I have been a chainsmoker for the last ten years. Is it why my tonsils are inflamed?

Question

Hello doctor,

I am a 36-year-old male. I have had a history of smoking for the past ten years and have been using an e-cigarette for the past five years. I also have an account of drinking over the weekends. I have no sore throat or sensation, but I noticed a small (less than 2 cm in length) fleshy bump on one tonsil, as well as possible signs of tonsil stones. Does this look concerning? Can it be cancer? There is no family history I know of head and neck cancer. I am worried. Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com

I am sorry for the discomfort. I saw the picture you attached (attachment removed to protect the patient's identity). There is a slightly swollen tonsil on the left side with a yellowish spot, probably reflecting? Tonsil stone on the surface. The right tonsil appears normal. There are white patches on the posterior pharyngeal wall. Overall, poor oral cavity hygiene is visible. You mention that you noticed it two to three days back, and there are no symptoms present at all. Smoking and alcohol consumption add to each other as a risk factor for throat and tonsil cancer, though it is commonly linked with HPV infection. Common symptoms of pharyngeal cancer or tonsil cancer include:

1) Lump in the neck.

2) Ulcer not healing in the back of the mouth.

3) Blood in the saliva or mouth can occur.

4) Sore throat not going away.

5) One tonsil is larger than the other.

6) Difficulty in opening the mouth and swallowing.

You have a long history of smoking and, in recent years, the use of an e-cigarette. They wear down our immune system, including the oral cavity, making it susceptible to the pathogen to grow, and can cause such changes. Definitely, there is tonsillitis due to frequent smoking habits. As of now, since there is no symptoms at all and the picture do not reveal much difference in the size of the tonsil but considering you have a long history of potential risk factor, I would suggest you get an ENT (ear, nose, and throat) consultation regarding the same to take an appropriate step at the earliest to rule out any cancer-related changes.

Also, I would suggest:

1) Gargle with saltwater.

2) Practice good oral hygiene.

I hope you find my reply helpful.

Take care.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

It felt good to me after reading your effort to quit the smoking habit and also tapering the nicotine strength in an e-cigarette. I encourage you to make this effort to quit smoking. I saw the picture you attached (attachments removed to protect the patient's identity).

1) There appears to be pinkish and moist mucosal color at the back of the oral cavity and around the tonsillar area, suggesting normal buccal mucosa.

2) There is no unilateral enlargement of the tonsil seen.

3) Tonsil crypt is visible, which is normal and can be seen on the medial surface of the tonsil.

4) On the left tonsil, there are yellowish spots visible.

5) There is no ulcerative or exophytic growth seen in the oral cavity or in the tonsil area.

So, the findings are benign, and you do not have any symptoms at all. Again, I would suggest you visit an ENT specialist at the earliest. Do not postpone it for a more proper oral and physical examination. I hope this helps.

Thank you.