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Lump in throat that is occasionally painful, occasional ear pain. Cancer ruled out. Advised CT scan. Why?

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I am a 34year old male. I have chewed tobacco for 10 years, and I drink beer. For the past 5 months, I have had a lump in my throat feeling on the right side, near my tonsil. It does not hurt to eat or drink, however it does hurt under my where the neck and jaw XXXXXXX on the right side. I also have occasional right side ear pain. No masses or swollen lymph nodes can be felt by the ENT. I have seen an ENT twice in the past week. Today he put a flexible tube up my nose and down my throat to take a look. He said that he saw red inflamation on the right side near the vocal cord. He then said that he was 99.9% sure that it was not cancer, but went ahead and ordered a CT scan(without contrast) anyway.

My question is why would he order a CT scan if he's "99.9%" sure that it is not cancer? Is he just saying that to relax me? I always thought a CT scan was used to help diagnose cancer. He said that since I've been having symptoms for 5 months, he would be able to see some kind of mass, and it would be spreading, and that he doesn't see any of that. He said he was ordering a CT to put my mind at ease, but it isnt working. Can cancer in the throat present as inflamation? He prescribed 20mg Prednisone tablets to help with inflamation. I cannot find any information on any throat disorder that can cause a lump sensation and mild ear pain that is not something very serious like cancer. I am near to having panic attacks over this. Please help.
Posted Mon, 3 Jun 2013 in Ear, Nose and Throat Problems
Answered by Dr. Nirmala P 3 hours later
Thanks for asking in Healthcare Magic.

Tobacco juice can produce inflammation in any part of oral cavity and throat and that is giving you the uneasy feeling especially while swallowing. Pain will not be felt unless the inflammation is severe. You should take this as a warning sign and should stop chewing tobacco as repeated inflammation can progress to cancer.

Tobacco chewing can also give rise to a condition called 'submucus fibrosis' within the oral cavity which is said to be a precancerous condition. Inflammation is usually associated with edema (swelling) and this edema gives you a feeling of lump in throat.

The ENT surgeon has rightly prescribed Prednisolone for you. Prednisolone is an anti inflammatory drug. Its anti inflammatory action is more powerful than the conventional analgesic anti inflammatory drugs like Ibuprofen. Otherwise inflammation can worsen and can spread to vocal cords affecting your voice and causing difficulty in swallowing.

The need for CT scan is to rule out the presence of any obscure (hidden) mass in the area of throat that cannot be examined directly. Besides, CT scan and MRI can pick up even minute (small sized) mass which can be missed in X-Ray soft tissue neck.

Geographic tongue is a harmless condition affecting the surface of the tongue often presents as red streaks like a map. It heals and is not associated with cancer. So please rest assured. Your lesion cannot be cancer and should be inflammation but it is high time you stop chewing tobacco as repeated assaults on throat can be XXXXXXX

I hope this helps. Please address to me if you have any further concerns.

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