I have white patches in the throat and a reddened soft palate. Is it oral cancer?

Question

Hello doctor,

I have been having oral symptoms for the last six months or so. I also have been a heavy drinker for the past seven to eight years. I discontinued this in January of this year. Started in the fall of last year with allergy, cold symptoms and has continued to the present day, even getting worse.

Every day without relief. I noticed the white patches in the throat and reddened soft palate. I have also had irritated scratchiness in the palate. My concern is oral cancer. I have had one of the white patches biopsied, and it was diagnosed as follicular lymphoid hyperplasia. Everyone says the soft palate is normal, but I am not convinced because of the length and duration. I underwent allergy testing, but I had none.

Also, I had an endoscopy to check for reflux, which was also negative. The last doctor I saw said he would remove my tonsils. I have had imaging tests, of which nothing has shown up. Could something be hiding, or could this be precancerous?

Also, I get white pimple sores that pop up and then go away, only to come back again in the same place. Not sure what I need to do next, but my prior alcohol abuse has me concerned about these symptoms. I realize these symptoms are all over the place, but it seems oral cancer can vary quite a bit.

Can you advise, please?

Answer 1

Hello,

Welcome to icliniq.com.

It is good that you stopped drinking. Meanwhile, I do not find any cancerous lesion in the pictures you sent (attachment removed to protect patient identity). However, none of the pictures show the posterior pharyngeal wall. If you can take a better picture, it will be appreciated.

Can you detail your symptoms more?
Do you have any foreign body feeling inside the throat?
Any difficulty in swallowing?
Any change of voice?
Any increased throat mucus?
Any recurrent post-nasal drip?
Any nose block or running nose, or sneezing?
Can you share the reports of your allergy testing?
Did you change your place of stay or work recently?

Your symptoms seem to suggest an allergic cause, and the constant allergy can be a cause for the chronic inflammation of the throat. Please revert to me with all details. Please upload the CT (computed tomography) and MRI (magnetic resonance imaging) reports, as well as the biopsy report.

I hope that this answers your query.

Kindly follow up if you have more doubts.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

Thanks for the detailed history you have given, as well as the reports and pictures (attachments removed to protect the patient's identity). Your throat does not show any precancerous or cancerous lesions. The spot that you have circled in black is just an ulcer. Such ulcers may occur repeatedly when there is a vitamin deficiency or an incomplete diet. We can suggest some remedies for that.

In the second set of pictures, I do not find much congestion or inflammation. But definitely your symptoms point towards some form of hypersensitivity. It may not be an allergy, as has been ruled out by the allergy testing. But this could be due to a vasomotor phenomenon or an unknown etiology.

But I do not find any reason to worry about cancer. I suggest you start on a steroid nasal spray if you have not till now. Additionally, a two-week course of Singulair (Montelukast) with Fexofenadine should be taken. When thick mucus is present, a mucolytic drug will help. Continue the nasal spray for two months.

Consult your specialist doctor, discuss with him or her, and start taking the medicines with their consent. You must avoid dust, smoke, and direct outside air. Avoid direct air from the AC also. Wear a mask when you venture outside. Stay away from strong smells and fragrances. Start yoga or some mind and body relaxation exercises.

Meanwhile, your MRI has very clearly shown that there is no lesion in the hidden areas (fossa of Rosenmuller, aryepiglottic folds, pyriform fossa, etc). That rules out any chance of cancer in those areas. If you are still worried, you can get a pan-endoscopy to rule out if there is an occult lesion anywhere from the nose and mouth to your upper intestines. That should allay all your fears.

If you are smoking, please stop that as well. In the long term, a tonsillectomy will be helpful. For the sores, I suggest applying Dologel ointment or gel after rinsing with warm water. Take a multivitamin supplement that has riboflavin, vitamin B12, and folic acid. Check your blood hemoglobin level and let us know.

Take a picture of your nails and send it to us. The latter is to rule out anemia. Anemia in your age group is known to occur along with Plummer-Vinson syndrome. If you need details on the sprays and any other medicines, please get back to me. Please let us know what medicines you have already taken, when, and for what duration. Also, throw some light on your food habits. Hope you do not smoke.

I hope that this answers your query.

Kindly follow up if you have more doubts.

Thank you.