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

Interested in more discussions like this? Go to the Head & Neck Cancer Support Group.

Profile picture for lunatuna @lunatuna

Thanks all. Everyone has a slightly tweaked version of the same thing but hopefully the longterm outcome is all good. I just started this journey with my husband and am asking what on my part (wife ) is most helpful ? I am trying now to fatten him up for chemo/radiation. Its not my style to hover but want to be helpful and supportive. Any advice is helpful from those of you who have gone through it.

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Take notes. Be there. Don't get discouraged. Know that foods will taste different and may taste awful or cannot be tolerated as time goes by. A feeding tube may be necessary. Keep him hydrated and exercised. He may or may not want visitors, honor that. Know that he is more scared than you but probably won't admit it.
My wife would probably have a lot more to add to this list. Know this however, you have people here that can help or answer questions as they come up. This won't go on forever. All things have an end and a bratwurst has two! Courage.

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Profile picture for johnbonani @johnbonani

Was your diagnosis Squamous Cell Carcinoma? Did you require a feeding tube or were you able to swallow?

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Same with me...tonsils and a bunch of nodes on left. Surgeon was adamant that I hold off on radiation and just observe so that's what I'm following. Oncologist also said he would do low grade but would not make much of a difference. He's watching me too. Just did my Navdx test today. Hoping for best.

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Profile picture for laconiaborn54 @laconiaborn54

October 2023 had both tonsils out left on cancer and tissue removed from back of throat. I also had neck surgery and 43 lymph nodes taken out luckily only one cancer. Over all surgery wasn't that bad. Yes throat was somewhat uncomfortable and ate ice chips and drank alot of water.
Neck surgery was no problem at all if anything hurt it was the drain they put in.
I opt out of radiation after doing homework and talking to others. I now go back to surgeon once a month so far alls ok for now.

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Was your diagnosis Squamous Cell Carcinoma? Did you require a feeding tube or were you able to swallow?

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October 2023 had both tonsils out left on cancer and tissue removed from back of throat. I also had neck surgery and 43 lymph nodes taken out luckily only one cancer. Over all surgery wasn't that bad. Yes throat was somewhat uncomfortable and ate ice chips and drank alot of water.
Neck surgery was no problem at all if anything hurt it was the drain they put in.
I opt out of radiation after doing homework and talking to others. I now go back to surgeon once a month so far alls ok for now.

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Profile picture for lunatuna @lunatuna

Thanks all. Everyone has a slightly tweaked version of the same thing but hopefully the longterm outcome is all good. I just started this journey with my husband and am asking what on my part (wife ) is most helpful ? I am trying now to fatten him up for chemo/radiation. Its not my style to hover but want to be helpful and supportive. Any advice is helpful from those of you who have gone through it.

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I had SCC on the base of my tongue and a couple of lymph nodes in the fall of 2020. I had chemo and proton radiation, since have had multiple cleans scans.

I wrote a blog during my experience (non-revenue generating) if you would like to review it. You can read it at:
https://stevefleurysblog.com/2020/10/29/part-1-the-beginning/
More importantly, my wife wrote a wonderfully insightful post of lists and non-advice advice.
https://stevefleurysblog.com/2021/01/05/lists-and-non-advice-advice/

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Profile picture for lunatuna @lunatuna

Thanks all. Everyone has a slightly tweaked version of the same thing but hopefully the longterm outcome is all good. I just started this journey with my husband and am asking what on my part (wife ) is most helpful ? I am trying now to fatten him up for chemo/radiation. Its not my style to hover but want to be helpful and supportive. Any advice is helpful from those of you who have gone through it.

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This was hard on my husband and a shock as he was healthy and never sick. To have to have chemo, radiation and take medicine was very hard for him, so I’m the one to do everything else. I made appointments, talked to nurses, looked up things to see what works and not, etc. He slept a lot and not feeling the best so I did everything. I had to fix things he could eat, sometimes he couldn’t eat anything, it was hard seeing him like this. Now he’s all done and trying to recover. Good luck.

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Thanks all. Everyone has a slightly tweaked version of the same thing but hopefully the longterm outcome is all good. I just started this journey with my husband and am asking what on my part (wife ) is most helpful ? I am trying now to fatten him up for chemo/radiation. Its not my style to hover but want to be helpful and supportive. Any advice is helpful from those of you who have gone through it.

REPLY
Profile picture for cris2 @cris2

My husband was diagnosed with tonsil cancer, same as you, a few lymph nodes in neck also. They didn’t do surgery since it already was in lymph nodes so recommended three chemo sessions and 35 radiations. They told us this was the best treatment for him, it was stage 2. It is hard, and since he is 78 harder. Just finished treatments and trying to heal. Good luck.

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Thank you cris2 for sharing that. We still have not made the decision on surgery vs radiation/chemotherapy.
Waiting on pet scan results then another doctor meeting, and will make the decision then. Either way will be difficult as all of these stories confirm but trying to focus on the bigger picture that there is life after this ordeal. On that positive note I wish you and your husband all the best.

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Profile picture for johnbonani @johnbonani

Thank you so much to all of you who have responded! It really is helpful to hear honest real life experiences of others who have gone throught it.

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My husband was diagnosed with tonsil cancer, same as you, a few lymph nodes in neck also. They didn’t do surgery since it already was in lymph nodes so recommended three chemo sessions and 35 radiations. They told us this was the best treatment for him, it was stage 2. It is hard, and since he is 78 harder. Just finished treatments and trying to heal. Good luck.

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Profile picture for jonesja @jonesja

I am not a doctor but this was my experience. I was diagnosed with HPV16+ OSCC in March 2023 at 56 years old. I had an option of Radiation/ Chemo or TORS surgery. In the end I just wanted it gone and cut out so I elected the surgery. Of course I was very fearful at the time. I have since learned that this type of cancer is very treatable and successful on either option. I had TORS robotic surgery April 2023. I had a right neck dissection as well with all lymph nodes removed as cancer had spread to a couple of lymph nodes and TORS surgery to remove primary tumor of 3cm at base of tongue. All margins clear. Also, I completed 30 rounds of Proton Radiation in July to "cleanup" and cancer that may have been left behind. I had NO chemo. I imagine if you are Stage 3 you will have radiation on top of your surgery as I did. As far as presurgery I don't recall doing much but waiting for the Surgery. The biggest issue I had was dysphagia and Not being about to swallow (eat or drink) for about two weeks after surgery. I would suggest to start doing mouth, tongue and swallowing exercises today. A Speech therapist can help you with this. As far as post-op. The pain is fairly severe for one week after surgery. I had alot of mucous where you feel like you are almost drowning. It will be hard to eat and drink or sleep. Think soft foods and Boost drinks. I had pain medications which helped tremendously. As of today I would say I am about 90% back to normal . It is a SLOW climb back and you will never be quite "normal" again but you will be alive. CT scans and throat scope every 3 months for a year or two to monitor any recurrence. Ask your doctor about the NavDX blood type which detects HPV16 cancer in the blood as it will help once you are being monitored. Good luck and Have Faith. It will be a journey for sure but you can do it! Stay positive.

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Thank you so much to all of you who have responded! It really is helpful to hear honest real life experiences of others who have gone throught it.

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