If you are on the older side, 50+, have been smoking most of your life, alcohol is your best friend, you want to lose weight but haven’t quite achieved it yet, work keeps you busy, stock markets keep you anxious, chances are a persistent sore throat can make you start wondering if Cancer has caught up with you. If you google non healing ulcers, persistent symptoms and lumps, your worries will escalate to another level. If you go to your ENT Surgeon, whom you don’t really know because, lets accept it, who knows an ENT surgeon ever, he may suggest an Endoscopy, and now you will really start to worry.
Let me solve this for you. It’s not simple, it’s not definitive or complete, but the following points are pretty good.
1 – If you haven’t been losing weight, you don’t have cancer. Almost always, Cancer patients start to lose weight quite early on. I know what you are thinking – “I am gaining weight” – so you are good. That’s right.
2 – A niggling sore throat, phlegm like sensation in the throat, something stuck in the throat feeling, is usually acid reflux.
3 – A lump in the neck that is soft, tender to touch, comes and goes are again nothing to worry about from a Cancer perspective.
4 – That white spot in your throat, that you have spotted with your telephone camera, is nothing.
5 – A one off blood in the sink, especially after a violent throat clearing exercise is again nothing to worry about.
So what should you worry about?
1 – Weight loss without dieting and exercise.
2 – Difficulty in swallowing food. Not saliva, but actual solid food. If you can’t seem to take it down, you have to worry.
3 – Persistent cough with recurrent episodes of blood, especially in expectorated sputum.
4 – Hoarseness of voice that keeps increasing and just doesn’t go away (not one that goes away in a few days and is associated with a flu.)
5 – A hard lump in the neck that was not there previously, has never decreased in size, usually painless.
6 – Ulcer in your mouth or tongue or cheek with thick white discolouration not getting better with time. Almost always painless to start with.
If you have a doubt, the best thing is to consult your General Practitioner and then an ENT Surgeon. Let the two decide the next steps for you. And if they suggest nothing needs to be done. Then that’s good. If there is something suspicious, then the first step is to look at it with a camera (Endoscopy), 2nd step is to do scans and the 3rd step is to take a biopsy (remove a tiny part of it and send to labs for final diagnosis). Final diagnosis is based only on biopsy. You can never avoid this step. Never. Once diagnosis has been confirmed, treatment plans can be figured out. World-wide, the best practice is for a multi-disciplinary team (Tumour Board / MDT) to look at the full picture and make a plan for you. At the very least, you must take the opinion of a Cancer Surgeon (pros and cons of surgery) and an Oncologist (pros and cons of Radiotherapy and Chemotherapy). Good news is Head and Neck Cancers are rare. So don’t worry until you have to.
NOTE: This article has been written strictly from an ENT perspective. The Author knows very little about anything else.