White Spots in the Throat - Causes and Its Association With Cancer

Introduction:

The white spots seen in the throat or mouth are always not cancerous. Benign or noncancerous lesions can also cause white spots or be due to some infections or irritation like bacteria or viruses. When the spots do not disappear even after treatment and are associated with other symptoms like hoarseness of the voice, sore throat, and difficulty in swallowing or breathing, which does not resolve after two weeks, it may be due to cancer involvement.

What Are the Causes of White Spots in the Throat?

White spots can appear in the throat for various reasons. They can be due to -

• Strep Throat - Strep throat is an infection present in the throat due to the Streptococcus bacteria. Strep throat can result in white patches in the throat. Apart from white patches, it can also cause fever, enlarged or palpable lymph nodes, headaches, and sore throat. Infections in the throat are called pharyngitis.

• Candidiasis - White throat patch can also be seen in candidiasis or oral thrush. It is a fungal infection. White patches can be seen on the mouth's buccal mucosa and the tongue's sides. These white patches can be scraped easily. It has an inflamed area under the white patch, which usually tends to bleed after scraping. It is associated with other symptoms like a burning sensation in the mouth, difficulty swallowing or eating, and disturbed taste.

• Tonsillitis - Inflammation of the tonsils is called tonsillitis. Tonsils are oval lymph nodes at the back of the throat or mouth. They help in preventing infections in the body by filtering out bacteria and other germs. Tonsillitis can cause other symptoms like difficulty swallowing, headache, sore throat, and bad breath.

• Mononucleosis - The Epstein-Barr virus causes infectious mononucleosis or kissing disease. It spreads through saliva. The symptoms other than white spots in the throat seen with infectious mononucleosis are fever, enlarged lymph nodes, tonsillitis, headaches, etc.

• Oral Herpes - It is a viral infection caused by the herpes simplex virus. The symptoms associated with oral herpes include white spots on the cheeks and painful sores on the gums, tongue, and roof of the mouth.

• Severe Acid Reflux - White patches can be seen in chronic irritation with severe acid reflux.

• Smoking, Tobacco Consumption, and Chronic Alcohol Consumption - Heavy smoking, tobacco consumption, and chronic alcohol use can result in white spots in the mouth. It can be due to various conditions like leukoplakia (a white, thick patch in the mouth that cannot be scrapped off).

• Epstein-Barr Virus Infection - Epstein-Barr virus can cause oral hairy leukoplakia. It is seen in people with weak immunity and can be associated with white patches on the tongue and oral cavity.

• Human Immunodeficiency Virus (HIV) or Acquired Immunodeficiency Syndrome (AIDS) - People with HIV or AIDS have weak immunity and are prone to many diseases like oral herpes, oral thrush, etc. White spots can also be seen in these conditions, along with other symptoms.

• Cancer - An abnormal white or red patch or spot in the mouth can be a sign of cancer.

What Are the Signs and Symptoms of Cancer Associated With a White Patch?

If the white patch seen in the throat or mouth is due to cancer, it is associated with other symptoms like -

• Sudden weight loss.

• Difficulty in swallowing.

• A lump can be seen in the neck or mouth.

• Trismus (difficulty in opening and closing the mouth and restricted jaw movements).

• Difficulty in speech.

• Halitosis or bad breath.

• Non-healing ulcers.

• Mobility of teeth.

• Pain in the mouth or throat.

• Bleeding from the mouth.

• Reduced food intake.

• Hoarseness of voice.

• Persistent cough.

• Difficulty in breathing.

• Persistent throat pain and soreness of the throat.

• Earache.

How Are White Spots in the Mouth or Throat Differentiated as Cancerous or Non-cancerous?

White spots in the throat or mouth are often due to infections or inflammation. These white spots can usually be scrapped off quickly. Most of the cancerous lesions cannot be scrapped off easily. But some non-cancerous lesions cannot be scrapped away, like canker sores (painful, small ulcers developing on the soft tissues), oral lichen planus (an inflammatory condition affecting the mucous membrane of the mouth), and leukoplakia (it is called leukoplakia when the white patch is thick and not scrapable. They are a non-cancerous condition. They have a rough surface that may start bleeding when scratched. If left untreated, these precancerous lesions can develop into cancer).

How Can One Diagnose Whether a White Spot Lesion Is Cancerous or Non-cancerous?

If a suspected white spot is identified along with some abnormal signs and symptoms, the white spots can be diagnosed as a cancerous or non-cancerous lesion with the help of a biopsy. In a biopsy, there will be the removal of some tissue cells from the suspected lesion, and it will be observed under a microscope. If there are any abnormal changes in the growth of cells, it can be suggestive of cancer. And if the cells have a normal growth pattern, it suggests a non-cancerous lesion.

What Are the Treatment Options for White Spots on the Throat or the Mouth?

The treatment of white spots in the mouth or throat depends on the cause which caused the white spots or patches.

• In case of bacterial infections, antibiotics are used to treat the white spot seen in the throat or mouth.

• Oral thrush or fungal infections are treated by using antifungal mouthwash or medications. Clotrimazole, Nystatin, Fluconazole, or Itraconazole treat oral thrush.

• Antiviral drugs are used to treat viral infections such as herpes. Acyclovir or Valacyclovir are used to treat herpes.

• Nonsteroidal anti-inflammatory drugs like Acetaminophen or Ibuprofen can relieve pain and swelling due to white patches.

• In the case of cancerous lesions, the treatment depends upon the stage and the extent of the cancer spread. The cancer treatment may include radiation therapy, chemotherapy, surgical therapy, immunotherapy, targeted therapy, and tonsillectomy (removal of the tonsils).

Conclusion:

White spots in the throat are usually due to infection or irritation. It can be due to bacterial infections like strep throat or fungal infections like oral thrush. It can also be due to inflammation of the tonsils, that is, tonsillitis. White spots do not usually result in cancer. It can be considered a cancer symptom when white spots are associated with other symptoms like hoarseness in the voice, sore throat, or pain in the mouth or throat.