- Actor Moshe Kasher’s recent tonsil cancer diagnosis has raised questions about the disease.
- Tonsil cancer is the most common oropharyngeal cancer.
- The symptoms of tonsil cancer can be confused with other, less serious conditions.
Moshe Kasher—an actor, writer, and producer best known to some for his role in The Pitt’s second season—recently shared some sad news on Instagram: He has tonsil cancer. The 46-year-old revealed that he found a bump on his tonsil three months ago while producing The Comeback Kid. He was eventually diagnosed with HPV-positive tonsil cancer.
While Kasher said he was “in pain” and “in the middle of a very difficult [recovery] process,” he added, “the good news is the cancer I have has an incredibly high cure rate—in the 95% zone.” But Kasher went on to warn his followers that tonsil cancer is an “epidemic in men under 55,” urging people to “get checked” and ensure their kids get the HPV vaccine.
Kasher’s news has raised a lot of questions about tonsil cancer and what symptoms to look out for. Unfortunately, they’re not always easy to spot. Here’s why.
Meet the experts: Daniel L. Faden, M.D., associate professor in the Department of Otolaryngology-Head and Neck Surgery at Harvard Medical School and director of the Cancer Head and Neck Cancer Genomics and Liquid Biopsy Program at Mass General Brigham Cancer Institute; Caitlin McMullen, M.D., surgeon in the Head & Neck – Endocrine Oncology Department at Moffitt Cancer Center; Kanwar Kelley, M.D., otolaryngologist, head and neck surgeon, and co-founder of Side Health.
What is tonsil cancer?
Tonsil cancer is a tumor on the tonsils, which are in the back of the throat. It’s the most common form of oropharyngeal cancer, according to the Cleveland Clinic.
Still, it’s not a common cancer overall. About 60,480 new cases of oral cavity or oropharyngeal cancer are expected to be diagnosed in the U.S. this year, while approximately 13,150 people will die from these cancers, according to estimates from the American Cancer Society (ACS).
What are the major symptoms of tonsil cancer?
Symptoms of tonsil cancer can be vague and non-specific, making them easy to brush off at first. These are some of the biggest symptoms of tonsil cancer, according to the Cleveland Clinic:
A sore throat that won’t go away.
This is a “persistent, one-sided sore throat,” says Daniel L. Faden, M.D., associate professor in the Department of Otolaryngology–Head and Neck Surgery at Harvard Medical School and director of the Cancer Head and Neck Cancer Genomics and Liquid Biopsy Program at Mass General Brigham Cancer Institute. People may also have a “foreign body sensation” in the throat, according to Caitlin McMullen, M.D., a surgeon in the Head & Neck–Endocrine Oncology Department at Moffitt Cancer Center.
Ear pain.
“Ear pain, especially on one side, can also be an early clue,” says Kanwar Kelley, M.D., otolaryngologist, head and neck surgeon, and co-founder of Side Health. Why ear pain? “The tonsil and the ear share the same nerve supply, so a tumor in the tonsil refers pain to the ear,” Dr. Faden says, adding that tonsil cancer often presents as “one-sided ear pain with a normal-looking ear exam.”
Bad breath.
Tonsil cancer commonly causes bad breath, or halitosis, for a few reasons. “Primarily, tumors can be smelly,” Dr. McMullen says. “They can trap food debris also, which can cause an odor.” Dr. McMullen adds that people may also have trouble with oral hygiene, such as brushing and gargling, if they have a painful lump in their throat—and that can lead to an odor, too.
A swollen lymph node.
“The single most common presenting sign is actually a painless lump in the neck—an enlarged lymph node,” Dr. Faden says. “Tonsil cancers—especially the HPV-related ones—tend to spread to the neck lymph nodes early, so a firm, painless neck mass is often the first thing people notice.”
Other symptoms of tonsil cancer can include blood in your saliva; trouble swallowing, speaking, or chewing; mouth pain; and sores in the back of your mouth that don’t heal, per the Cleveland Clinic.
Overall, Dr. Faden says, “The theme is persistent and one-sided.” You can have several symptoms of tonsil cancer at once, or you may only deal with one, he adds: “A single persistent, asymmetric symptom—a neck mass, one-sided sore throat or ear pain, or an asymmetric tonsil—is enough to get checked. Don’t wait it out.”
What else can these symptoms indicate?
Doctors stress that having symptoms linked with tonsil cancer doesn’t mean you have tonsil cancer. “Plenty of benign things mimic this,” Dr. Faden says, including:
- Tonsillitis
- Mononucleosis
- A peritonsillar abscess
- Tonsil stones
- Reactive lymph nodes from a recent infection
What to do if you notice these symptoms
Don’t panic if you notice these symptoms, but don’t brush them off, either. “Regular viruses or colds can cause similar symptoms,” Dr. McMullen says. “But if those symptoms persist after two weeks, it is important to get checked.”
She suggests first consulting with your primary care provider, or an ear, nose, and throat doctor if you have access to one. “They will do a physical exam and determine if there is something concerning and potentially order imaging like a CT scan,” Dr. McMullen says.
Overall, doctors say it’s important to continue to push for answers if you’re struggling with symptoms that won’t quit. “Most tonsil cancers today are caused by HPV and often occur in otherwise healthy, middle-aged nonsmokers, which is part of why they get overlooked,” Dr. Faden says.
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