Ok I am back. I have a couple questions. I have had a sore throat for a little while now. I have seen Dr. Rounds on three occasions the ENT at Mass General. He put me on Augmentin for two weeks and then three weeks. The sore throat would clear up for two weeks then come back. It is presently very mild and I just saw him yesterday. I also have an enlarged nymph node on the right side that hasnt gone away in the six weeks even after the meds. he did two laryngoscopes both he said had negative pathology. So now I am stuck with a sore throat and this lymph node and I am still worried about cancer. i cant get it out of my mind even though he said there isnt anything that looks cancerous in my mouth or throat. What do I do from here? I am still worried but he said I shouldnt be. I dont feel as if my mind will be at ease until the sore throat is gone and the node is too. What do I do? Has anyone had or heard of an experience like this. Any thoughts or advice would help.

You have seen a highly qualified person at a well-recognized facility. You have no visible to the eye pathology, which while it happens occasionally, is uncharacteristic of an oral cancer. You have had a positive response to antibiotic treatment, which if you had cancer, would have had "0" impact. You have a same side swollen node which would be typical for an infection, since that is where an advanced infection from the described location would drain to. In my opinion, (not having all your test results in front of me, and not being a doctor), you have an infection which was partially resolved by antibiotic treatment, and which may have been completely resolved by longer term exposure to antibiotics or alternative (gram negative or positive) antibiotics. If you had been seen by a generalist in a rural area who does not come across oral cancers very often, I might be more skeptical, but in your case you seem to be on the good side of things. A culture of your throat should give you specific bugs to go after with specific drugs....... If a culture shows no bugs, then you have a new question on your mind. If it isn't bacterial or viral in nature what is it?

Hi,

I can't tell you where to go next; all I can do is tell you that I had similar symptoms for a year and since the swelling went down on drugs and the lymph node biopsied negative no one was concerned. Now the bad news is that when the doc and I finally said let's just remove this node it's annoying! he found a tumor underneath wrapped around my carotid artry and jugular. Second surgery was the neck disection to find the cancer site.
Your doctor and Brian are probably right, and there may be other people that can come on and tell you what a possible next step is if you are still concerned.
I wish you luck.
Take care,
Dinah

Things like Dinah's experience happen, luckily not that often. You have to do what makes you feel comfortable, and no one anywhere on the internet, this message board, etc., who is not your doctor can give you medical advice that is absolute, without examining you and having the proper qualifications to do so properly. You now will have to decide if you desire a second opinion from someone else with a different perspective than your first doctor. Please do not rely on this site or any other web source for the answers to your problem. The best that any can do, is offer you suggestions or a new line of thought you might not have considered. And even with the good intentions of people that have been through the experience, most that post here and elsewhere are not doctors, and there is the potential for misinformation to be dispensed. If you have doubts, or if further treatments as I suggested above do not resolve your problem, have your doctor refer you to an associate for another opinion and possibly a new direction. You have not been through all the possible tests that would have disclosed something like dinah's...a cervical CT scan etc. A fine needle biopsy of the node would be relatively painless and inexpensive, and you could get results back in just a few days. You also didn't mention if the node was sore. Nodes that are the drainage sites for infections usually are fairly tender when touched. Perhaps you want to look into that if further treatment does not produce results. Obviously any medical condition which does not resolve needs to be examined in further detail until finite answers or resolution are yours and it goes away completely. We see too many misdiagnosis of OC when prescriptions of antibiotics continue for too long a period without complete resolution of the problem. It happens, even in the best institutions. Medicine is like a puzzle, you really don't get the whole picture without examining lots of pieces of the puzzle first. Each examiner of the puzzle looks at it from a different perspective and with different tools. Pick a specialist with a different background, and different experience base if you decide to pursue this. But for sure, you should not live with a sore thoat for months and months without knowing why.

Thanks for the advice. I am not looking for answers just suggestions. I am actually feeling better. I talked with my mom last night and she said we have a family history of enlarged nodes for no particular reason. She said they just dont drain right so that is more comforting. my sore throat is getting better everyday and Dr. Rounds said that if it were linked to cancer it would be persistently sore. If it continues he said to follow up and we will go from there. So for right I will just hope that it clears up which it seems to be doing. What I failed to mention before is that Dr. Rounds said it was a sever case of tonsilitis that seems not be resolving. Thanks for the suggestions.

Good for you Adamchuk...glad you are feeling better. As usual Brian's advise is right on track and so sensible...so if any questions arise in the future you know there are things to do.

Take care,
Dinah

Hi Adam:

Glad to have you back! When Dave went for his follow up with Dr. Rounds recently we did ask him about you and hoped you were doing okay. I agree with all of the above messages and given that Dave and I know Dr. Rounds VERY well (and he diagnosed David's OC), I can tell you that oral cancer is a topic he is well versed in diagnosing(he was a regular member of the head & neck cancer team at Mass Eye & Ear until he left to become the chief of ENT at Newton-Wellesley) and you are in good hands with him.One of the most impressive things I like about Dr. Rounds is that in addition to his skill, he is humanistic and will spend time calming your fears as you have probably found already in your interactions with him.

If your anxieties persist, you could ask to see one of his colleagues at Mass Eye & Ear for a second opinion(Dr.Rocco and Dr. Vavares are both great). Dr. Rounds is a great believer in collecting information from many sources(he advocated we do this when dave was diagnosed) and isn't likely to be offended. I would also suggest you be honest with him about the level of your anxiety if it persists(you need to tell him if worry is starting to encroach on your day to day life again).

The fact that he did two scopes demonstrates his healthy conservative approach. I can tell you that it took all of 10 seconds for him to look in Dave's mouth and say we needed a biospy.I trust Dr. Rounds and really believe he would err on the side of your safety. But, the most important thing is YOUR comfort so keep going back for follow-up and ask him about a biospy and/or CAT scan if it will give you peace of mind.

I was going to also ask if he mentioned persistent tonsillitis(then I saw your most recent post) because this is a common problem with college age people and a node can stay enlarged for a long period of time post-infection. Augmentin is often used for treatment.Is the node tender now and has is been before? How did Dr. Rounds explain it to you? Just a thought-has anyone around you (think you mentioned a girlfiend) having similar symptoms?

Keep us posted,

Kim

Thanks Kim. To answer your questions, my girlfriend does not have any symptoms. I have been pretty cautious in my handlings of kissing her and stuff. The node is somewhat tender not really right when I touch it but a after I touch it or feel it it does feel tender and hurt a bit. It is also very mobile, which I have heard that cancer nodes are often hard and immobile. As far as symptoms at school, everyone is getting sick lately and I am coming down with a cold so that probably isnt helping. I feel confident with Dr. Rounds and he was very accomodating. Like I said I am going to give it some time and try and get more rest (which is near impossible with my workload and hockey) and see how things turn out. I have a history of tonsilitis and Dr. Rounds said if the sore throat does persist then he wants me to have them taken out. So I will probably go back to see him soon if this keeps up. Thanks everyone for the advice and support. Best of luck to you guys Kim, I hope Dave is doing well and pulling through. My thoughts and prayers are with you guys.

I read this topic with interest yesterday. I did not respond at that time. Adam, my husband had a swollen node that everyone had an answer for (except tongue cancer) It was tongue cancer. John knew there was something there. You know your own body better than anyone else. If you think something is amiss--find out what it is to your own satisfaction.
Meredith