Tonsil cancer is a type of cancer that begins in the cells of your tonsils. Your tonsils are two oval-shaped pads in the back of your mouth that are part of your body's germ-fighting immune system.

Tonsil cancer often causes difficulty swallowing and a sensation that something is caught in your throat. Tonsil cancer is often diagnosed late in the disease, when cancer has spread to nearby areas, such as the tongue and the lymph nodes.

Treatment for tonsil cancer usually involves surgery to remove the cancer. In some cases radiation therapy and chemotherapy also are recommended.

  • Collaboration. At Mayo Clinic, ear, nose and throat specialists (otorhinolaryngologists) form a multidisciplinary team with experts in radiation oncology, oncology, plastic and reconstructive surgery, pathology, radiology, and rehabilitation medicine in order to provide whole-person care for people with tonsil cancer. Other professionals are included as needed.
  • Experience. Each year, Mayo Clinic doctors care for more than 300 people with tonsil cancer. The experience and expertise ensures that your care team is prepared with the knowledge and resources to provide you with exactly the care you need.
  • Access to the latest. Mayo Clinic doctors have access to the latest technology for treating tonsil cancer. Examples include transoral robotic surgery and intensity-modulated radiation therapy.
  • Innovative approach to treatment. Most tonsil cancers diagnosed at Mayo Clinic are associated with human papillomavirus (HPV), which has a profound effect on tonsil cancer prognosis. For this reason, Mayo Clinic doctors test all tonsil cancers for HPV.

    Mayo Clinic doctors are studying new treatment protocols for people with HPV-associated tonsil cancers that reduce the amount of treatment given and lower the risk of treatment side effects, without sacrificing cure rates.

  • A full range of treatment options to consider. Mayo Clinic doctors will work with you to review all of your treatment options and choose the treatment that best suits your needs and goals. The range of treatments offered to people with tonsil cancer includes surgery, radiation therapy and chemotherapy. You may also choose to enroll in a clinical trial.
  • Comprehensive cancer center. Mayo Clinic Cancer Center meets strict standards for a National Cancer Institute comprehensive cancer center, which recognizes scientific excellence and a multidisciplinary approach to cancer prevention, diagnosis and treatment.

Mayo Clinic in Rochester, Minn., ranks #1 for ear, nose and throat in the U.S. News & World Report Best Hospitals rankings. Mayo Clinic in Scottsdale, Ariz., is ranked among the Best Hospitals, and Mayo Clinic in Jacksonville, Fla., is ranked high performing for ear, nose and throat by U.S. News & World Report.

At Mayo Clinic, we assemble a team of specialists who take the time to listen and thoroughly understand your health issues and concerns. We tailor the care you receive to your personal health care needs. You can trust our specialists to collaborate and offer you the best possible outcomes, safety and service.

Mayo Clinic is a not-for-profit medical institution that reinvests all earnings into improving medical practice, research and education. We're constantly involved in innovation and medical research, finding solutions to improve your care and quality of life. Your doctor or someone on your medical team is likely involved in research related to your condition.

Our patients tell us that the quality of their interactions, our attention to detail and the efficiency of their visits mean health care — and trusted answers — like they've never experienced.

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Mayo Clinic's multispecialty team of doctors uses the latest diagnostic techniques to identify the cancer cells and determine the extent (stage) of the cancer progression.

Tests and procedures used to diagnose tonsil cancer include:

  • Physical exam. Your doctor will perform a comprehensive exam to understand your condition and investigate your signs and symptoms. Your doctor will carefully examine your mouth and will feel your neck for any abnormalities. A mirror or a small, flexible, fiber-optic scope may be used to closely examine your tonsils and surrounding tissue.
  • Imaging tests. Imaging tests help your doctor understand the extent of your cancer and aid in treatment planning. Your doctor may recommend computerized tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET).
  • Removing a sample of tissue for testing. In order to confirm the diagnosis, your doctor may recommend removing a sample of suspicious tissue from your tonsil for laboratory testing.

In the lab, highly skilled and experienced pathologists examine the tissue under microscopes to determine the types of cells involved and rate the aggressiveness of the cancer.

At Mayo Clinic, all tonsil cancers are tested for the presence of the HPV virus because this greatly influences prognosis and treatment.

At Mayo Clinic, a team of experienced doctors from several specialties works together with you to develop an individualized treatment plan to provide exactly the care you need.

Treatment for tonsil cancer that hasn't spread beyond the tonsil may include combined radiation therapy and chemotherapy (chemoradiation) or surgery followed by radiation therapy. Advanced tonsil cancers may require a combination surgery, radiation therapy and chemotherapy.

Surgery

The goal of surgery for tonsil cancer is to remove as much of the cancer as possible. Surgery can be used to manage all stages of tonsil cancer, but it's particularly effective for early-stage cancers. Whether surgery is right for you depends on the size, type, location and depth of the cancer.

Doctors at Mayo Clinic have access to advanced surgical approaches to ensure complete removal of tonsil cancer while preserving function.

