You know the feeling at the beginning of any pesky cold—congestion, a sore throat, and, probably, swollen tonsils. In rare cases, though, sore throats involving your tonsils could be a sign of cancer, which Grammy-winning country singer John Berry recently experienced.
Berry, 59, shared in a Facebook video that he started feeling a “catch” in his throat that felt just like the “skin of a Spanish peanut was stuck in my throat.” And, when he shined a flashlight down the back of his mouth, he noticed his tonsils were “really swollen.” After a visit to the doctor, he was prescribed a round of antibiotics and steroids, but his symptoms continued. He eventually saw an ear, nose, and throat specialist who had him undergo a CT scan, which revealed that he had two tumors in his tonsils.
Berry’s wife, Robin, said in the video that her husband will undergo treatment for about five weeks, adding that “all is well.” Berry also told his fans that his cancer is “highly treatable” and has an “incredible” 90 percent cure rate.
Tonsil cancer is one of a group of mouth and throat cancers that are becoming increasingly common.
As the name implies, tonsil cancer is a cancer that starts in the cells of your tonsils, the two oval-shaped pads at the back of your mouth, the Mayo Clinic says.
Tonsil cancer is often lumped in with a group of cancers called oropharyngeal cancers, which are cancers of the throat, back of the tongue, and soft palate, Caitlin McMullen, M.D., a surgeon in the department of head and neck endocrine oncology at Moffitt Cancer Center, tells SELF. “In general these cancers are uncommon, but the rate of oropharyngeal cancers is rising worldwide, in particular in North America [in relation to] the human papillomavirus (HPV),” she says.
According to recent estimates from the Centers for Disease Control and Prevention (CDC), about 3,400 new cases of HPV-related oropharyngeal cancers are diagnosed in women and about 14,800 cases are diagnosed in men each year in the U.S. And, as SELF explained previously, the rates of these cancers have been rising since the late 1990s.
It's difficult to estimate exactly what chunk of these oropharyngeal cancers are tonsil cancers, but Erich Madison Sturgis, M.D., a professor in the department of head and neck surgery at The University of Texas MD Anderson Cancer Center, tells SELF that he’s seen a “rising number” of cases of this form of cancer lately. "As a medical community, we are seeing more patients coming in with tonsil cancer," Omid Mehdizadeh, M.D., an otolaryngologist and laryngologist at Providence Saint John’s Health Center in Santa Monica, Calif., tells SELF. "We’re getting a lot of patients who have never been smokers or drinkers, and historically those were the ones that would be more likely to develop tonsil cancer."
The symptoms of tonsil cancer can be tough to distinguish from those of a "regular" sore throat.
Tonsil cancer can cause difficulty swallowing and a feeling like something is caught in your throat, the Mayo Clinic says, but those are also pretty standard for a sore throat related to a minor viral or bacterial illness.
So it's important to pay attention to what other symptoms you have in addition to the sore throat. If the culprit is something like a cold, flu, upper respiratory infection, or strep throat, you'll probably also notice a fever, runny nose, and body aches, Melin Tan-Geller, M.D., an otolaryngologist at ENT and Allergy Associates and associate professor at the Albert Einstein College of Medicine/Montefiore Medical Center, tells SELF.
The timing of your symptoms matters, too. Most viral respiratory illnesses resolve within 10 days (although it may take longer for a persistent cough to go away). If you have a sore throat that won’t quit, your doctor will generally recommend waiting it out or treating it with antibiotics to see if that helps clear the infection. But that won’t help if you’re actually dealing with tonsil cancer, Dr. Sturgis says. So, if even that doesn't work, that could be a sign that you're dealing with something more serious.
A few other things to look out for with tonsil cancer include bleeding from your throat or swollen lymph nodes that won’t go down, Dr. McMullen says. People with tonsil cancer may also have a visible sore at the back of their throat, Dr. Tan-Geller says, and you may even notice that one side of your tonsils is swollen while the other isn’t. “That would be a sign that something isn’t right,” Dr. Sturgis says.
"In general, a persistent sore throat that doesn't respond to antibiotics should be evaluated by a specialist," Dr. Mehdizadeh says.
If you have a sore throat that doesn’t go away within a few weeks or with standard treatment, see a specialist.
Specifically, it's worth seeing an ear, nose, and throat specialist. There, the doctor will examine your mouth and throat, might feel your throat for any lumps, and use a mirror and bright light to examine the inside of your mouth, the Mayo Clinic says. If your doctor finds anything that looks abnormal, they’ll likely take a sample of cells to be sent out to a lab for testing and may order imaging tests like a CT scan or MRI.
If you are diagnosed with tonsil cancer, the right treatment plan for you depends on your individual case and how far your cancer has progressed, Dr. McMullen says. Given how vague the symptoms can be and how easy it is to write off a sore throat, tonsil cancer is usually diagnosed later in the disease, when the cancer has spread to the tongue and lymph nodes, the Mayo Clinic says. Depending on your stage, your doctor may recommend surgery to remove the infected tonsils, radiation, chemotherapy, or a combination of those things, Dr. McMullen says.
Overall, the prognosis for tonsil cancer is “excellent” if it’s treated well, Dr. Sturgis says. However, the treatment is "not easy" and really requires a specialist who treats this fairly regularly, Dr. Sturgis notes. “If it fails, it’s unlikely there will be a chance to salvage the situation. That’s why it’s important to be treated by someone who does this a lot.”
Given that so many of these cancers are associated with HPV infections, experts also stress the importance of getting the HPV vaccine and vaccinating your kids, which helps protect against the strains of HPV that are most likely to cause cancer. “The reason we’re having this epidemic of oropharyngeal cancers is HPV,” Dr. Strugis says. “We’ve got to get our kids vaccinated.”