The tonsils serve an immune function, protecting the body from bacteria entering through the nose and mouth. Tonsil cancer, a type of oropharyngeal cancer, develops in the tonsil region – significant lymphatic tissue situated on both sides of the oropharynx. This cancer typically originates from squamous cell epithelium and often localizes to one side, either left or right, rarely affecting both.

Individuals who smoke, consume heavy alcohol, or are infected with HPV virus face a higher risk of tonsil cancer. The disease often presents no distinct symptoms in its early stages. Symptoms typically emerge as the tumor grows, leading to persistent sore throat, difficulty swallowing, pain radiating to the ear, and voice changes.

Master of Science, Doctor Vuong Ngoc Duong, Deputy Head of the Radiotherapy Department at Tam Anh General Hospital Hanoi, states that radiotherapy forms a key part of the multimodal treatment protocol for tonsil cancer, customized according to the patient's disease stage and overall health.

Curative radiotherapy for tonsil cancer

For certain cases of HPV-positive tonsil cancer where the tumor remains localized and has not spread, or for patients unsuitable for surgery, doctors may prescribe radiotherapy as the sole treatment option.

Radiotherapy employs high-energy radiation beams to destroy DNA, causing cancer cells to cease division and undergo necrosis, leading to their natural elimination from the body. This method targets the primary tumor and high-risk lymph node areas containing cancer cells, providing curative treatment without extensive surgical intervention. This approach helps preserve the patient's speech and swallowing functions.

Adjuvant radiotherapy after surgery

Following surgical removal of a tonsil tumor and cervical lymph node dissection, some patients may still present high-risk factors, such as cancer cells found at the surgical margins or suspected invasive lymph nodes. In these instances, doctors prescribe adjuvant radiotherapy to eliminate any remaining cancer cells and reduce the risk of recurrence.

A technician adjusts a patient's position for tonsil cancer radiotherapy. Photo: Tam Anh General Hospital

Combined radiotherapy and chemotherapy for disease control

Doctors prescribe combined radiotherapy and chemotherapy for locally advanced tonsil cancer with a high risk of recurrence and multiple cervical lymph nodes. This combination aims to enhance tumor destruction or shrinkage, improve disease control, and increase survival time, helping patients avoid extensive surgical resection.

Palliative radiotherapy

In cases of advanced or late-stage tonsil cancer, radiotherapy can still shrink tumor size, reducing pain, hoarseness, and difficulty swallowing. This method also helps alleviate headaches, nausea, and paralysis when the disease has metastasized to the brain, eases shortness of breath with lung metastasis, and helps preserve mobility for patients with bone metastasis.

Doctor Duong notes that the tonsils are situated near many critical structures responsible for swallowing, speaking, and saliva production. Therefore, radiotherapy aims not only to deliver an adequate dose to the tumor but also to limit exposure to healthy tissue, thereby reducing side effects. Modern techniques like intensity-modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) precisely contour radiation doses around the tumor, minimizing impact on adjacent organs and significantly reducing patient side effects.

By Thanh Long