What Is the Prognosis for Tonsil Cancer?

Medically Reviewed by Melinda Ratini, MS, DO on May 31, 2022
4 min read

When you learn that you have tonsil cancer, you may want to know about your prognosis -- an estimate of how serious your disease is and what to expect in the future.

Keep in mind that not everyone wants to learn their prognosis, and that's OK. But if you do, your doctor is the best person to ask. They do tests to see how large your cancer is and whether it has spread from your tonsils to another part of your body. The results will guide your treatment and help you learn about your outlook.

There are a few key things that have an impact on your tonsil cancer prognosis, including your age and health, the stage of the cancer, and whether you have human papillomavirus (HPV) -- an infection that's passed through sex.

Your age. Tonsil cancer used to be diagnosed more often in people in their 60s or 70s. Today younger people get this cancer. One reason is that HPV is more common in young people. HPV raises your chances of getting a cancer of the mouth and throat.

Being young could be an advantage when it comes to your prognosis. Some studies show that people who are 40 or younger have a better outlook than older people.

Your health. Good overall health could be another reason why young people do better than older people with this cancer. Having heart disease, lung disease, or another long-term condition can lead to a worse prognosis.

Your cancer stage and grade. You'll have a better outlook if your doctor catches your cancer early, before it grows and spreads. Early-stage tonsil cancer that has not spread outside of the tonsil can be treated and possibly even cured.

When tonsil cancer spreads to the lymph nodes, it can travel from there to other parts of your body. Cancer that spreads to lymph nodes in your neck or to other organs has a worse prognosis than cancer that is only in your throat. This doesn't mean your cancer can't be treated -- only that it may be harder to treat than an early-stage cancer.

Also important is your cancer's grade -- how different the cancer cells look under a microscope compared to normal cells. Knowing the grade can help your doctor predict how quickly your cancer will spread. High-grade cancers tend to spread faster than low-grade ones.

Whether you're HPV-positive. When you're diagnosed, your doctor will test you for HPV. People with HPV-positive tonsil cancer have a better outlook and a higher chance of a cure than those with HPV-negative cancer.

If you smoke or drink. You'll have a better outcome if you don't smoke or drink. Smokers are more likely to get tonsil cancer, and to die from it, than nonsmokers. Continuing to smoke or drink during treatment can cause treatment complications and may make it not work as well.

Which treatment you get and how you respond to it. Surgery, radiation, and chemotherapy are all treatments for tonsil cancer. Your doctor will help you choose the treatment that is most likely to work best for you.

If you have surgery, your doctor will remove the cancer and an area of healthy tissue around it called a "margin." Having clear margins means that your surgeon is able to remove all of the cancer, which can improve your prognosis.

When your doctor talks to you about your prognosis, they may use the phrase "5-year survival rate." It's a number based on research done on large numbers of people with oropharyngeal cancer -- cancers of the tonsils and the base of the tongue.

Keep in mind that survival rates don't predict what will happen to you in the future. Your outlook has to do with the kind of treatment you get and a host of things, like your age and overall health.

Five-year survival rates are the percentage of people with cancer who are alive 5 years or longer after their diagnosis. The overall 5-year survival rate for oropharyngeal cancer is 67%. That means 67 out of 100 people are alive 5 years after their diagnosis.

Researchers have also developed specific 5-year survival rates for oropharyngeal cancer that are based on whether and where the cancer has spread:

  • Early-stage cancer that hasn't spread: 85%
  • Cancer that has spread to nearby lymph nodes, tissues, or organs: 68%
  • Cancer that has spread to distant parts of the body: 40%

People with HPV-positive tonsil cancer have a 5-year "disease-free" survival rate of about 86%. Disease-free survival means they have no signs of cancer during the 5 years after their diagnosis.

It's important to know that all these numbers come from studies that were done a few years ago. People who are diagnosed with tonsil cancer today may have a better prognosis thanks to new treatments.

If you choose to talk to your doctor about your specific prognosis, make sure you get all your questions answered. Ask if there are things you can do to improve your outlook, like joining a clinical trial, where researchers study experimental treatments.

Show Sources


American Cancer Society: "Survival Rates for Oral Cavity and Oropharyngeal Cancer."

Canadian Cancer Society: "Prognosis and survival for oropharyngeal cancer."

Cancer.Net: "Oral and Oropharyngeal Cancer: Stages and Grades," "Oral and Oropharyngeal Cancer: Statistics."

Cedars Sinai: "Tonsil Cancer."

Journal of Cancer Metastasis & Treatment: "Early stage squamous cell carcinoma of the tonsil presenting with multiple organ metastases including skin and brain after successful local treatment."

Mayo Clinic: "Tonsil Cancer."

MD Anderson Cancer Center: "Q&A: What You Should Know About Tonsil Cancer."

Medscape: "Head and Neck Carcinoma in the Young Patient."

Mount Sinai: "Human HPV and Throat/Oral Cancer Frequently Asked Questions."

National Cancer Institute: "Oropharyngeal Cancer Treatment (PDQ)-Health Professional Version."  "Understanding Cancer Prognosis."

National Foundation for Infectious Diseases: "Facts About HPV for Adults."

StatPearls: "Cancer, Tonsil."

THANC Foundation: "Oropharyngeal Cancer Prognosis."

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