Which tonsil cancer treatments are best for you will depend on the size, stage and HPV status of your cancer, as well as your overall health and your preferences. Tonsil cancer treatment options may include surgery, radiation therapy, or a combination of chemotherapy and radiation therapy.
Researchers are studying whether people with HPV-related tonsil cancer can be treated with lower doses of radiation and chemotherapy. This less intense treatment causes fewer side effects and, in early studies, seems to be as effective as higher doses. If your tonsil cancer is found to be HPV-related, you and your doctor might consider a clinical trial studying less intense treatments.
The goal of surgery for tonsil cancer is to remove as much of the cancer as possible. Surgery can be used to treat all stages of tonsil cancer.
Surgery is most often done through the mouth (transoral surgery). Surgeons pass specialized tools through the mouth to access the cancer and remove it with cutting tools or lasers.
In certain situations, it may be necessary to make a large incision in the neck to remove larger cancers and cancers that have spread to the lymph nodes. Reconstructive surgery and rehabilitation may be needed to restore your ability to eat, speak and swallow.
Radiation therapy uses high-powered beams of energy, such as X-rays or protons, to kill cancer cells.
Radiation therapy might be used alone to treat small cancers that haven't grown beyond the tonsil. Sometimes radiation therapy is used after surgery if the cancer can't be removed completely or if there's a risk that the cancer may have spread to the lymph nodes.
Radiation can also be combined with chemotherapy as an initial treatment or as an additional treatment after surgery. The chemotherapy makes the cancer cells more vulnerable to the radiation and may increase the effectiveness.
Chemotherapy uses drugs to kill cancer cells. For tonsil cancer, chemotherapy is usually combined with radiation therapy. It can also be used alone to slow the growth of tonsil cancer that has recurred or has spread to other areas of the body.
Rehabilitation specialists in speech therapy, swallowing therapy, dietetics, physical therapy and occupational therapy help with rehabilitation that may be necessary after surgery or radiation therapy.