Procedures used to treat tonsil cancer include:

  • Transoral surgery. At Mayo Clinic, surgeons remove most tumors through the mouth (transoral surgery). This approach doesn't require lengthy reconstruction and rehabilitation of the throat region after surgery to improve speech and swallowing function. To remove the cancer, doctors may use cutting tools or lasers during surgery.
  • Transoral robotic surgery. Head and neck surgeons offer transoral robotic surgery, which provides more precise access to the cancer. Typically this surgery is safe, effective and enables faster recovery times compared with standard surgical approaches.
  • Open surgery. In certain cases, such as with large cancers or cancers that have spread in the neck, surgeons may use an approach that uses a large incision in the neck to remove the cancer.

Mayo Clinic surgeons work closely with pathologists during surgery to identify tumor boundaries to allow for complete removal of the tumor. If the tumor has spread beyond the tonsils, the surgeon removes nearby lymph nodes.

  • Reconstructive surgery. People with advanced tumors who experience face, jaw or neck disfigurement after tumor removal may need reconstructive surgery. Ear, nose and throat experts and surgeons in plastic and reconstructive surgery work together to restore the appearance of the face, jaw or neck and use of the mouth. Experts in oral and face (maxillofacial) surgery may also be involved.

Radiation therapy

Radiation therapy uses high-powered beams of energy, such as X-rays, to kill cancer cells. Radiation therapy may be an option for early or advanced tonsil cancer.

Mayo Clinic radiation oncologists have access to the most advanced radiation therapy treatment, such as intensity-modulated radiation therapy, which precisely targets radiation to tumor cells and limits radiation exposure to nearby normal tissue.

Chemotherapy

Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be used along with radiation therapy to treat locally advanced tonsil cancer. For tonsil cancer that has recurred or has spread to other areas of the body, chemotherapy may be recommended to slow the growth of the cancer.

Rehabilitation

Some people need help to improve their swallowing and speech function during and after tonsil cancer treatment. At Mayo Clinic you have access to a variety of experts to help you cope and recover, including specialists in speech and swallowing, physical therapists, occupational therapists, and dietitians.

If cancer or treatment makes it difficult for you to eat enough to get all the nutrients you need, your doctor may recommend tube feeding (enteral nutrition).

The Nicotine Dependence Center at Mayo Clinic can help people who want to stop using tobacco. Continuing to use tobacco increases your risk of a tonsil cancer recurrence.

Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people. In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

At Mayo Clinic, ear, nose and throat specialists (otorhinolaryngologists) form a multidisciplinary team with experts in radiation oncology, oncology, plastic and reconstructive surgery, pathology, radiology, and rehabilitation therapies to care for people with tonsil cancer. Other experts are included as needed.

For appointments or more information, call the Central Appointment Office at 800-446-2279 (toll-free) 8 a.m. to 5 p.m. Mountain Standard Time, Monday through Friday or complete an online appointment request form.

At Mayo Clinic, ear, nose and throat specialists (otorhinolaryngologists) form a multidisciplinary team with experts in radiation oncology, oncology, plastic and reconstructive surgery, pathology, radiology, and rehabilitation therapies to care for people with tonsil cancer. Other experts are included as needed.

For appointments or more information, call the Central Appointment Office at 904-953-0853 8 a.m. to 5 p.m. Eastern time, Monday through Friday or complete an online appointment request form.

At Mayo Clinic, ear, nose and throat specialists (otorhinolaryngologists) form a multidisciplinary team with experts in radiation oncology, oncology, plastic and reconstructive surgery, pathology, radiology, and rehabilitation therapies to care for people with tonsil cancer. Other experts are included as needed.

If you want to successfully stop using tobacco, you can get expert help through the Mayo Clinic Nicotine Dependence Center.

For appointments or more information, call the Central Appointment Office at 507-538-3270 7 a.m. to 6 p.m. Central time, Monday through Friday or complete an online appointment request form.

See information on patient services at the three Mayo Clinic locations, including transportation options and lodging.

Doctors and scientists in Mayo Clinic's Department of Otorhinolaryngology are studying new ways to diagnose and treat tonsil cancer, including research into improving and innovating head and neck surgery techniques.

Mayo Clinic doctors are studying innovative treatment protocols for people with tonsil cancer related to HPV that decrease the amount of treatment given and reduce the associated side effects, without sacrificing cure rates. In clinical trials, people with HPV-associated tonsil cancer are offered surgery to remove the cancer, followed by a reduced dose of radiation therapy.

Cancer research is conducted in coordination with the Mayo Clinic Cancer Center. The Mayo Clinic Cancer Center receives funding from the National Cancer Institute and is designated as a comprehensive cancer center — recognition for an institution's scientific excellence and multidisciplinary resources focused on cancer prevention, diagnosis and treatment.

See a list of publications by Mayo Clinic authors on tonsil cancer on PubMed, a service of the National Library of Medicine.

Nov. 12, 2014