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Oncology (General Cancer)/Oral Cancer? How worried should I be?


Toward the end of January I got the flu that was going around for 8-10 days, mostly recovered, and then went through another bout immediately after.

As I was recovering from the second round of the flu, I noticed my lymph nodes near my adam's apple stayed swollen(they were not swollen before I got the flu), often accompanied by a slight pinching sensation in the same area like someone took a couple fingers and placed them on my neck. I wrote this off to simply some lagging symptoms that would go away or my imagination (which can sometimes be over active).

Fast forward 2 months with these symptoms sometimes seeming to go away, but sometimes coming back (never actutely).  I woke up one morning to notice what I later found out were enlarged circumvallate papillae, small raised red dots on the middle to back of the top of my tongue (but not toward the front of my tongue)that had a slight burning sensation, and a mild sore throat.  I also had some slightly raised bumps on both sides of my tongue near my molars.  I shined a flashlight in the back of my mouth and didn't see anything that looked like what my old strep throat looked like when I was a kid, but there were maybe half a dozen small slightly lighter than the rest of my throat areas (sores?) that looked somewhat irritated. I also noticed while looking in the mirror that when I swallowed, the left side of my neck seemed to have slightly more tissue (although not a hard lump or anything).  I also have a thin white film over some of my tongue, which I have later been told by my PCP is yeast, and normal.

I scheduled an appointment with my PCP and after a normal blood test and x ray of my sinuses he said it was probably nothing to worry about and gave me amoxicillin for 10 days, which I have taken to no effect.  My symptoms in that time have gone from mild sore throat to a burning sensation in the back of my throat and on my tongue similar to when you eat hot food that rarely diminishes.

My doctor offered me a choice of 3 ways to proceed, whether I wanted him to try a different anti-biotic, to take a CT scan of my neck, or to see an ENT specialist. I asked which one he would choose for himself and he said the CT scan, which scared me since when I think CT scan I think cancer.

After some discussion about the expense of having the CT scan, I decided on the ENT, but the appointment is almost 2 weeks away, and anxiety has got the best of me so here I am.

Does this sound like oral cancer?  Does my doctor's recommendation of a CT scan seem reasonable?  Should I wait the 2 weeks to see the ENT before doing anything else?  Is there some other course of treatment available to me that would provide me some further information (dentist, oral surgeon, something else)? What would cause this all to happen after the flu?

From your description I don't think it's cancer;  it sounds more like you have some kind of infection that the amoxicillin didn't handle.  I think an ENT visit is more reasonable than a CT scan at this point.  Sometimes having the flu sets you up for getting another kind of infection -- I don't know if you have otherrisk factors, including smoking, age, diabetes, etc, but if you have a coating of yeast on your tongue that isn't strictly speaking normal.  It generally points to a temporary or permanent deficiency in your immune status -- again, possibly a post-flu thing.  Dentists often are pretty good at mouth conditions, but not always; there isn't a lot of difference between an ENT and an oral surgeon.  If you aren't doing it already, I'd suggest making sure you are taking a good vitamin supplement and deep-rinsing your oral cavity with a salt solution or an over the counter mouthwash -- that means gargling and rinsing for several minutes at least twice a day.  Hope this helps.  

Oncology (General Cancer)

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Donald Higby, M.D.


I can answer almost all questions related to the treatment and natural course of most kinds of cancer, especially cancers of prostate, colon, lung and breast.


I have been a practicing medical oncologist for 36 years, and have been chief of service at a major medical center for 25 years. I've also done research in cancer treatments.

American Society of Clinical Oncology

New England Journal of Medicine American Journal of Medicine Journal of the American Society of Clinical Oncology Hematology Transfusion Medicine

MD, Stanford University Internal Medicine residency, St. Louis University School of Medicine, St. Louis, MO Medical Oncology Fellowship, Roswell Park Cancer Institute, Buffalo, NY

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America's Best Physicians, last 14 years

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