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Dr. Chip
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 22771
Experience:  Over 20 yrs of Family Practice
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Scared of oral/throat cancer

Resolved Question:

I've been dealing with a lump in my throat about a month. Before the past month, my throat would occassionally have the lump sensation, but it was never like this. My primary care doctor spotted cobblestoning in my throat from the post nasal drip and suggested it was acid reflux and post nasal drip(about a month ago). I also have been dealing with whiteness and dryness on my tongue, as well as lesions on my tongue. Yesterday I went to the hospital because I had noticed I had lost around 15 pounds, and because I was very dizzy, nauseous, felt feverish and I could not eat although I had barely eaten anything that day (loss of appetite). I am 18 years old, and over the past year I have heavily used tobacco with hookah(technically smokeless tobacco) and cigarettes and very occasionally cigars, but less with cigarettes. At the hospital they did blood tests, both of them came out fine and they did 2 x rays of my neck and chest. They did not have me swallow or anything during the x rays. They referred me to an ENT specialist, and a GI specialist. They prescribed nasonex to me because they believe that this is a post nasal drip and acid reflux issue. My whole throat feels swollen and my neck feels tender to move, especially up and down. I am still very worried that it is cancer. Should I be worried? (also I do not have strep) Nobody seems to think it's cancer but for some reason I'm very worried.

Submitted: 1 year ago.
Category: Health
Expert:  Dr. Chip replied 1 year ago.
Hi--can you tell me more about this lump in the throat sensation? And more about the tender feeling?
Customer: replied 1 year ago.

What would you like to know about the lump? It doesn't hurt that bad but it has a bulging sensation. It also feels kind of close to my adam's apple, and I can especially feel it when breathing through my mouth or laying on my back, or both. And my neck/throat feels especially swollen (although it doesn't appear it on the outside) and tender on the sides of my adam's apple, especially if I tilt my head up. There is a slight feeling of straining when I tip my head up. I was sent home from the ER thinking it was pharyngitis or some sort of bacterial infection, and was told to follow up with those specialists. My throat also has a feeling of tightness, which relates to the swelling feeling, i'm guessing

Expert:  Dr. Chip replied 1 year ago.
OK--so are you saying, with this lump, that there seems to be a problem with your swallowing? And what studies if any did the GI and ENT specialists do?
Customer: replied 1 year ago.

Some minor difficulty from the swallowing yes, and I haven't gone to the GI and ENT yet, I went to the ER last night and they directed me to them. I have gotten x-rays of my neck and my chest, both turned out to look normal, according to the doctor in the ER last night

Expert:  Dr. Chip replied 1 year ago.
OK--the weight loss of 15 pounds--over what period of time and because you were eating less?
Customer: replied 1 year ago.

i'm assuming the weight loss happened over a span of 2 weeks, I did not weigh myself throughout the process. I think i might have been eating less because along with all of this going on, my anxiety and stress levels have been through the roof. But also, it's difficult to eat with my lack of appetite

Expert:  Dr. Chip replied 1 year ago.
And have you had a long standing problem with anxiety and stress? If so, have you had any therapy for that?
Customer: replied 1 year ago.

yes, and I have had therapy and I usually have it under control, but this situation has made me much more anxious than I've ever been, to the point where I signed up for an account on here

Expert:  Dr. Chip replied 1 year ago.
OK--and the physical exam of your neck by the doctor was completely normal?
Customer: replied 1 year ago.

what do you mean by physical exam? I haven't had anything yet, I've gone to the ER yesterday, gotten an x-ray and bloodwork and that's about it, and the x ray was normal, along with the bloodwork

Expert:  Dr. Chip replied 1 year ago.
Didn't the doctor at the ER examine you and I assume he checked your neck and throat by laying hands there?
Customer: replied 1 year ago.

