Thank you Christine. I have read (and re-read) the HPV facts page. It is detailed and informative. While the odds of this being throat cancer are statistically very low, the fact that the possibility exists is enough to have me concerned, especially in light of my high risk factors.

To be clear, I don't have any sores in my mouth.

Since a biopsy is the only way to truly diagnose this and from my understanding, a fine needle biopsy is a very quick and minimally invasive procedure, I'm confused as to why my ENT wouldn't do this simply to rule out anything serious? It seems like a a very low-risk, low-cost procedure to rule out something potentially life-threatening. Am I incorrect here? It seems like this is the only way to get a fairly quick and conclusive answer. I'm fortunate to have good health insurance and GP who would likely do it for me relatively quickly so I may explore that option.

Also, the nature of these swollen lymph nodes is concerning. They are all clustered together, near the area I am experiencing symptoms, and are rubbery and painless. Combined with the fact that I have no other symptoms of infection (no fever, no sinus issues, etc.), I find this to be quite troublesome. Heathy 32 year old men in good physical condition with no other symptoms typically don't experience clusters of painless, swollen lymph nodes.

Last question, I'm wondering if anyone has any experience with nasendoscopys being inconclusive. Right now, my only peace of mind is knowing that two trained ENTs scoped me and found nothing of concern. However, I also understand HPV-linked throat cancer, specifically back of the tongue SCC can be difficult to spot and is quite good at avoiding detection which is typically why it is diagnosed in it's later stages when other symptoms start to present. I am concerned that could be what I am dealing with. How much comfort can I take in the nasendoscopys not revealing anything despite these other symptoms (sore throat, difficulty swallowing, hoarse voice requiring frequent throat clearing, and swollen lymph nodes). The nasendoscopys I received appeared to me (a layman) fairly thorough, checking my entire sinus cavity, throat, and voice box. However, there are plenty of posts on this forum of folks who had clean nasendoscopys only to find out later that they had advanced stage HPV-linked throat cancer. That is giving me the most concern.

Thanks again for your help and I admire all of you on this forum. The uncertainty of all this is so completely disconcerting to me.