What is Tonsillar Squamous Cell Carcinoma (TSCC)?
Tonsillar Squamous Cell Carcinoma (TSCC) is a type of cancer that originates in the tonsils, located in the throat. It is the most prevalent form of tonsil cancer and is often classified as a type of throat cancer.
Disease Epidemiology
- In 2024, over 21,000 new cases of oropharyngeal cancer were reported in the United States.
- TSCC accounts for 15–20% of all oropharyngeal cancer cases, making it one of the most common subtypes.
- It is more prevalent in men than women, with a male-to-female ratio of more than 2:1.
- In North America and Europe, 70–80% of TSCC cases are linked to Human Papillomavirus (HPV) type 16, and HPV-related TSCC generally affects younger patients.
Causes
The development of TSCC is influenced by several factors:
1. HPV Infection:
Particularly HPV type 16, a significant risk factor for TSCC.
2. Smoking:
Smoking more than 1.5 packs daily triples the risk.
3. Alcohol Consumption:
Consuming four or more alcoholic drinks daily increases the risk sevenfold.
4. Other Risk Factors:
- Poor dental hygiene.
- Genetic predisposition.
- Immune system suppression.
- Exposure to harmful chemicals.
- Prolonged radiation exposure.
Signs and Symptoms
Common symptoms of TSCC include:
- Persistent sore throat.
- Pain or difficulty swallowing.
- Lump in the throat or neck.
- Bad breath.
- Blood in saliva.
- Hoarseness or voice changes.
- Ear pain.
- Constant fever.
- Unintentional weight loss.
Diagnosis
A thorough diagnostic process includes:
1. Physical Examination:
Assessment of the throat, neck, and chest for lumps or masses.
2. Imaging Techniques:
CT scans, MRI, and X-rays to determine the tumour’s location, size, and spread.
3. Biopsy:
A small tissue sample is collected and tested in the lab to confirm the presence of cancer.
4. Tumour Markers and Cytology:
Sputum cytology and USG-guided fine needle aspiration cytology help in identifying cancer cells.
Treatment
Treatment typically involves a combination of surgical and therapeutic approaches:
1. Surgery:
The primary treatment is the removal of the tumour with clear margins (healthy tissue around the tumour).
2. Radiation Therapy:
Often recommended after surgery to lower the risk of cancer recurrence.
3. Chemotherapy:
Used in advanced cases or when surgery and radiation are insufficient.
4. Immunotherapy and Targeted Therapies:
Emerging treatments to enhance outcomes, particularly in HPV-related TSCC.
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