I think he might have, I don't remember it was an assistant I think. I'm debating on going back tonight because I'm not sure, so i'm asking here

Expert:  Dr. Chip replied 1 year ago.
OK--before I answer, can you tell me why exactly with all this you think it could be throat cancer?
Customer: replied 1 year ago.
Weigh loss, lump in throat, I haven't had my actual throat checked out with a scope and I haven't had a biopsy. I'm very fatigued and my neck feels so swollen right now, especially upon looking down and looking up
Expert:  Dr. Chip replied 1 year ago.
OK--first off you're really too young for this likely to be throat cancer in the first place. And for a throat cancer to cause significant swallowing problems and perhaps neck swelling from enlarged nodes and weight loss it would have to be large and far advanced and not causing these problems in the short space of a month. I think a good bit of this is your anxiety but I also think your major problem is likely gastric reflux and the GI doctor can work that up with an upper endoscopy and a screen for H pylori--the so-called ulcer bug.
Customer: replied 1 year ago.
Okay thank you for the reply. I noticed this lump about 6 months ago and it would come and go. Even with my heavy tobacco use you wouldn't think I have throat cancer?
Expert:  Dr. Chip replied 1 year ago.
No--it takes years for tobacco use like that to cause cancer and if it were a tumor that caused swallowing problems because of its size the symptoms of the lump wouldn't come and go--that sounds very much like anxiety
Customer: replied 1 year ago.
Okay thank you. What about the swollen feeling? Do you think it's from acid reflux? Post nasal drip? Or what about the lump? Or the lesions on my tongue and whiteness on tongue?
Expert:  Dr. Chip replied 1 year ago.
I think the lump is really in your imagination--it's a classic symptoms of an anxiety problem and not really a lump at all, although you could have some post nasal drip that's causing it. The swollen feeling is most likely from the reflux. Let me know how it goes, Jared, and I hope I've calmed your fears here. And please remember to rate my service to you
Customer: replied 1 year ago.
I am calmed. And there are actual cobblestoning in the back of my throat. They noticed at the hospital, so that may be causing some discomfort. Other than that what makes you think I don't have cancer? What about the oral issues
Expert:  Dr. Chip replied 1 year ago.
What didn't I say above that made it unclear I didn't think you had cancer? And tell me about the tongue lesions which is what I assume you're referring to?
Customer: replied 1 year ago.
I have lesions under the two sides of my tongue and its black and blue near them. My doctors didnt seem concerned about them but they're there and they occasionally hurt. My tongue feels strained sometimes while eating and they tingle and taste weird sometimes
Expert:  Dr. Chip replied 1 year ago.
Any change of showing me a photo of the lesions?
Customer: replied 1 year ago.
Yes give me an hour or so. I'm at dinner with my family right now. It's very difficult to swallow my food should I return to the ER?
Expert:  Dr. Chip replied 1 year ago.
OK--I'll wait. Obviously if you can't swallow food or water you should to to the ER but I think you're way over reacting to this
Customer: replied 1 year ago.
I can swallow water fine but it Takes me a few times to swallow food completely. My mom says she has similar issues with acid reflux
Expert:  Dr. Chip replied 1 year ago.
I'm not sure what you meant by it takes a few times to swallow food completely?
Customer: replied 1 year ago.
I mean that I can't swallow my food as easily as usual. It takes a few swallows to get all the food down
Expert:  Dr. Chip replied 1 year ago.
Since when? And is that with any type of solid food?
Customer: replied 1 year ago.
Since about an hour ago. I can drink alright. It might be from the post nasal drip mixed with the inflammation from acid reflux. Should I still go? I was having difficulty swallowing chicken
Expert:  Dr. Chip replied 1 year ago.
I think this right now is entirely your anxiety and nothing else--go ahead with your dinner and later give me the photo
Customer: replied 1 year ago.

sorry I fell asleep for a short while once I got home. I am taking the pictures now

Expert:  Dr. Chip replied 1 year ago.
OK--I'll wait
Customer: replied 1 year ago.

okay, I took them with my phone so they aren't great quality wise. I will be sending them in a second

Expert:  Dr. Chip replied 1 year ago.
OK
Customer: replied 1 year ago.

