Brief Answer:
USG Neck, FNAC. Not likely to be cancerous.

Detailed Answer:
Hi,

Thank you for your query.

1. Get a Neck Ultrasound (USG) done. This will confirm whether this swelling is a lymph node or a part of the sub-mandibular salivary gland and the exact size.

2. Usually sub-centimeter sized lymph nodes are considered reactive (not significant). If this swelling is the size of a XXXXXXX it must be larger than one centimeter and hence warrants attention.

3. This is probably due to chronic sinusitis. An FNAC (Fine Needle Aspiration Cytology) can be done to settle the diagnosis, sometimes USG guided if necessary.

4. This unlikely to be cancer as it has been there for a year. There are about 300 interconnected lymph nodes in the head & neck region alone and they would progressively enlarge if there was a cancer.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.

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Brief Answer:
There is no cause for worry.

Detailed Answer:
Hi,

Thank you for writing back.

1. Since you have noticed it and it troubles you, get the USG and FNAC done.

2. This will settle the issue once and for all.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.

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Brief Answer:
No. Absolutely not.

Detailed Answer:
Hi,

Thank you for writing back.

1. No Absolutely not.

2. I treat head & neck cancer patients and this is cannot be an aggressive cancer since it has been there for over a year.

3. The above investigations will settle the diagnosis.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.

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Brief Answer:
PND leads to Granular Pharyngitis which may cause blood stained sputum.

Detailed Answer:
Hi,

Thank you for writing back.

1. Chronic Sinusitis in many people leads to a Post Nasal Drip (PND). This PND infects the lymphoid tissue scattered throughout the throat.

2. This lymphoid tissue is delicate and easily bleeds on coughing, spitting or sucking on the throat. The other common causes include nasal bleeding (due to the chronic sinusitis), dental inflammation and Vitamin C deficiency (especially if you have any exposure to tobacco). Rule out any acid reflux.

3. Hence an occasional blood stained sputum. Get the sputum examined on three successive days for bacterial culture (including AFB-Acid Fast Bacilli) and occult blood.

4. Repeat routine blood tests and compare them with the ones last May. Get a Dental and ENT check-up (preferably with a Nasal Endoscopy & a VideoLaryngoScopy) and start multi-vitamin supplements (including Vitamin C).

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.

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Brief Answer:
Yes, it is not likely to be cancer. Stop further use of Skoal.

Detailed Answer:
Hi,

Thank you for writing back.

1. Yes, it is not likely to be cancer since it has been there for more than a year.

2. You should stop using Skoal as it is a tobacco based product. A few years after stopping this your risk of developing a cancer will drop to that of a non-user.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.

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Brief Answer:
Your risk for cancer is very low. Keep a regular follow-up.

Detailed Answer:
Hi,

Thank you for writing back.

1. Your risk for cancer is very low.

2. Do get regular follow up done regarding these symptoms.

Wishing you good health.

Regards.

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