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At UT Southwestern Medical Center, our cancer teams are dedicated to providing exceptional care for people with head and neck cancer, including tonsil cancer. We provide comprehensive care from screening and diagnosis to treatment, including services to help restore vital functions and cosmetic appearance.
As the only National Cancer Institute-designated comprehensive cancer center in North Texas, we deliver the best cancer care available today and push to discover new treatments. NCI designation means we offer patients the ability to participate in the broadest possible range of clinical trials, with access to potential therapies that aren’t available at other facilities.
Harold C. Simmons Comprehensive Cancer Center
Cancer Care at the Highest Level. Anywhere.
Advanced Diagnosis and Treatment for Tonsil Cancer
Cancer can develop in the tonsils, a pair of soft tissue masses in the back of the throat that help fight infection as part of the immune system. Tonsil cancer, one of several types of throat cancer, can develop even in people who have had their tonsils removed, if small areas of tissue remain.
Our tonsil cancer care team includes ear, nose, and throat (ENT) specialists; radiation and medical oncologists; oral and reconstructive surgeons; physical and occupational therapists; and speech pathologists. We work collaboratively for each patient, providing personalized treatment that combines experience and expertise from all team specialties.
Risk Factors of Tonsil Cancer
Certain factors can increase the risk of developing tonsil cancer, but not everyone at risk develops the condition. In fact, people without known risk factors can develop tonsil cancer. Risk factors include:
- Age, with most people being diagnosed over age
- Alcohol use
- Tobacco use
- Human papillomavirus (HPV), a sexually transmitted virus
Some risk factors can be avoided to help prevent tonsil cancer. Learn more about head and neck cancer awareness and prevention.
Symptoms of Tonsil Cancer
Tonsil cancer symptoms can resemble those of other, less serious conditions such as infections, so the cancer is often not detected until it has spread to the mouth, throat, or nearby lymph nodes. Patients should see their doctors if they have any of the following symptoms that persist, even with the use of antibiotics or other treatments:
- One tonsil is larger than the other
- Either tonsil is bleeding
- Changes in the voice, such as hoarseness
- Difficulty swallowing
- Ear pain, especially if it is on only one side
- Lump in the neck
- Persistent sore throat
- Unexplained weight loss
Diagnosis of Tonsil Cancer
Our ENT cancer specialists conduct a thorough evaluation, which includes a:
- Physical exam
- Discussion of personal and family medical history
- Discussion of symptoms and risk factors
- Review of any previous treatments
We often use a mirror and light to examine the mouth and throat, or we might use a laryngoscope (a thin, flexible tube with a lighted camera), which is inserted through the nose, for a closer look.
Our doctors might recommend one or more tests, such as:
tomography (CT) scan: CT uses specialized X-rays with or
without a contrast agent to produce cross-sectional, 3D images of the mouth,
throat, and neck.
- Magnetic resonance
imaging (MRI) scan: MRI uses radio waves and a strong
magnet to produce detailed images of the mouth, throat, and neck. We sometimes use
a contrast agent with MRI for more detail, and the scan can also show whether
cancer has spread to lymph nodes in the neck.
- Positron emission tomography (PET) scan: Using small amounts of radioactive
materials and a special camera, PET scans produce highly detailed images that
can detect cancerous cells.
- Ultrasound: We can look at blood vessels, lymph nodes, and other soft tissue
in the neck with an ultrasound, which uses high-frequency sound waves and a
computer to produce images.
X-ray: We sometimes use a chest X-ray to see if cancer has spread to the
- Biopsy: Our
ENTs take a small tissue sample that a pathologist analyzes under a microscope
for the presence of cancer cells or HPV. We can usually perform biopsies in the
office using numbing medication and a fine needle. If more tissue is needed, we
can perform surgery to remove a piece of tonsil tissue or the entire tonsil.
Treatment for Tonsil Cancer
Treatment options vary based on the stage of cancer, its size and location, and whether it has spread. For early-stage cancers, we often recommend chemoradiation (combined chemotherapy and radiation therapy) or surgery followed by radiation therapy. Treatment options include:
- Surgery: Because it is particularly effective for early-stage tonsil cancer, we often
begin with surgery to remove as much of the cancer as possible. We might
remove cancer tumors, the entire tonsil, or surrounding tissues such as lymph
nodes if cancer has spread to them. For open surgery, we access the tonsils
through an incision in the neck. Some patients need radiation therapy or
chemoradiation after surgery.
- Minimally invasive robotic surgery: Our
surgeons also have expertise in minimally invasive procedures that require no
incisions. We perform transoral (through
the mouth) procedures to remove
cancer tumors, an entire tonsil, or nearby tissues, if needed. Minimally
invasive procedures we use include transoral robotic surgery (TORS) and
transoral laser microsurgery, in which the surgeon uses a microscope and laser
technology to view and destroy cancer cells. Some patients need radiation
therapy or chemoradiation after surgery.
therapy: Our doctors use radiation, a treatment with
high-energy waves such as X-rays or gamma rays, to treat tonsil cancer.
Radiation therapy can destroy cancer cells that remain after surgery, and it
can also treat inoperable tumors.
Chemotherapy (medications that destroy cancer cells) given at the same time
as radiation therapy is known as chemoradiation. It’s used in some cases to
help preserve speaking and swallowing ability. Chemoradiation is also helpful
in destroying any remaining cancer cells after surgery.
Anticancer medications work to destroy cancer cells and prevent them from
spreading. We sometimes use chemotherapy to shrink tumors before radiation or
surgery to improve success of those treatments.
- Targeted therapy: Some types of tonsil
cancer cells have a specific protein, EGFR, that causes aggressive growth.
Specialized chemotherapy known as targeted therapy works to block the action of
the EGFR protein and slow cancer growth.
- Reconstructive surgery: Patients with advanced tonsil cancer might need reconstruction after the removal of large tumors. Our plastic surgery and ENT experts work together to restore swallowing and other oral functions or to reconstruct a more natural appearance of the face, neck, and jaw.
For patients who are having radiation therapy for tonsil cancer, we recommend having any necessary dental work done before treatment. Radiation treatment slows healing and can cause other side effects. Learn more about cancer and transplant dental care.
At UT Southwestern’s Harold C. Simmons Comprehensive Cancer Center, patients have access to every available treatment option, delivered by the most experienced head and neck cancer specialists in Dallas. Find out more about all the options we offer for head and neck cancer treatment.
We offer a variety of head and neck cancer support services for patients and their families, such as:
- Oncology rehabilitation
- Integrative therapies
- Nutrition counseling
- Support groups
As a medical research institution, UT Southwestern frequently conducts head and neck cancer clinical trials, giving our patients access to the newest treatments. Patients should speak with their doctors about the availability of clinical trials.
Related Conditions and Treatments
We have a wide range of clinical trials open to patients with all types and stages of cancer. Search for opportunities to participate in a cancer study.
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Oral and Maxillofacial Surgery Clinicat UT Southwestern at Empire Plaza 2 1440 Empire Central Drive, 1st Floor
Dallas, Texas 75247 214-645-3999 Directions to Oral and Maxillofacial Surgery Clinic Parking Info for Oral and Maxillofacial Surgery Clinic
Otolaryngologyat UT Southwestern Monty and Tex Moncrief Medical Center at Fort Worth 600 South Main Street, 2nd Floor, Suite2.800
Fort Worth, Texas 76104 817-882-2430 Directions to Otolaryngology
University Hospital Radiation Oncology Clinicat Radiation Oncology Building 2280 Inwood Road
Dallas, Texas 75390 214-645-8525 Directions to University Hospital Radiation Oncology Clinic