Its probably only a tonsil infection, he thought, just like every other person in their 30’s would think, for he was not only young, but also a never-smoker and non-alcoholic. A few weeks had passed but the foreign body sensation and pain during swallowing were only seeming to get worse with time. He decided to delay no further and consulted his local physician who told that the fleshy mass that was seen in his left tonsil could be cancer and he better consult an oncologist for final diagnosis and management. His worst fears came true when he learnt that it was indeed a cancer arising from the tonsil.
Even for oncologists like us who were trained in “How to Break the Bad news to cancer patients”, its never easy to convey to a 30-year old that he has cancer. “I do not smoke or drink, why me?” is one of the questions we hear often from young Tonsillar cancer patients. In these patients, there is usually a viral cause-The Human Papilloma virus (HPV), which is also the causative agent implicated in other cancers like cervix, vulva, vagina, penis and anus. The good news is that HPV-associated tonsil cancers have excellent prognosis and hence we were able to re-assure the patient.
Once the Biopsy and staging workup were completed, we came to know that the cancer had spread to the lymph nodes in his neck as well. We counselled him and although anxious at first, he co-operated well during the entire duration of his treatment. He had received concurrent chemotherapy (6 cycles) along with External beam radiation therapy over five and a half weeks. He tolerated the treatment well and completed the course without any interruptions.
After the treatment completion, he was on regular monthly follow-up during when he was symptom-free and clinically disease-free. When he visited us for his 3rd month follow-up, he had complete clinical and radiological resolution of disease. His quality of life, as told by him, was as good as Pre-disease status.
The modality of Radiation therapy delivered to him was one of the recent advancements in the field of oncology in our country known as Volumetric Modulated Arc Therapy (Varian, RapidArc®) which helps to deliver radiation therapy with great accuracy and precision such that the tumor gets the desired dose for cancer cell kill and the surrounding normal organs receive minimal doses. This helps cancer patients to undergo treatment with minimal side effects without compromising on cancer cell kill.
We wanted to bring forward the message through our patient that people should not ignore their symptoms however trivial they might seem, whichever life style they follow and whatever their age is, because cancer doesn’t discriminate based on these variables only. It is to our advantage that we should utilize the healthcare resources around us and get ourselves checked, should any symptoms arise. If we are able to diagnose it fairly early as in the case of our patient, cure from cancer is very much possible.
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