Cancerbackup: Q-214

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I have been diagnosed with squamous cell cancer of the tonsil. My doctor says I can have either surgery or radiotherapy. Which should I choose?

Cancers of the tonsil are quite uncommon. Very special skills are needed for their treatment. So before you take any decisions about treatment it is important that you make sure, either by asking your GP or asking at the hospital, that you are being looked after by a team that specialises in the treatment of cancers of the head and neck.

The options for treatment are surgery, often followed by radiotherapy, or radiotherapy (which may or may not be given with some chemotherapy). The precise choice of treatment depends on a number of factors such as the age of the patient, the size of the cancer and whether or not it has spread to involve the surrounding tissues. Your question suggests that your specialists have already considered these factors and that either surgery or radiotherapy would have an equal chance of successfully treating your cancer. Certainly there is no clear evidence from clinical trials to show that one type of treatment is better than the other.

Usually surgery will involve quite a major operation which will result in a degree of permanent disfigurement. Radiotherapy usually involves a course of treatment over some weeks, usually on an out-patient basis, or rarely a small operation under anaesthetic to insert radioactive seeds into the tumour (or, sometimes, a combination of both these methods). Quite high doses of radiation are necessary and so the mouth and throat become very sore during treatment and for some weeks afterwards, this soreness can sometimes make swallowing difficult. Chemotherapy may or may not be given during the radiotherapy and this could increase the side-effects. The precise details of surgery and radiotherapy vary for individual patients and so it is important that you discuss with your specialists exactly what surgery and radiotherapy will involve in your own case, including the short and long-term side-effects you can expect. This will then enable you to make an informed choice.


Content last reviewed: 01 January 2005
Page last modified: 23 March 2005

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