Sticky Sensation in the Throat
Simple Benign Causes and Dangerous Causes

JC Sanasam *

Throat anatomy diagram :: Pix - Indolences / Wikipedia.org

It is a common experience for doctors to receive alarmed and panic-stricken patients who happen to land up in their clinic or chamber or in their hospital out-patient-office, with various farfetched or heavy-handed complaints. A common presentation of such kind is the patient's decisive assertion with conviction that he has developed cancer in his throat.

It is usually the relatives of patients who had died of throat cancer who rang the alarm bell in such patients. The poor guy could not sleep throughout the whole pervious night. Naturally the doctor would like to know why he (the patient) suspects that he has throat cancer.

Here, what such a patient commonly answers is that he has a sticky sensation in the throat.

'How long have you been feeling this discomfort?'

'Oh, quite for some time. I've gone to other doctors; they say it's pharyngitis. But I haven't got any relief with their treatment.'

'Well, is the discomfort or your symptom persistent, or persistently progressive? In other words do you get relieved of it from time to time?'

'No, it's not persistent. Well, yes, I do get relieved of this nasty feeling sometimes, and very often I reckoned it won't come back again. But one odd day the same symptom reappears. My friend said his uncle had the same thing; he was eventually found to have throat cancer, and he died. I got so upset then and that's why I've rushed up to you, doctor.'

With this brief preliminary history-taking, any rational doctor would like to comfort and reassure the patient that it might not be cancer; because cancer symptoms, seemingly not aggressive though, are persistently progressive without any significant period of relief in between. A cancer patient will be able to definitely discern that his symptom has been continuous; rather it has aggravated more this week than what it was last; and by three to months of cancer in the throat the patient should have had much worse added symptoms than just a sticky sensation in the throat.

The doctor, of course, would say, 'Anyway let's have a check'; and he will start to take formal and technical history before he takes the patient to clinical examination.

On the other hand, among easy going patients, there can also be one who would casually come to an elaborate-loving doctor and complain that he has some sticky sensation in the throat, which in the long run would result into a skewed patient-doctor relationship.

'How long have you been experiencing this?'

'Oh, quite for some time?'

'How many days or weeks or months?'

With expression of some irritation for unnecessary details the patient will vaguely say, 'Maybe 4 months, er … perhaps 5 months.'

'Do you get relieved of it sometimes?'

'No, never.'

'Has it grown worse now than before?'

'Yes.'

'Or in other words do you think that it has aggravated more this week than the last?'

More irritation … 'Yes, I told you it has grown worse.'

'Any other problems you experienced?'

'Oh, all sorts. In the head, in the nose, all around.'

'What in the nose?'

'I don't know, some stuffy feeling, maybe.'

'Would you call it nasal obstruction or in simple words, blocked nose?'

Sign of getting bored … 'I told you stuffy …; alright you can call it nose-block.'

'Okay fine, do you ever experience bleeding from the nose?'

'Yeah, from the mouth too, I often spit out blood.'

'Bleeding from the nose?'

'I told you.'

'No, you said you spitted blood.'

'I said "yeah" when you asked about the nose!'

'Right. Okay, which side of the nose?'

'Seems the left.'

'You said "in the head", what in the head?'

'Some heaviness, maybe headache.'

'On the left side, is it?'

'Yes.'

'Any other problem? Like in the ear?'

'It seems there is some block in the ear.'

'Would you say there is impairment of hearing? Is it on the left ear?'

'Yes sort of.'

'Is it left ear?'

The patient gets exasperated … 'I told you "Yes". Why all this, like police interrogation?'

The doctor deviates from answering. He suspects some malignancy somewhere in the nasopharynx (the space behind the nose above the palate) or in the laryngopharynx (further down the mouth cavity) or in one of the sinuses around the nose. He sort of admonishes the patient, 'You have suffered from this illness for more than 3 months, what took you so long in consulting doctors?'

'I did not suffer much. I thought it was only a minor thing that would go away in due course. Moreover I was away from home working for road construction in the hills; earning for livelihood. So I hardly had time.'

'But you know, without good health life is nothing. Anyway let us start afresh more systematically with the clinical history, and then I will examine you physically. If you don't know how to relate your problems let me shoot you with certain questions, you just answer 'yes' or 'no.'

'You've asked so many questions like the police do. I'm not a criminal. And yet you want to ask me more questions?

'Yes, I need to know some more details and you got to give me straight answers.'

This is the picture. The presenting symptom may sound almost same. The patient of the first category may be of a simple benign non-dangerous disease like naso-muco-ciliary-drip-disorder but the patient of the second category most probably is of a dangerous malignant cancer.

More information about sticky sensation in the throat, next week.