Cancer of the tonsils occurs predominantly in men. It is strongly linked to smoking and alcohol consumption. Recent evidence suggests that human papillomavirus (HPV) is associated with tonsil cancer as well. People who have HPV-related tumors and who are non-smokers seem to have better survival rates. This cancer often spreads to the lymph nodes in the neck. Cancer of the tonsils occurs most often in people between the ages of 50 and 70.
A sore throat is often the first symptom. Pain usually radiates to the ear on the same side as the affected tonsil. Sometimes, however, a lump in the neck resulting from the cancer's spread to a lymph node (metastasis) may be noticed before any other symptoms. Symptoms of Nose and Throat Disorders: Neck Lump A doctor diagnoses the cancer by performing a biopsy of the tonsil, in which a sample of tissue is removed for examination under a microscope. Evaluation usually includes laryngoscopy (examination of the larynx), bronchoscopy (examination of the lungs), and esophagoscopy (examination of the esophagus). These areas are evaluated because of the high risk of additional cancers being present (up to 10%). A chest x-ray is done, and a computed tomography (CT) scan of the head and neck usually is also done.
About 50% of the people survive for at least 5 years after diagnosis, although the exact number depends on the stage of the cancer at the time of treatment.
Treatment typically includes radiation therapy, surgery, and chemotherapy. Small tumors may be treated with surgery alone or radiation therapy. Large tumors commonly are treated with a combination of chemotherapy and radiation therapy. Surgery may be needed for tumors that do not respond to the combination. Surgery may involve removal of the tumor, lymph nodes in the neck, and part of the jaw. There have been notable advances in the reconstruction used after surgery to remove the cancer, resulting in significant improvements in function and appearance.
Last full review/revision July 2012 by Richard V. Smith, MD