There does not appear to be a genetic link to oral cancers. There are links to GERD but those are more in that larynx and below that. They contribute to a tissue change called Barrett's that leads to adenocarcinomas if left untreated. Getting his reflux under control is paramount, and a upper endoscopy to see if any of those tissues are converting to Barrtet's esophagus would seem prudent.

I would not count on any general MD's to get this diagnosis right in the short term. He should be seeing an ENT doctor ( there are two types, one that does head and neck surgery and one that see lots of other tonsillitis and stuff in kids. You want to find someone that has the additional head and neck surgery training). This kind of ENT will recognize the risky thing right way, and use a scope and his fingers to explore everything near the base of his tongue and tonsillar pillars carefully, two prime occurrence sites.

Some of these symptoms are very characteristic of oropharyngeal cancer (please don't panic until a doctor says so) the sensation that something is stuck in your throat, unilateral ear aches, chronic hoarseness (which can also come from GERD), inflamed tonsils very characteristic of the fastest growing segment of the oral cancer population. Also a painless, firm, lump in the neck, usually on the same side as the sore tonsil.

Risk factors for these cancers are viral (HPV16) and his youthful use of smokeless tobacco is likely a non issue.

So let's hope this is reflux/GERD related, and the scans show nothing important. He can start on over the counter Prilosec immediately which in a few days will begin to knock down the acid production in his stomach. It's a proton pump inhibitor that used to be an Rx drug but is now OTC.

Please report back in, ask any specific questions you have, or come here for just moral support and to vent. We all hope this turns out to be nothing serious.