Is It Cancer If I Have Recurrent Sore Throats?

Posted on Sun, 29 Apr 2012

Question: hello im a 55 year old woman . i have been suffering with my throat for about 3 month now which started with a noice in my throat when i breath then sore throats which kept coming back then i started having slight swallowing difficulties and the pain in my throat and ears but my throat wasnt sore just pain and my voice went croakyi went to the doctor in may and to cut a long story short ive visited the hospital had a endoscopy and they found a hiatus hernia but have had to be refered back to the e n t department for further investigation on going to the ent the specialist has decided to do another endoscopy on my nasal passage but has said that it the trouble im having could be caused by the hernia . i am concerned as we are now in july and this has been going on now for almost 3 month . the symtoms are not getting any better in fact worse i am now getting shooting pains through my head and phlegm in my throat along with the pain in throat and ears and dizzyness occasionally , which are sometimes worse than others . i have a strong family history of cancer including my brother who died of squamous seal carcinoma of the pharygeal wall and it seems a long time to be waiting if it is something serious as i wont get my results until beginning of august .

Answered by Dr. Sumanth.P (45 minutes later)

Hello XXXXXXX

Thanks for your query.

Hiatus hernia do not need surgical intervention unless it is very severe as manifested by pain in the throat due to regurgitation of stomach contents into oesophagus.

Endoscopy cannot diagnose carcinoma.

So to exclude it you say the doctor regarding your family history of carcinoma pharynx.

you might have to go for a biopsy of the concerned tissue.

Since ENT specialist excluded the cause from his side, you consult a medical gastoenterologist initially.

Try to reduce your weight if you are obese.

Avoid spicy food and alcohol and smoking which are aggravating factors for hiatus hernia.

Also have moderation in your dinner, quantity wise and see to that your head end is at a higher level while sleeping.

You can use a thick pillow or two pillows to support your head.

Also do not use articles which compress your abdomen like belts.

Do salt water gargling for sore throat which works well.

Do not get tensed up with your problem.

It is always better to visit a multispeciality clinic since you get access of every doctor at a stance.

Hope I have answered your query.

I will be available for your follow up queries if any.

Wishing you good health.

Regards,

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Sumanth.P (2 hours later)

im sorry ive been told all this . im not getting any heartburn or gas and the hernia is not causing any problems but can the hernia cause all the symptoms i am getting . my throat is not sore i have pain in my throat and ears but it is not sore .i think i should have a scan to show if anything sinister is going on and i think this has took to long from may if they are thinking there is a chance of cancer . would a scan detect things better just really worried that they have waisted time and could they have gone straight for a scan when they were thinking it could be throat cancer. the main question is can the hernia cause pain in my throat and ears shooting pain in my head croaky voice dizzyness and a general feeling of feeling reaaly ill and drained

Answered by Dr. Sumanth.P (10 minutes later)

Hello,

Good to hear from you again.

Hernia can cause all the symptoms mentioned by you according to my knowledge.

Do not think it to be a carcinoma for sure and do not blame any doctor for that matter.

Since any doctor would start with preliminary investigations.

You kindly notify to your doctor regarding non subsidance of your long term symptoms and particularly regarding your family risk for carcinoma pharynx.

Hope I have answered your query.

Wishing you good health.

Regards.

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Sumanth.P (5 hours later)

Sorry you are not making it very clear . Would a scan be better for diagnosis of cancer in this case . The doctor said it could be cancer and that's wot they were looking for . And I thought a hiatus hernia gave none or very little symptoms I'n most cases I am taking tablets for the hernia but the symptoms remain the same .. What are your views could you please answer all the questions as I don't think I've got a proper answer to my questions

Answered by Dr. Sumanth.P (2 hours later)

Dear Christopher6371,

1. A Hiatus Hernia is present in one third cases of reflux. In Laryngo Pharyngeal Reflux (LPR) there may be no esophageal symptoms such as heartburn which is seen in GERD (Gastro Esophageal Reflux Disease).

2. LPR is also known as Silent Reflux, Atypical Reflux or EERD (Extra Esophageal Reflux Disease) and may contain digestive enzymes and bile in addition to gastric acid. LPR can cause all the symptoms mentioned by you.

3. Symptoms of LPR include:
(i) Frequent sore throat, pain in throat, sinuses and even the ears [stomach acid has been identified in the middle ear cavity recently, via the eustachian tubes],
(ii) Wheezing (noise while breathing),
(iii) Hoarseness (croaky voice),
(iv) Post nasal drip (phlegm),
(v) Difficulty in swallowing, dryness in throat, frequent throat clearing
(vi) Globus sensation (foreign body sensation or feeling of something stuck in the throat)
(vii) Shooting pains in head (Trigeminal Nerve irritation)
(viii) Dizziness (Vagus Nerve irritation)

4. You need to under go a few investigations:
(i) A Videolaryngoscopy and Stroboscopy to look for signs of LPR.
(ii) A Barium Swallow Study
(iii) Esophageal Manometry and 24 Hr ambulatory dual probe pH monitoring if available.
(iv) FEES (Fibreoptic Endoscopic Evaluation of Swallowing) or FEESST (Fibreoptic Endoscopic Evaluation of Swallowing with Sensory Testing)

5. In view of your strong family history of cancer, you may insist on n MRI Scan or a PET Scan if your symptoms persist in spite of treatment. Referred pain to the ear can arise from cancers in the oral cavity, base of tongue, soft palate, pharyngeal wall, tonsils, pyriform fossa, larynx and upper esophagus. However the diagnosis of cancer will be rare.

6. If you are wondering why you are suffering from these symptoms now, it is possible that your hypothyroidism is slowing down your system causing LPR. Frusemide is a loop diuretic and in the long term can lead to hypokalemia (low potassium), worsening your symptoms, making you feel really ill and drained.

7. You have not mentioned the medication that you are taking for your hiatus hernia. It should include a proton pump inhibitor. Remember that Sucralfate and frusemide interact.

Hope I have answered your query. If you have any follow up queries I will be available to answer them.

Regards.

Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Raju A.T