Treatment of Tonsil Cancer
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Tonsil cancer is not a single diagnosis but a group of pathologies. It includes several dangerous, rapidly progressing diseases characterized by the malignant transformation of lymphoid tissue of the palate, tonsils, and root of the tongue.
Content
- What are the tonsils, and what are they for?
- How to differentiate tonsil cancer from other malignancies
- More on how to spot tonsil cancer
- Treatment tactics for tonsil cancer
- How are tonsils removed by surgery?
- Photodynamic therapy for tonsil cancer
- Palliative therapy for patients with tonsil cancer
- Indications for preventative surgery
- The cost of treatment in Europe
- How to start tonsil cancer treatment in Europe?
What are the tonsils, and what are they for?
The tonsils consist of connective and lymphoid tissue with lymphocytes – cells that are a fundamental part of the immune system. Our body has several tonsils: pharyngeal, palatine, lingual, and tubal ones.
The palatine tonsils also have a kind of a hematopoietic function: lymphocytes (white blood cells) undergo differentiation in the lymphoid tissue. Thus, the tonsils are an important part of our immune system, the removal of which is not desirable. The significance of tonsils is confirmed by the fact that even a damaged tonsil plays its role in the normal functioning of lymphocytes.
Thanks to the porous structure of the tonsils, pathogenic microorganisms that try to enter the body are surrounded by the cells of the immune system, recognized and destroyed. Tonsils are a reliable barrier to infections, and if the body cannot cope with the disease, the tonsils become inflamed.
How to differentiate tonsil cancer from other malignancies
While feeling discomfort in the throat, many people do not rush to see a specialist, preferring treatment at home. This can be dangerous because the initial stage of tonsil cancer is almost indistinguishable from inflammatory throat pathologies, such as sore throat, flu, and acute respiratory infections.
Therefore, it is essential to be very careful. People can suspect the cancerous lesion of the tonsils by the following signs:
- Pain in the throat; a feeling of resistance when swallowing
- Growth of lymph nodes and enlargement of the tonsil on one side
- Edema and swelling in the neck area
- Change in the voice without obvious reason
But even with these symptoms, not everyone visits a specialist, considering the mentioned signs and manifestations of other diseases, for example, the thyroid gland pathology, chronic tonsillitis, inflammation of maxillary sinuses, etc. So, self-treatment is not an option at this stage.
As the disease progresses, the listed signs of the malignant process are joined by the following ones:
- Pain in the throat, extending to the ears, cheeks, and temporal areas
- Persistent cough, accompanied by a significant discomfort in the chest
- Fatigue
- Rapid weight loss
These signs can also be present in somatic pathologies, so examination becomes a must.
More on how to spot tonsil cancer
The insidiousness of the pharyngeal ring lymphoid tissue cancer is in the absence of any symptoms at the initial, well-treatable stages. The first signs of tonsil cancer are difficult to distinguish from a cold or sore throat, so they do not alert a patient and he does not rush to see a specialist.
To detect the cancer development in the larynx area, timely, doctors recommend remembering the following non-specific symptoms of tonsil cancer at its early stages. If the following signs appear, you should immediately contact an otolaryngologist for a consultation:
- Difficulty making swallowing movements and persistent dryness in the mouth
- Persistent dry cough
- Frequent tinnitus
Patients also experience the common symptoms of tonsil cancer that accompany any oncological process. The signs that indicate the possible development of cancer include fever, increased sweating, general weakness, unexplained fatigue at rest, loss of appetite, and other symptoms of intoxication.
The fact is that the initial symptoms of tonsil cancer in women and men are the same, but males are statistically less likely to pay attention to them and see a doctor. This fact leads to the fact that there is a higher mortality rate from tonsil cancer among the male population.
Treatment tactics for tonsil cancer
The tonsil affected by cancer is treated depending on the morphological structure of the neoplasm, the stage of the disease, the degree of tonsil cancer invasiveness, and the presence of metastases to lymph nodes or other organs. Surgery, radiation therapy, and chemotherapy are the most widespread treatments for the diagnosis.
Since the oral cavity and surrounding areas have numerous vascular and nerve bundles, doctors can remove the tumor surgically only in the early stages, when its size is small, access to it is free, and it has not grown into the surrounding tissues. Surgery is often performed after radiation therapy when the malignant tumor decreases in size.
Treatment of tonsil cancer with ionizing radiation is indicated when tonsil cancer has distant metastases. Only affected tissues are irradiated with gamma- or beta-particles. After radiation therapy, the tumor and affected lymph nodes are removed surgically. Since one of the side effects of treatment with ionizing radiation is stomatitis, it is worth examining the oral cavity for dental caries and removing sources of infection before starting therapy.
Chemotherapy most often is combined with radiation therapy. Chemotherapy is most effective in patients with highly differentiated tumors. Cytostatics are used, which suppress cancer cells. Innovative chemotherapy preparations are monoclonal antibodies that have demonstrated high efficacy in clinical trials.
If the cancer is advanced and there are numerous metastases, chemotherapy is combined with radiation treatment. Surgery is obligatory in this case. If the tumor blocks the airways, a tracheostomy is indicated. If cancer has invaded the lower jaw, the bone is removed and replaced with a transplant during reconstructive intervention.
Surgical treatment is always supplemented with irradiation of the postoperative scar area and chemotherapy. After treatments, follow-up examinations every six months are mandatory to detect a possible recurrence timely.
How are tonsils removed by surgery?
Nowadays, tonsils are removed using sparing methods and modern equipment. Surgery can involve partial or complete organ removal.