http://s1295.photobucket.com/user/pomjared21/media/justanswer1_zps8c7a9bfc.jpg.html here is a picture of my tongue. It is coated with a white color/fuzzy stuff and is thick white in the back

Expert:  Dr. Chip replied 1 year ago.
OK--how long have you had that and does the tongue hurt? This doesn't scrape off at all with a toothbrush?
Customer: replied 1 year ago.

nope doesnt scape off at all and my tongue is sore to move sometimes. My tongue also feels very dry. I am going to the dentist on tuesday for all of these oral issues, I will next show you pictures of my lesions

Expert:  Dr. Chip replied 1 year ago.
Sorry--pictures of your lesions?
Customer: replied 1 year ago.

on my tongue http://s1295.photobucket.com/user/pomjared21/media/justanswer2_zpsbc05a499.jpg.html here's one, I can try to get you a better picture but it is impossible to see the sore from the camera's perspective.

 

 

 

here's the other http://s1295.photobucket.com/user/pomjared21/media/image_zpsd3d04776.jpg.html

 

 

 

and here's the cobblestoning:http://s1295.photobucket.com/user/pomjared21/media/cobblestoning_zpsae33ac24.jpg.html?filters[user]=137302826&filters[recent]=1&sort=1&o=1

 

 

let me know what you think or if you'd like me to try to take better pictures

Expert:  Dr. Chip replied 1 year ago.
OK--what you're calling lesions--those little red marks on the side of the tongue?
Customer: replied 1 year ago.

no, maybe I should get a better picture. There are sores on my tongue that are not cankers. on the right side it is way more developed, would you like me to try for a better picture?


 

Expert:  Dr. Chip replied 1 year ago.
Just one more time and then we need to wrap all this up
Expert:  Dr. Chip replied 1 year ago.
OK--the tongue looks like thrush--a yeast infection that can resolve on its own but that can be treated with mycostatin mouthwash or oral Diflucan. The sore and the thrush and the cobbling I think is all from reflux. All of that would account for the swallowing problem, but again no need to worry about cancer.
Customer: replied 1 year ago.

thank you so much but however,they checked me for thrush at the hospital and I didn't have thrush. Do you have any idea what else this could be?

Expert:  Dr. Chip replied 1 year ago.
How did they check?
Customer: replied 1 year ago.

They ran blood tests and urine tests, and told me I didn't have thrush after looking into my mouth, maybe it was overlooked, I'm not sure

Expert:  Dr. Chip replied 1 year ago.
That's not how one checks for thrush--just looking at your tongue and if necessary taking a scraping of the white material and looking at it under the microscope is how you make the diagnosis. Jared, this page is long and I think I've covered everything about all this so far, so lets close with a rating from you and you can get back to me on a new page when you need to
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 22771
Experience: Over 20 yrs of Family Practice
Dr. Chip and 4 other Health Specialists are ready to help you
Customer: replied 1 year ago.

okay I'm sorry I'm still new to this site and not sure how it works. Thank you for all your thoroughness, patience and help.

Expert:  Dr. Chip replied 1 year ago.
My pleasure and maybe I'll hear from you again
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 22771
Experience: Over 20 yrs of Family Practice
Dr. Chip and 4 other Health Specialists are ready to help you
Customer: replied 1 year ago.

Is the feeling of an object stuck in throat or a lump common with post nasal drip and acid reflux? I have been having horrible acid reflux regardless of my food intake, and post nasal drip. It seems to be getting worse. What should I do to prevent this from worsening?

Expert:  Dr. Chip replied 1 year ago.
What exactly do you mean by horrible acid reflux?
Customer: replied 1 year ago.

I can feel it in my chest laying down and the burning sensation of it crawling up, especially last night when I went to go to sleep. My family has tons of history with GI issues.

Expert:  Dr. Chip replied 1 year ago.
How long have you been on the Prevacid and were you screened for H pylori?
Customer: replied 1 year ago.

I've been taking prevacid for almost a month and I don't think I have been tested , I still have to make an appointment with my GI specialist, but he wasn't in today because of Labor day.

