These two blood tests do practically nothing to say that you might not have cancer. At
your age however it is almost unheard of for lung or larygeal cancer. If you have a first-degree relative with one of these cancers then your risk of developing cancer in your lifetime would be 50% higher relative risk for lung cancer. (I'm not sure of the statistical difference for laryngeal cancer.) The more likely source of some blood tinged mucous as you describe would by far by infections of the bronchi or sinuses with post-nasal drainage. If you cough up more blood or this is a more recurrent pattern then that would be a more concerning pattern. A full workup to rule out laryngeal and/or lung cancer would include a chest CT, a bronchoscopy and a larygoscopy. I do not think these tests are needed at this time mainly because of your age. These cancers are more of a risk as you get older and have a 20 plus pack-year history of smoking. The main thing that you can do to your benefit now would be to quit smoking. This for one would reduce your average respiratory infections per year in half (on average). If you continue to smoke then your lifetime risk of lung cancer will approach 10% while if you quit your risk will drop to less than 0.5% . I hope this info helps. Follow up questions are welcome if you have any.
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Anthony Bray MD
The blood tests are a matter of degree in terms of what you can determine from them. If you had a sed rate of 2 and normal blood counts then I would interpret that as meaning that nothing of major metabolic or immunologic significance is going on at that time. I have seen patients where the first clue to a malignancy was an elevated sed rate and /or high white count for example. The normal values to my interpretation safely say that you do not have a malignancy of any significant size; but do not mean that you couldn't possibly have some pea-sized group of abnormal cells somewhere. The inner cheek biopsy must have been to evaluate a suspicious looking area. The biopsy tells only what is going on at that spot and can't determine the health of the tissue throughout your body. Symptoms of larygeal cancer are usually a change in voice, chronic hoarseness, a chronic feeling that you need to clear your throat, a "frog in the throat" type of sensation. An ENT can directly visualize your vocal cords with a laryngoscope and this may have been done if an ENT did your cheek biopsy.
With regard to the symptom of cough; many smokers will develop chronic bronchitis due to chronic irritation of the airways. This is the most common cause of cough day in and day out in smokers. Smokers are more susceptible to lower respiratory infections and this is more likely to cause a more severe cough, one that is more likely to keep you up at night and one that is more likely to produce a yellowish productive sputum. With lung cancers; their association with the symptom of cough may depend on their location. Those cancers that start out near the chest wall may not be associated with much cough until they are advanced. Those that start or involve a bronchus are more likely to be associated with a cough. Coughing up bright red blood even in relatively small amounts is potentially a very concerning symptom. If erosion of a bronchus is associated with an infection then this is more likely to be assciated with streaks of blood within a yellowish sputum or a rusty colored sputum.
With laryngeal cancers cough is not typically a primary symptom but may be common in this patient group. As with all cancers , the earlier the detection and treatment then the better the results tend to be. At your age and after only one year of smoking then your risk of either larygeal or lung cancer would be extremely unlikely at this time. I think you are probably becoming overly alarmed about this as a possibilty when in reality it is very unlikely to be connected to your symptoms. That being said perhaps your current fear may be used to the positive to help motivate you to quit smoking before these serious conditions do become a threat. I hope this helps and further follow up questions are welcome if you have any.Oh and it would typically take years for an early cancer to metastasize but this can vary quite a bit.
Best regards, XXXXX XXXXX MD
Well, I think it is VERY unlikely that you have throat cancer based on your age. Also it is not like you've been smoking since you were 5 years old. Also keep in mind that a cancer does not just get better so symptoms from it do not come and go; they come on and gradually get worse. So hoarseness that comes and goes would not be consistent with a cancer.An early symptom of throat cancer might be a "frog in the throat " feeling or a tickle type cough or hoarseness. Swelling of the throat, coughing up blood, weight loss, neck pain, trouble swallowing would more likely be late type symptoms. I think you are fine. The red threads you have noticed are probably just an artifact from inhaled dust from the sounds of it. I hope this helps.
Good Luck, Anthony Bray MD
Well, the "frog in the throat " sensation is a common expression for a feeling that you need to clear your throat , but then your clear your throat and it does not improve. It is the sensation associated with swelling of the vocal cords. It is a common sensation that most people experience on occasion . It is generally associated with a cold and resolves in a couple of days. If you should ever have a throat cancer, we are mainly referring to cancer of the vocal cords because this tissue undergoes at lot of damamge and repair over the years. If a cancer involves the vocal cords then it typically causes an alteration of the voice or hoarseness that would not go away. It may cause ulcerations of tissue that will not heal and so coughing up blood becomes a chronic thing. Difficulty swallowing is a common red flag symptom. This may include aspirating fluid into the windpipe or simply having trouble swallowing food. Cancers that start in the vocal cords may have different patterns of spreading to local tissues and may vary greatly in how rapidly they progress. Some people will stay in denial or avoid treatment for as long as they can which adds to the variable presentation when people are first diagnosed and the estimate of how fast they progress. As for bleeding from the throat vs other areas. A common scenario that many people may have from time to time is an upper respiratory infection which irritates sinus tissues and causes some blood streaked mucous that drains to the back of the throat and may be coughed forward. If you have any ongoing production of blood then it should be checked out. A sinus infection would be limited in time and any streaking of blood would clear up. I hope this helps clear it up for you.
Best Regards, XXXXX XXXXX MD
Yes, I think you are fine. After quitting smoking you may have about 6 weeks of an increased cough because cilia that move stuff out of your airways are being repaired and the mechanism to keep your airways clear is getting back on track. After that you will experience less cough and probably feel an improved sense of energy. Except for the occasional cold that anyone may get, I think your throat will be fine.
Yes, I gathered that you had become obsessed with worry over a condition that you had no realistic chance of having at this stage of your life. You need to stop examining every bit of spit with a magnifying glass or a microscope or whatever you are doing! You may have an anxiety disorder such as obsessive compulsive disorder. You might consider seeing a physician who deals with OCD and/or anxiety disorders in general. There is nothing that I can say that is likely to free you from your tendancy to worry. Sometimes our thought process gets sort of stuck in a particular cycle. I kind of like to think of it as similar to a glitch in a computer program. I suggest that you seek help with regard to this problem and it will probably help you temendously if you can hook up with a good psychiatrist . I think you may fit more into the OCD category and not the hypochondriasis category. I hope this helps to point you in the right direction.
Good Luck To You! And if you would please hit the "ACCEPT" button and I would greatly appreciate it! Thank You, XXXXX XXXXX MD