Hi everyone! I've learned so much reading through the posts on this forum -- thank you for sharing!

My 21 year-old son may have tonsil cancer and the ENT would like to perform a tonsillectomy ASAP. We have a second opinion appointment tomorrow with a different ENT. I am trying to figure out the best next steps for a diagnosis.

Background: My son developed a sore throat about two weeks before Christmas. He feels like there is something caught on the left side of his throat. He's lost 5 pounds due to pain with eating and swallowing He was diagnosed with strep (no swab or cultures) and a double ear infection on 12/26. Antibiotics cleared up the ears but not the throat, so a new antibiotic was prescribed, but that was not effective either.

On Friday the ENT said both tonsils looked enlarged and craggy and infected, with the left much larger than the right. He listed several non-malignant issues that could be the cause, but was also concerned about cancer because of the asymmetrical size. He did not swab, scope, or use any mirrors during the exam. He recommended a tonsillectomy ASAP with pathology on the tissues removed.

Is a tonsillectomy the best next step? Should there be a biopsy or imaging before taking out the tonsils? Should I seek a third opinion at Hopkins or Cleveland Clinic?

My husband is a 4x cancer survivor, but this is our first brush with oral cancer.

Thank you!

Welcome to the forum. I am sorry you need to join our family but we are here for you and will try our best to support you.

I'm afraid we can't really recommend one treatment over another. We are a group of cancer patients and caregivers whose lives have been impacted by oral cancer. We do not have the medical knowledge to diagnose or recommend treatments. That should be up to your doctors who have had years of training.

I would assume that in order to report on the pathology on the tissues removed, a biopsy will have to be performed. Do you know if the ENT has had a lot of experience treating oral cancer? This may be a consideration while you are looking for a possible third opinion. If you are indeed going to get a third opinion, it may help if you get a referral to a comprehensive cancer centre where they use a team approach and where they deal with oral cancer on a daily basis.

Please keep us informed of what you decide to do.

Welcome to OCF! Im sorry you have a need to use our group for your 21 year old son. Im hoping his diagnosis is something much less serious than oral cancer. Without a biopsy being done the ENTs can only give a well educated guess as to what is causing your sons symptoms.

Just remember... surgeons cut, thats what they do and usually recommend. Once its been removed, its not possible to put it back or return 100% functionality. I suggest seeking out an opinion from an ENT who specializes in treating oral cancer patients and preferrably is affiliated with a Comprehensive Cancer Center (CCC). A few of the tops ones are Sloan-Kettering, MD Anderson, Johns Hopkins with a few more across the US. Since this was only just discovered a few weeks ago there is time to get that extra opinion (and biopsy). Then as a family you must select the best team and treatment plan.

Hopefully whatever your son has going on is not cancer. But, if it would be you are in the best place for info and support. Heres a link that goes into more detail about diagnosis, biopsies, etc.

Best wishes!!!


OCF Main Site --- Understanding/Diagnosis