Just Diagnosed with Tonsil Cancer - How to Treat?

Posted by johnbonani @johnbonani, Mar 15, 2024

I've just been diagnosed with stage three tonsil cancer on Feb 22nd. 63 year old male. Have seen the surgical oncologist and the radiology oncologist, both present the pro's and con's of each, both treatments sound terrible. Both recommend there own procedure and essentially leave it up to me the patient to decide. I'm wondering if some of you in this discussion have had surgery then radiation or just radiation/chemotherapy with no surgery or combination? Full dose of radiation sounds awful but then so does the surgery and I'm told they'll have to do radiation after but perhps a lower dose. Any feedback would be so very much appreciated.
🙂 - John B

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Profile picture for lollie @lollie

Hi John
I finished 7 wks radiation and 7 rounds of chemo in January 2024. My right tonsil cancer (hpv 16) was only at a stage 1, but had metastasized to a lymph node in my neck, so surgery was not an option. I had a feeding tube installed before treatment, and had it removed by June; I had started the long process of eating by mouth maybe a month or so out from treatment- late removal was mostly due to scheduling...I also had to wean off painkillers which were administered thru the tube. I've been cancer free almost a year and a half now. I do have chronic lymphedema in my neck which I treat daily with a FlexTouch compression suit. Pretty hassle free. Treatment is tough, but I found my team (oncologist, radiologist, tech team, lab team, palliative care, speech and physical therapists) to be super and majorly supportive. I trusted them to get me through the process and they didn't let me down...neither did my husband and family and friends. One thing to remember: be patient with your body and mind thru recovery. It takes many months to recoup your strength. The mental game can be challenging, but once you survive cancer treatment and the disease is gone you can pretty much do anything!

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@lollie did you have a tonsillectomy?

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Hello all,

Firstly I am male 54 from Canada, in 2016 I was diagnosed with stage 4b tonsil cancer that had spread to multiple lymph nodes primary tumour was 2.5”. I enrolled in a study and was chosen to do ORATOR ( robot ) surgery and a neck dissection, originally they thought I would avoid radiation & chemotherapy. Unfortunately it was too advanced and I underwent 6 chemotherapy sessions and 30 radiation sessions. I am cancer free so far, I won’t lie it has not been easy but any day you wake up and are still alive is a gift. I wish everyone good health and if anyone has questions or just needs to talk I am a great listener

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Diagnosed with tongue cancer in 2024. Had 22 lympnodes removed and a glossectomy to rebuild my tongue. Followed by 30 radiation treatments. I had nasalpharangeal cancer in 2021 and had 39 radiations and 8 chemo treatments. The radiation has been brutal on my body. I have severe radiation fibrosis. It has prevented me from swallowing much. All I can do is a few sips of water at a time. Currently it is inflamed and I'm on steroids to see if the swelling goes down a bit. Needless to say I'm still on a feeding tube. It's a long road to recovery. If anyone has any more suggestions to help with my fibrosis let me know. I'm doing speech therapy and physical therapy and have lymphatic drainage 3 times a week.

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Hi John
I finished 7 wks radiation and 7 rounds of chemo in January 2024. My right tonsil cancer (hpv 16) was only at a stage 1, but had metastasized to a lymph node in my neck, so surgery was not an option. I had a feeding tube installed before treatment, and had it removed by June; I had started the long process of eating by mouth maybe a month or so out from treatment- late removal was mostly due to scheduling...I also had to wean off painkillers which were administered thru the tube. I've been cancer free almost a year and a half now. I do have chronic lymphedema in my neck which I treat daily with a FlexTouch compression suit. Pretty hassle free. Treatment is tough, but I found my team (oncologist, radiologist, tech team, lab team, palliative care, speech and physical therapists) to be super and majorly supportive. I trusted them to get me through the process and they didn't let me down...neither did my husband and family and friends. One thing to remember: be patient with your body and mind thru recovery. It takes many months to recoup your strength. The mental game can be challenging, but once you survive cancer treatment and the disease is gone you can pretty much do anything!

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I am in my 7th week of radiation and chemo( cisplatin). The treatment is really rough but as a physician I did a lot of research of the literature and if your squamous cell is HPV positive, this is the way to go with greater than 85 % chance of cure. Have them get a HPV DNA level( this is done by Naveris and is called NAVDX) before you start. If HPV DNA goes to zero after treatment you are in a great place.

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Welcome to the group. I just found it a week ago.

I was diagnosed with hpv tonsil cancer in Jan 2024 after visits to my primary care doctor, dentist, oral surgeon and finally my ENT. That diagnosis was via biopsy, a Petscan and NavDX blood test that is specific to hpv cancer. It is a specific form of tonsil cancer caused by exposure sometime in my life to someone who had hpv. I never smoked. The Petscan showed some areas of concern in my left lung; the tonsil was on my right side. As a result I had surgery on that lung and 6 nodes were removed, none of which showed cancer after biopsy. That was actually great news even though I now have several scars on my left side!