During surgery, affected areas can be treated using ultralow temperatures (freezing with liquid nitrogen) or ultra-high temperatures (cauterization with infrared or carbon laser). After the damaged tonsil or part of it dies off, it is directly removed. Such surgery is painless, as the local anesthetic is applied to the tonsils. In the postoperative period, the patient may suffer from a sore throat and a slight increase in body temperature for some time.
Electrocoagulation can also be used for such purposes when a high-frequency electric current is applied to damage and destroy tonsils. The operation is painless and bloodless. However, the use of electric currents can adversely affect the healthy tissues surrounding the damaged tonsil. There can be some complications after the operation.
Ultrasonic excision is another option for surgery. Cutting tissue to remove a tonsil is carried out with the help of high-frequency sound. Such surgery has its own advantages, as blood vessels or nearby tissues are not damaged.
The surgery can also be performed in a traditional way, using a scalpel and a wire loop. This operation is performed under general anesthesia and is accompanied by mild bleeding. Immediately after surgery, a patient lays on the side, and an ice pack is placed on the neck (cold helps constrict the blood vessels and prevents bleeding). In the next few days, a patient takes antibiotics to prevent a possible infection.
Contraindications to surgery include:
- Blood clotting disturbances
- Heart pathologies (angina pectoris and tachycardia)
- Kidney diseases
- Decompensated diabetes mellitus
- Severe forms of arterial hypertension
- Active tuberculosis
- Acute infectious diseases
- Pregnancy, third trimester
Photodynamic therapy for tonsil cancer
One of the most advanced methods of treating tonsil cancer is photodynamic therapy. Photosensitizing substances are injected into the area of the neoplasm (locally). They quickly accumulate in the malignant tumor that is exposed to laser radiation after. The photosensitizers absorb the laser light, which triggers a biochemical process that destroys cancer cells.
Photodynamic therapy makes it possible to cure the disease without surgery or chemotherapy, and thus without relevant side effects. However, treatment with photodynamic therapy is only possible for superficial neoplasms (such as squamous cell cancer of the tonsil), in the absence of bone tissue affection, metastases in regional lymph nodes or distant metastases.
Palliative therapy for patients with tonsil cancer
At the advanced stages of the diagnosis, curative treatment is often not possible due to the presence of distant metastases and cranial bone lesions. Nevertheless, there are ways to relieve symptoms, extend a person's life, and slow down the progression of tonsil cancer.
Chemotherapy and radiation therapy are usually used for this purpose. Cytoreductive interventions are also possible. They are not aimed at the destruction of the tumor but allow a maximum reduction of its size. This often makes it possible to avoid critical complications.
When deciding on palliative surgery, chemotherapy, or radiation therapy, the doctor evaluates its possible advantages and side effects. The most reasonable therapeutic scheme is elaborated by a tumor board.
Indications for preventative surgery
There are certain indications for removing tonsils before detection of a malignant process. These are:
- Chronic tonsillitis (irreversible changes in the function of the tonsils and their constant inflammation)
- Development of purulent abscesses, affecting the larynx area
- Unconscious closure of the airways by enlarged tonsils (obstructive sleep apnea)
- Severe immune disturbances
Chronic tonsillitis is one of the main indications for surgery to remove the tonsils. The natural function of the tonsils (protection against bacteria and viruses) is lost in the course of such a disease, and the tonsils themselves become a focus of the inflammatory process.
Chronic tonsillitis can lead to the development of heart disease (affection of mitral and tricuspid valves) and joint disease. It can also cause severe kidney disease. However, early tonsillitis is treated effectively with conservative methods (medications, irrigation, lubrication, physical therapy procedures, etc.). If the treatment of chronic tonsillitis is ineffective, the inflammatory process progresses, and the damaged tonsils no longer contain healthy lymphoid tissue.
In this case, doctors recommend surgical intervention. Surgery to remove the tonsils entirely or partially is called a tonsillotomy.
The cost of treatment in Europe
There is an opinion that the cost of treatment in Europe is exorbitantly high. It prevents many patients from receiving a professional and effective solution to the problem in European hospitals. Cancer patients and their relatives bear considerable expenses for treatment, but the level of treatment varies from country to country. Those who understand this choose European hospitals for treatment and get good results.
Thanks to the development of medical tourism, each patient has the right to choose the country and the clinic with the best quality of medical services and the most reasonable cost of treatment. When assessing the price and quality ratio, the most reasonable prices for treatment are in Germany.
The cost of tonsillectomy for tonsil cancer ranges from 10,800 EUR and 17,400 EUR. The cost of tonsillectomy and cervical lymph nodes resection for tonsil cancer ranges from 12,800 EUR and 21,200 EUR.
No doctor will be able to give you the exact cost of treatment in absentia because several factors influence it. The ultimate price depends on the type and size of the tumor, degree of malignancy, the extent of the tonsil cancer spreading, therapeutic and diagnostic methods used, the type of surgery or other treatments, the type of antitumor drugs, etc.
You can find information regarding the cost of treatment in Europe for your diagnosis on the Booking Health website.
How to start tonsil cancer treatment in Europe?
To start tonsil cancer treatment in European hospitals, you can use the services of Booking Health. Booking Health can resolve every issue, starting from getting a visa to enter the country of choice and up to providing the services of a personal interpreter.
Booking Health will be glad to be your guide, informing you about the possibilities for treatment in European hospitals, where the patient will be provided with the highest quality medical care and where the chances of recovery will be the highest.
We will help you in your journey towards recovery. You will not have to worry about anything, as Booking Health will organize the whole treatment.
To start the treatment in European hospitals, fill in the request form on the Booking Health website, and a medical advisor will contact you as soon as possible.
Authors:
The article was edited by medical experts, board certified doctors Dr. Nadezhda Ivanisova and Dr. Sergey Pashchenko. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
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