Lawrence Chow / ENT Doctor
Tonsillar Cancer: Understand the Symptoms and Causes to Identify and Treat it Early!
Case Study:
“Mr. Cheng, a 55-year-old with a long-term history of smoking and heavy alcohol use, recently sought medical attention due to persistent throat pain and difficulty swallowing. An oral examination revealed swelling and ulceration on one of his tonsils. A biopsy confirmed a diagnosis of tonsil cancer. Unfortunately, due to late detection, the cancer had already metastasized to the cervical lymph nodes, requiring a comprehensive treatment plan involving surgery, radiotherapy, and chemotherapy.”
What is Tonsil Cancer?
Tonsil cancer is a malignant tumor arising from the tonsillar tissue, predominantly classified as squamous cell carcinoma and categorized as a type of head and neck cancer. In Hong Kong, most patients are males over 45 years old. Tonsil cancer is staged into four phases, but early symptoms are often nonspecific, leading to delayed diagnosis. Many patients are diagnosed at advanced stages (III or IV) when the cancer has already spread to other body parts.
Common Symptoms and Complications
Early Symptoms:
- Throat discomfort or mild pain, often mistaken for pharyngitis.
- Unilateral tonsil enlargement, surface roughness or ulceration, sore throat, and difficulty opening the mouth.
Progressive Symptoms:
- Severe throat pain, accompanied by tinnitus or pain on the same side of the ear, unrelieved by medication.
- Dysphagia, hoarseness, and painless neck lumps (indicating cervical lymph node metastasis).
- Rapid weight loss and breathing difficulties (due to airway obstruction by the tumor).
Late-Stage Symptoms:
- Distant metastasis to organs like the lungs or liver, leading to organ failure.
Causes and Risk Factors
- HPV Infection: 70% of tonsil cancers are linked to HPV, particularly high-risk strains like HPV-16.
- Chronic Inflammation: Recurrent tonsillitis may trigger cellular mutations.
- Smoking and Alcohol: Synergistic damage to mucosal tissues by tobacco and alcohol.
- Environmental Exposure: Long-term contact with chemicals or radiation.
- Immunosuppression: Higher risk in HIV/AIDS patients or organ transplant recipients.
Diagnostic Methods
- Laryngoscopy: Visual examination of tonsil morphology and cervical lymph nodes.
- Biopsy: Tissue sampling for pathological analysis.
- CT/MRI Scans: Assess tumor size and invasion extent.
- PET-CT Scans: Detect systemic metastasis.
- HPV Testing: Determine viral involvement to guide treatment.
Treatment Options
Treatment depends on cancer staging, typically involving a multimodal approach:
Surgery:
- Early-stage tumors: Tonsillectomy with preservation of surrounding functions.
- Advanced cases: Extensive resection with cervical lymph node dissection.
Radiotherapy:
- Effective for radiation-sensitive tumors (e.g., HPV-positive cases), used alone or post-surgery.
- Advanced techniques like Intensity-Modulated Radiation Therapy (IMRT) minimize damage to healthy tissues.
Chemotherapy and Targeted Therapy:
- For advanced or recurrent cases, combined with targeted drugs.
- Immunotherapy (e.g., PD-1 inhibitors): Shows significant efficacy in metastatic or recurrent tonsil cancer.
By raising awareness and promoting early detection, the prognosis of tonsil cancer can be significantly improved. Regular check-ups and lifestyle modifications are critical for high-risk populations.
Early detection is critical for effective treatment. Please immediately contact ENT Head and Neck Surgery Centre for detailed evaluation by our ENT specialists (Tel: 3100 0555).
Source:
HK ENT Specialist Ltd.
ENT Head and Neck Surgery Centre
For ENT Services, Audiology & Speech Therapy,
Sleep Disordered Breathing Management,
Hearing Aid Prescription & Medical Cosmetic Services
https://www.hkentspecialist.hk
Hypopharyngeal Cancer: The Silent Throat Killer – Do Not Ignore the Warning Signs of Swallowing
Case Study
“Mr. Kang, a 58-year-old with a long-term smoking and alcohol consumption history, recently experienced persistent sore throat, dysphagia, and hoarseness. After examination via endoscopy, he was diagnosed with Stage III Hypopharyngeal Cancer (mid-to-late stage). Mr. Kang underwent tumor resection surgery followed by radiotherapy and is currently under observation, requiring regular check-ups to monitor recurrence.”