Expert:  Dr. Chip replied 1 year ago.
OK--at this point you need the H pylori screen since if it's positive it would explain why the Prevacid is ineffective and with antibiotics it can be eradicated and the problem would be solved. You may need something like Nexium if the H pylori screen is negative.
Customer: replied 1 year ago.

In the mean time is there anything I should do or shouldn't do to help soothe my symptoms?

Expert:  Dr. Chip replied 1 year ago.
You can try some Maalox or Mylanta along with probiotics and some apple cider vinegar in a glass of water
Customer: replied 1 year ago.

You still don't feel there is any need to worry about cancer, even with my heavy tobacco use in the past?

Expert:  Dr. Chip replied 1 year ago.
No--nothing to worry about there.
Customer: replied 1 year ago.

thank you, XXXXX XXXXX you think is causing the loss of appetite though? can acid reflux cause me to feel full although I am not? or cause nausea while eating?

Expert:  Dr. Chip replied 1 year ago.
It can cause a fullness or bloated feeling and if severe enough can suppress the appetite. And it can cause nausea.
Customer: replied 1 year ago.

Do you think that is what caused me to lose 15 pounds?

Expert:  Dr. Chip replied 1 year ago.
Yes and not from cancer.
Customer: replied 1 year ago.

You read my mind. But it seems the "bloating" and "fullness" is concentrated in my throat/neck. is this normal?

Expert:  Dr. Chip replied 1 year ago.
Yes with reflux like that and also remember anxiety can make the feeling seem more than it is.
Customer: replied 1 year ago.

okay thank you, XXXXX XXXXX any things I should look out for over the next few days? Like any conditions that would require emergency attention?

Expert:  Dr. Chip replied 1 year ago.
No Jared--nothing serious is going to come of this in the next few days so don't worry about that.
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 22771
Experience: Over 20 yrs of Family Practice
Dr. Chip and 4 other Health Specialists are ready to help you
Customer: replied 1 year ago.

would cancer have shown in the x rays?

Expert:  Dr. Chip replied 1 year ago.
No--not any throat or oral cancer.
Customer: replied 1 year ago.

hmm, I guess I still need to get those checked out. You don't think I have either correct?

Expert:  Dr. Chip replied 1 year ago.
No, I don't have any reason to think you have any kind of cancer.
Customer: replied 1 year ago.

I used to drink tons of soda in the past, like some days I would even drink a 12 pack. Would this raise any of your concerns? I was heavy soda drinker for a long time maybe about 5 to 4 years until about a year ago I cut back

Expert:  Dr. Chip replied 1 year ago.
No, that wouldn't have put you at any risk for cancer.
Customer: replied 1 year ago.

Do you think it could have something to do with smoking? I smoked while I had these symptoms until it really started to bother me, and then I stopped about 2 weeks ago.

Expert:  Dr. Chip replied 1 year ago.
Nicotine increasing stomach acid production so it could exacerbate reflux
Customer: replied 1 year ago.

i'm sorry for being so paranoid, I've just never experienced anything like this in my throat.

Expert:  Dr. Chip replied 1 year ago.
I fully understand. It's very difficult to let go of that kind of anxiety until you've been thoroughly checked out but I'm sure before long you can put your fears at rest.
Customer: replied 1 year ago.

what makes you think that I don't have throat cancer or oral cancer, if you don't mind me asking?

Expert:  Dr. Chip replied 1 year ago.
No real risk factors and you really don't have the right symptoms. In fact, only a large tumor would cause any symptoms at all and that would be easily seen either on exam or with a ct scan.
Customer: replied 1 year ago.

I haven't had any real exams yet. Would an nasendoscopy be needed for proper examination? and I've only had x rays, no real CT scan or anything

Expert:  Dr. Chip replied 1 year ago.
Well to get the whole nine yards checked out you'd need the nasal scoping and an upper endoscopy. And you have had the physical exam with no indication of a tumor so far.
Customer: replied 1 year ago.

but regardless, you feel no need for me to stress about cancer?

