I had sudden onset of pain/discomfort in my throat on the left side in spring 2013 while drinking a homebrew and smoking a cigar on my front porch. The immediate sensation was that of swallowing a corn chip the wrong way and having it go down slowly. It's possible I swallowed a tiny sliver of glass from the homebrew. (The bottle neck broke off and I just brushed the one piece of glass I could see off the bottom part of the break poured the contents into a pint glass.)

The acute pain subsided quickly but I was left with a sensation of something in my throat by the base of the left side of my tongue or under my skin near the bend in my jaw. I thought nothing of it but listed "difficulty swallowing" on a checklist when I saw my new GP in June 2013. He was very concerned and sent me to an ENT.

The ENT said my history didn't fit oral cancer but did a thorough workup anyway, including a scope of my throat and found nothing. He palpitated heavily in my oral cavity and the outside of my throat. Nothing. After this visit, the sensation seemed intensified and I read up on cancer and started getting spooked. I started gargling with strong salt water and diluted hydrogen peroxide in case it was just an infection. I noticed blood on a paper towel-covered finger when probing back there to see if I felt anything. I returned to the ENT about a month and a half after my first visit with more pronounced sensations. Again he probed and palpitated and felt nothing. He grabbed my larynx and squeezed, asking if it hurt. After getting to the point of nearly choking me I said "yes?" but it really didn't hurt at all. He decided to send me for an MRI (after considering a CT but said the MRI would find things the CT could miss) but felt it wasn't really necessary. He said if I had anything to be concerned about it would hurt like hell when he was poking around. The MRI was performed in September, 2013 with and without contrast. He called after receiving the results saying there was nothing (no "mass") but that I had a slightly enlarged thyroid and ordered a blood test which came out fine. He then released me to my GP to figure out what's going on.

I haven't been back to my GP since the thyroid test because he's writing a diet book and is more concerned about instructing me about our cavemen ancestors and how you should only consume vegetables that are stir-fried, not baked or steamed or boiled. I'm also unemployed and uninsured so I don't have a lot of resources to chase this down. I did return to the ENT in February, 2014 over concern about a white spot that appeared on my right tonsil that hadn't gone away in over a month. He said it was normal but did another thorough exam which didn't show anything else to be concerned about.

My ENT is a fantastic doctor and a surgeon to boot. I trust him but this discomfort still remains and I do worry. I've tried controlling the things I can (exercise, diet, weight, supplements) but it still remains. If my ENT says there's nothing to worry about, should I trust him or do I need to pursue this further? The behavior of the symptoms closely map to hyoid syndrome or glossopharyngeal neuralgia in how the sensations seem to track along a line between my tonsil, base of tongue and inward towards adam's apple. I don't mean to self-diagnose but I don't have financial resources at the moment.

Additional info:
I also have had post-nasal drip (a red irritated line down the left side of my throat) for nearly a year now. I stopped smoking cigars but even when I did it was less than one a month on average.
I use CPAP consistently and for a year or so I also used 12hr Afrin at night. I stopped doing this in June 2013 when my GP said it was very bad for me. Could this have caused some damage which explains the post nasal drip?

Thanks,

Wango64

I would see another ENT. He may be good by but he clearly isn't up to date. These days base of tongue cancer - HPV related - is on the rise. There is no such thing as a "history" that would indicate the potential for oral cancer of this type. If you've had even one sexual partner you could have had HPV. This cancer is also found in the tonsil as well - truth be told. Usually HPV related oral cancer affects people between 30 and 60. There is not often pain associated with it, it tends to be diagnosed by a difficulty swallowing or swollen lymphnodes. This is why it is found usually in the later stages.

The cancer he may have been referring to was the smokers/drinkers non HPV oral cancer. (From your intro I assume you do both - though probably not to excess) often this cancer hits people who are older mostly male who drink and smoke a lot. (Though people like myself who do none of those things get it as well.) the difference between the two is location. Non HPV cancers are usually located in the oral cavity - tongue, gums, cheek, palate. HPV- in your throat, or tonsil.

I would get a second opinion. Take care

[quote=Cheryld]I would see another ENT. He may be good by but he clearly isn't up to date. These days base of tongue cancer - HPV related - is on the rise. There is no such thing as a "history" that would indicate the potential for oral cancer of this type. If you've had even one sexual partner you could have had HPV. This cancer is also found in the tonsil as well - truth be told. Usually HPV related oral cancer affects people between 30 and 60. There is not often pain associated with it, it tends to be diagnosed by a difficulty swallowing or swollen lymphnodes. This is why it is found usually in the later stages.

The cancer he may have been referring to was the smokers/drinkers non HPV oral cancer. (From your intro I assume you do both - though probably not to excess) often this cancer hits people who are older mostly male who drink and smoke a lot. (Though people like myself who do none of those things get it as well.) the difference between the two is location. Non HPV cancers are usually located in the oral cavity - tongue, gums, cheek, palate. HPV- in your throat, or tonsil.

I would get a second opinion. Take care

[/quote]

After saying I didn't fit the profile he did add that the incidence of non-smoker cancer is on the rise which is why he did the workup he did.

I do have a 5mm swollen lymph node on that side that I noticed in early March. It is small, rubbery and moveable and a little tender.

I was reading your signature - you had "irritation" several years before the diagnosis? What type of irritation? Was it cancer then that they missed or did it develop into cancer?

Get checked out by another ENT. My first symptom was a PAIMLESS bump in my neck and 5 cancer docs later BAM Stage IV oral cancer.

I'm going to go to another ENT. My first ENT did an MRI, laryngoscopy, palpitations, etc. What do I do/say to get the next ENT to look at it differently? Am I not communicating something right?

I rarely go to doctors so I'm bad at this.

My current ENT graduated magna cum laude from Duke University and went to medical school in SF graduating with thesis honors. He has high ratings on yelp.

What do I look for in a second-opinion ENT? Do I need to be picky or just pick one near by?

An ENT who specializes in oral cancer will be much more proficient at being able to diagnose you than one who primarily puts tubes in childrens ears as their main field of practice.

Wango - I had sinus drainage and irritation for 2 months before looking in my mouth with a mirror and flashlight only to find a tonsil swollen up all the way to the uvula. Of course that got my attention and me into the doctor's office. My first visit the doc (physicians assistant actually) thought it some benign infection treatable with antibiotics (which didn't help). That's when they suggested an ENT and I got lucky and found one who can recognize possible cancer and know to do a biopsy.

Apparently you haven't found that ENT yet. Maybe you should bring the biopsy subject up for conversation. Biopsy and pathology exam is the way cancer is diagnosed.

Good luck with it, however it goes.

Tony