What is Hypopharyngeal Cancer?
Hypopharyngeal cancer originates in the hypopharynx (the area connecting the throat to the esophagus) and is a type of head and neck cancer. Due to its隐蔽位置 (hidden location), early detection is challenging. Approximately 70% of patients, like Mr. Kang, are diagnosed only after the cancer has metastasized to cervical lymph nodes or distant organs (e.g., lungs, bones, liver). Consequently, treatment outcomes are often poor.
Common Symptoms and Complications
Early symptoms are subtle, but the following signs warrant vigilance:
- Typical symptoms: Sore throat, dysphagia, hoarseness, neck mass, ear pain (referred pain).
- Long-term complications: Tumors may obstruct the airway or esophagus, leading to malnutrition or breathing difficulties. Metastasis to lymph nodes or distant organs significantly complicates treatment.
Causes and Risk Factors
- Primary risk factors: Smoking, heavy alcohol consumption, betel nut chewing (a major trigger in regions where betel nut use is prevalent).
- Other factors: Chronic irritation from gastroesophageal reflux disease (GERD), diets lacking fresh fruits/vegetables, human papillomavirus (HPV) infection.
- Genetics and environment: Family history or prolonged exposure to asbestos/chemical dust increases risk.
Diagnosis and Tests
- Endoscopy: Flexible fiber-optic laryngoscopy to visualize lesions.
- Imaging: CT/MRI scans to assess tumor extent and metastasis.
- Biopsy: Tissue sampling to confirm cancer type.
- Systemic evaluation: PET-CT scans to detect distant metastasis.
Treatment Options
- Early-stage (I/II): Radiotherapy ± localized surgery.
- Advanced-stage (III/IV): Multidisciplinary approach (e.g., tumor resection with lymph node dissection, followed by adjuvant chemo/radiotherapy).
- Targeted & immunotherapy: Anti-EGFR agents (e.g., Cetuximab) or immune checkpoint inhibitors (e.g., Pembrolizumab) for late-stage cases.
- Supportive care: Nasogastric tube placement, speech therapy to improve quality of life during recovery.
Conclusion
Quitting smoking/alcohol and early detection are crucial in combating hypopharyngeal cancer. Individuals with smoking/drinking habits experiencing persistent throat discomfort should seek prompt medical evaluation. For ENT concerns, contact ENT Head and Neck Surgery Centre or call 3100 0555 for specialized care.
Source:
HK ENT Specialist Ltd.
ENT Head and Neck Surgery Centre
For ENT Services, Audiology & Speech Therapy,
Sleep Disordered Breathing Management,
Hearing Aid Prescription & Medical Cosmetic Services
https://www.hkentspecialist.hk
Ear Pain and Discomfort – What It Is and How It’s Treated
Ear Pain and Discomfort – What It Is and How It’s Treated
Often referred to as an earache, this could refer to any form of irritation such as a burning sensation in the ears or a dull, constant pain that does not go away. Some earaches come with tinnitus, a sharp ringing sound inside the ear.
Ear pain is more common in children than it is with adults. When it does occur in adults it is often accompanied with a sensation of vertigo or even Meniere’s Disease, a sign that there is something wrong with the inner ear. Continue reading
Ruptured Eardrum Symptoms and Treatments
Ruptured Eardrum Symptoms and Treatments
A ruptured ear or perforated tympanic membrane occurs when a tear or hole appears in the eardrum, separating the middle ear and ear canal. If this occurs, your middle ear becomes susceptible to injury and hearing loss. While some ruptured eardrums heal quickly, others require treatment or surgery.
Symptoms
Ear pain is the most common symptom and may be accompanied by bloody, pus filled or clear drainage. You will also experience some degree of hearing loss, hear ringing sounds or feel vertigo, resulting in vomiting and/or nausea. It’s very important you see a doctor because the inner and middle ears are very delicate and susceptible to disease if not treated. Continue reading
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另所有文章內使用的人名均為化名。
另所有文章內使用的人名均為化名。