My treatment plan was 35 radiation and 6 chemo sessions. No surgery was done because that would delay treatment. My blood went out of spec after 2 chemo sessions and they discontinued it. I did 29 radiation sessions but couldn't take the side-effects and stopped. I had severe mucus to the extent I couldn't sleep at night. I choked and had difficulty clearing the mucus to the extent I thought I might suffocate.

Prior to treatment I had had a feeding tube placed in my stomach and was on a liquid diet for about three months. I had swallowing therapy and learned to massage my neck to reduce lipidemia. Both were invaluable!

In June of 2024 a Petscan showed potential cancer in the node adjacent to the tonsil. My ENT recommended operating and taking out that node and 5 more below it. It's an operation that is in an area that involves muscles, nerves and arteries and potential negative outcomes. I requested a biopsy of the node and 5 samples came back negative. I was scheduled for the next Petscan and NavDX in a month and decided to wait those results before deciding what to do. Both came back negative and I sought a 2nd opinion from another ENT. He reviewed my file and recommended not to operate . I stayed with him. Since then I've had an additional Petscan and two NavDx tests, all negative.

I gradually transitioned back to solid food with some difficulty and had the feeding tube removed. At that point I had lost my saliva, taste and went from 178 to 143 lbs. I drank a lot of 1ot of water and still do. My taste has somewhat returned. Saliva not so much. My weight is back to 163.

I tried acupuncture in hopes of getting my saliva back. After 9 sessions over a 2 month time period there was no improvement. I just learned from this forum that another participant had success 10 years ago with electro-acupuncture. I'm going to speak with a local acupuncturist that uses that form this week and will post my experience.

That's my story to date! Good luck and please feel free to contact me any time.

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Profile picture for kmlnj @kmlnj

I know tonsils and thyroid are not near each other. But, most important is to be in the care of very experienced doctors. You don't have to like them. Just trust them.
I am 72. Had a complete thyroidectomy plus neck dissection. 35 radiation to that area. Plus 6 chemotherapy boosters.
You are undergoing treatment one day at a time. I was on a liquid diet for 2 months. I hired someone to drive me to and fro treatment.
Make the best choice for your health. Don't decide based on what you think you can get through.
Peace and virtual hugs.

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Thank you I know it’s going to be tough have to take one day at a time

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I know tonsils and thyroid are not near each other. But, most important is to be in the care of very experienced doctors. You don't have to like them. Just trust them.
I am 72. Had a complete thyroidectomy plus neck dissection. 35 radiation to that area. Plus 6 chemotherapy boosters.
You are undergoing treatment one day at a time. I was on a liquid diet for 2 months. I hired someone to drive me to and fro treatment.
Make the best choice for your health. Don't decide based on what you think you can get through.
Peace and virtual hugs.

REPLY
Profile picture for Colleen Young, Connect Director @colleenyoung

@drmarchell1, I add my welcome. As @hrhwilliam suggested, I moved your comment to this existing discussion about a new diagnosis of tonsil cancer here:
- Just Diagnosed with Tonsil Cancer - How to Treat? https://connect.mayoclinic.org/discussion/just-diagnosed-tonisl-cancer-how-to-treat/

I did this so you can read previous posts as well as connect with other members who have experience with tonsil cancer like @sapphire1158 @slmoore0626 @brad78 @lizralpol @cmickelson15 @jclassey @laconiaborn54 and others.

@drmarchell1, I know this is all very new and I bet you have many questions about what to expect. Have you been told about the treatments you may be having? How are you doing?

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Met with doctors and was told it actually started in my tongue they said they couldn’t operate on it would have to go through 7 weeks of chemo and radiation

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I was diagnosed late last year - surgery to remove left tonsil and neck dissection in February of this year (Stage 1). The first few weeks after surgery was very difficult but I did get through it. The doctors recommended radiation - because I researched treatments I had a very good discussion with the radiation oncologist about reducing the treatments from his initial 5 to 4 weeks. I used the creams/lotions given to me on my neck constantly. The only side effects I encountered were dry mouth and loss of taste. It has been two months since my last treatment and am gradually getting my taste back! Dry mouth still plagues me. I have found I mix water with a drink like a Gatorade or orange juice and am drinking that all day long. Yep, lots of trips to the bathroom but your skin will look great! Right now I am trying to gain the weight back that I lost.

The one piece of advice I can give is to research on reputable sites. Ask questions, go into your appointments prepared. I am like a little kid always asking why. No one can advocate for you as well as you.

This is an incredible discussion group. I have not posted before but have read thru many discussions and that alone is worth its weight in gold! In a way, I find companionship with those who have or are going through similar to me and what they do about it.

Blessings to you-saying prayers for a complete recovery!

Hang in there! Each day is better than the one before.

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