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Head and Neck Cancer

Is it safe to remove a cancerous tonsil?

06/23/2008

Question:

I have had a CT scan, PET scan, etc. and the diagnosis is tonsil cancer. The doctor is going to remove the tonsil before he does a biopsy to determine what type of cancer it is. This worries me because I am afraid it may spread before I can do the radiation (or other staging). Possibly a modified neck dissection due to lymph node involment. I wanted to know if this is typical to remove a tonsil before doing a biopsy and do I run the risk of it spreading? Thank you. My surgery is next Tuesday, 6/10/08. I am not a good candidate for surgery due to blockages in carotid arteries and take blood thinners that I must stop so I can have surgery.

Answer:

There is many good ways to treat tonsilar cancer. Removal of a tonsilar cancer usually requires more than just removing the tonsil. If there is an obvious lesion on the tonsil, a simple biopsy is all that is needed and no one so far has shown that it improves the cure rate to remove the tonsil completely. There is no evidence that a biopsy or a tonsillectomy causes the tumor to spread. If there is no visible lesion in the throat nodes are present in the neck to suggest a lesion in the throat, it is routine to remove the tonsil so that the entire tonsil can be examined to identify a possible tumor in the tonsil. At our institution, we prefer to treat tonsilar cancer with radiation or chemoradiation. Very few patients eventually require surgery. So far, no one has shown that either approach is better. Good luck with your surgery.

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Response by:

Pierre  Lavertu, MD, FRCS(C), FACS Pierre Lavertu, MD, FRCS(C), FACS
Professor of Otolaryngology-Head and Neck Surgery
School of Medicine
Case Western Reserve University