[3] Main risk factors of developing carcinoma tonsil include tobacco smoking and regular intake of high amount of alcohol.
[4] Other risk factors include poor maintenance of oral hygiene, a genetic predisposition leading to inclination towards development of throat cancer, immunocompromised states (such as post solid-organ transplant), and chronic exposure to agents such as asbestos and perchloroethylene in certain occupations, radiation therapy and dietary factors.
[citation needed] The primary tumor does not have readily discernible signs or symptoms as they grow within the tonsillar capsule.
The affected tonsil grows into the oropharyngeal space making it noticeable by the patient in the form of a neck mass mostly in the jugulodigastric region.
As the tonsils consist of a rich network of lymphatics, the carcinoma may metastasize to the neck lymph nodes which many are cystic.
The additional symptoms include a painful throat, dysphagia, otalgia (due to cranial nerve involvement), foreign body sensation, bleeding, fixation of tongue (infiltration of deep muscles) and trismus (if the pterygoid muscle is involved in the parapharyngeal space).
[citation needed] On the other hand, the tumor may also present as a deep red or white fungating wound growing outwards, breaking the skin surface with a central ulceration.
This wound-like ulcer fails to heal (non-healing) leading to bleeding and throat pain and other associated symptoms.
[citation needed] During biopsy, the lesion may show three signs: gritty texture, firmness and cystification owing to keratinization, fibrosis and necrosis respectively.
[10] It has also been stated under the FDA poisonous plant data base by the U.S Food and Drug Administration [11] An unbalanced diet, deficit in fruits and vegetables has shown to increase the risk of cancer.
[citation needed] The fourth edition of WHO' s classification of head and neck tumors subdivides squamous cell carcinoma of the tonsil into two types: HPV positive or negative.
The cancer cells may spread to adjacent structures, to lymphatics or to distant locations in the body producing secondary tumors.
[citation needed] The tumor may spread locally to soft palate and pillars, base of tongue, pharyngeal wall and hypopharynx.
Factors influencing the incidence of distant metastasis are:[citation needed] The records of 471 male patients with tonsillar carcinoma seen at the Veterans Administration Medical Center, Hines, Illinois, have been reviewed to establish the incidence and site of distant metastasis.
[citation needed] The first step to diagnosing tonsil carcinoma is to obtain an accurate history from the patient.
Finally, the stage is decided by concluding the above results and referring the following chart: The treatment for tonsil carcinoma includes the following methods:[18][19] Early radio-sensitive tumors are treated by radiotherapy along with irradiation of cervical nodes.
[citation needed] Prognosis is determined by various factors such as stage, Human Papilloma Virus (HPV) status, Lymph infiltration of cancer cells, spread of cancer cells beyond the lymph node capsule, margins of the tumor and the extent of metastasis.
Generally the patient presents very late due to the lack of definitive symptoms in the early stages of the disease.
Surgical removal of the tumor and lymphadenectomy of the cervical (neck) lymph nodes can also be taken up at the main treatment method instead of radiation.
Another method of treatment includes, first, surgical removal of tumor as well as cervical lymph nodes followed by chemoradiation or radiation to decrease the chances of recurrence.
[22] Spread of cancer cells to local structures like tissues, vessels, large nerves and lymphatics worsens a patient's prognosis.