the type of HPV that increases the risk of these
cancers also increases the risk of oropharynx cancers including cancer of the tonsil. This type
of HPV is called HPV16.
Researchers are looking into how HPV of the mouth is passed on. There is some evidence to
show that it is passed on through sexual contact through oral sex but it may also be passed
on through mouth to mouth contact or in other ways.
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http://www.cancerresearchuk.org/about-cancer/cancers-in-general/cancer-questions/tonsil-cancer
Treatment for tonsil cancer
Your doctor may offer you any of these treatments for oropharyngeal cancer
Surgery
Radiotherapy
Chemotherapy
You may have either surgery or radiotherapy to treat early tonsil cancer. Early means a small
tumour that is still contained within the tonsil. If you have a cancer that is larger, has grown
throughout the tonsil, or has started to grow outside it, you may have surgery followed by
radiotherapy. More advanced cancers that have grown outside the tonsil may need
shrinking before they can be removed. You may have chemotherapy or radiotherapy or both
to try to shrink the cancer. This is called down staging. If the cancer does shrink, you may
then be able to have an operation to remove it.
Advanced cancers cause symptoms such as pain, bleeding and difficulty swallowing. You
may have radiotherapy or chemotherapy or both to help control symptoms.
There are other experimental treatments being investigated, for example, photodynamic
therapy (PDT). For this treatment, you have to take a drug that concentrates in the cancer
cells. The drug is harmless until a bright light is shone onto the cancer cells. This then kills
the cells.
As you can see, treatment depends on how far the cancer has grown. So the first step for
your specialist is to find out
How far your cancer has grown into local tissues
Whether it has spread to nearby lymph glands
Whether it has spread to any other part of the body
This is called staging the cancer. Your doctor will be able to tell you more about which
treatment is best for you once your cancer has been staged.
Surgery
You may be able to have an operation to remove the part of the throat that contains the
cancer. There are different types of operation. The part of your throat removed depends on
the exact site of the tumour. If your cancer is very small, you may only need a very simple
operation. This can be done using local anaesthetic or with laser surgery, and you don't
need to stay overnight in hospital.
For larger more extensive cancers you may need a more complicated operation and need to
stay in hospital for a while. For the most complicated surgery, you may have to have part of
your soft palate or the back of your tongue removed. Your surgeon will rebuild this with
tissue taken from another part of the body. There is more information about this surgery in
the treating mouth and oropharyngeal cancer section.
http://www.cancerresearchuk.org/about-cancer/cancers-in-general/cancer-questions/tonsil-cancer
All types of treatments have side effects. Sometimes surgery to the throat causes a lot of
swelling in the area and makes it difficult to breathe normally. If this is the case then your
surgeon may need to make a hole in your windpipe, at the base of your neck. This hole is
called a tracheostomy and will allow you to breathe while the swelling is there. It is usually
only temporary and will be removed once your wound has healed. There is information
about having a tracheostomy and how it may affect you in the section about living with
mouth and oropharyngeal cancer.
Some operations on the throat can affect your speech. We take it for granted that it is easy
to speak, but it is actually a very complicated process. To produce sound we use our throat,
soft palate, lips, nose, mouth and tongue. If you have surgery to any of these, your speech
may change. This may not be very noticeable and may only be temporary. But sometimes
the change is permanent. If you have any speech difficulties at all, a speech and language
therapist can help you manage. We have information about speech loss and how to cope
with it.
Radiotherapy
You may have radiotherapy
On its own to treat a small tonsil cancer
Either before or after surgery to treat a larger cancer
To help relieve the symptoms of advanced tonsil cancer
Doctors may use both external radiotherapy and internal radiotherapy (brachytherapy) to
treat tonsil cancer. You usually have external radiotherapy treatment once a day for a few
weeks. Brachytherapy is most likely to be used for small cancers. You may have
brachytherapy if your cancer has come back after earlier treatment with external beam
radiotherapy.
There is information about the general side effects of radiotherapy and specific side effects
to the head and neck area in the radiotherapy section.
Chemotherapy
Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer. Chemotherapy has not
always been a treatment of choice for tonsil cancer. But recent research has suggested that
combining chemotherapy with radiotherapy may help as much as surgery for large cancers
of the head and neck, including tonsil cancer. We need further research in this area.
If you have tonsil cancer, you may have chemotherapy before your main treatment to help
shrink the cancer. This is called neo adjuvant treatment. When a cancer is shrunk before
further treatment, this is called down staging. The drugs most commonly used to treat
cancer of the tonsil are
Fluorouracil and
Cisplatin
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Click on the links above to find out the specific side effects of each drug.
It has been found that using these 2 drugs together is more effective in shrinking the cancer
than using one of them alone. Other chemotherapy drugs and combinations have been
tested but none has yet produced results as good as cisplatin and fluorouracil.

Updated: 5 August 2014