Expert:  Dr. Chip replied 1 year ago.
Absolutely no reason--I myself, if this were me, would have no fear of cancer here
Customer: replied 1 year ago.

thanks dr. chip. It's just tough because of all the discomfort as well as the fear of what is unknown, and the fact that I've had to wait so long in between doctors for the past month while I feel it getting worse

Expert:  Dr. Chip replied 1 year ago.
Try to rest easy, Jared and keep me in the loop as to how it goes.
Customer: replied 1 year ago.

just one more question, you don't think the straining feeling in my throat, the lump, or difficulty swallowing has anything to do with cancer at all? just for peace of mind

Expert:  Dr. Chip replied 1 year ago.
No--most of that is pure anxiety and some of it is the inflammation in your throat.
Customer: replied 1 year ago.

what about the occasional sharp pains and bulging feeling? do you think it's from the inflammation as well?

Expert:  Dr. Chip replied 1 year ago.
Yes--cancer just doesn't do that
Customer: replied 1 year ago.

Okay, thank you for your comfort, I will get back to you when I return from the dentist's tomorrow. The dentist should put my mind at ease about my fear of oral cancer, or will tell me if I have it, but according to most doctors, it's highly unlikely. Again, thank you so much

Expert:  Dr. Chip replied 1 year ago.
Any time at all Jared
Customer: replied 1 year ago.

It almost feels like there's more than one lump though, Should that be a concern? one higher than the other that kind of is like an itch, the other is near where I swallow andi feel like I can feel it when i swallow

Expert:  Dr. Chip replied 1 year ago.
You really aren't feeling true lumps even though you may think that's what they are. Most of this is just your anxiety and I guess it'll take the scopes and the ct scan to get all this worry completely out of your mind.
Customer: replied 1 year ago.

sorry that my anxiety has gotten a hold of me. I also notice the back of my mouth has a very sour taste to it, so I'm using that to help me relax and try to get my mind off cancer and my mind on it being post nasal drip and acid reflux

Expert:  Dr. Chip replied 1 year ago.
It's most likely just the reflux.
Customer: replied 1 year ago.

okay, sorry for making these so long, I should be fine for the rest of the night. thanks for all your help and patience

Expert:  Dr. Chip replied 1 year ago.
I fully understand Jared--try your best to get your mind on other things and try to stop the wheels from spinning and smoking in your mind.
Customer: replied 1 year ago.

just to be sure, you're not holding back information just to comfort me right?

Expert:  Dr. Chip replied 1 year ago.
Jared, not only would that be totally unprofessional, unethical and harmful, I just don't do that. I don't lie and withholding some of the truth would be the same to me as lying. If you were my best friend I still wouldn't just tell you what you wanted to hear unless it wall the whole truth.
Customer: replied 1 year ago.

okay thank you so much. I'll talk to you another time

Expert:  Dr. Chip replied 1 year ago.
I'll be here
Customer: replied 1 year ago.

what would this "throbbing" feeling in my throat come from? irritation? I can feel it in my throat when I take in a deep breath

Expert:  Dr. Chip replied 1 year ago.
Throbbing?
Customer: replied 1 year ago.

yeah, my throat just feels heavy it's an odd sensation, especially where it has the swelling feeling. it has gotten worse over the past 2 days, should I go back to the hospital? I still can breathe and swallow alright

Expert:  Dr. Chip replied 1 year ago.
Oh, stop it Jared--no you don't need to go back to the hospital. I don't know exactly what you mean by your throat feeling heavy though
Customer: replied 1 year ago.

it's hard to describe. around my adam's apple my throat feels heavy as if there were something there. it kind of feels tender or swollen

Expert:  Dr. Chip replied 1 year ago.
I honestly think you're imagining all that. There's nothing wrong with your neck or your throat down there so just rest easy and get back to me on a new page when you do need to talk to me again
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 22771
Experience: Over 20 yrs of Family Practice
Dr. Chip and 4 other Health Specialists are ready to help you

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