Slideshow: Anatomy of a Sore Throat

New Health Advisor: “White Spots on Throat”

What Does Throat Cancer Look Like?

Jennifer Welsh is a Connecticut-based science writer and editor with over ten years of experience under her belt. She’s previously worked and written for WIRED Science, The Scientist, Discover Magazine, LiveScience, and Business Insider.

Updated on October 09, 2022

William Truswell, MD, is a board-certified facial plastic surgeon and otolaryngology (head and neck) surgeon. He is president of the American Board of Facial Plastic and Reconstructive Surgery and treats skin cancer patients as part of his practice.

Throat cancer is a subgroup of head and neck cancers. It typically refers to cancers that originate in the pharynx (the throat). Thickened white patches on the lining of the throat are usually the earliest signs of cancer or a precancerous condition in the throat.

The most common type of throat cancer is called squamous cell carcinoma (SCC). This and other types of throat cancers are most often caused by environmental factors, including smoking or chewing tobacco. Infection with human papillomavirus (HPV) is an increasing cause as well. Additional exposures that increase the risk for throat cancers include alcohol and betel quid, a stimulant used in Asia.

Major health insurance companies have faced legal trouble over their claim denial practices. In February 2018, the insurance commissioner of California announced plans to investigate Aetna’s coverage denial practices after a former medical director of the insurance company admitted that he never once looked at a patient’s medical records when deciding whether to deny claims over the three years he worked in the position, according to CNN.

According to the National Cancer Institute, there were more than 53,000 cases of oral and pharynx cancer in 2020. Approximately 10,000 patients who have been diagnosed with these cancers died. The five-year survival rate for these cancers is about 66%.

This article reviews the appearance of several types of throat cancers and briefly describes their symptoms.

A White Patch

Some throat cancers begin as oral leukoplakia, a general term for a white lesion in the mouth of an unknown cause.

Leukoplakias are premalignant lesions, which means they’re not cancerous yet, but could develop into cancer. About 3% to 17.5% of these lesions are or will become cancerous in 15 years, while others go away independently.

Common symptoms of oral leukoplakia include a persistent cough and sore throat lasting for more than three weeks.

A Red Patch

Other throat and mouth cancers show up as red patches called erythroplakias. These are rare, isolated, velvety patches in the mouth and/or throat that typically show up in older patients.

Erythroplakia lesions are usually premalignant, but most of these red patches become cancerous, so it’s important to get them checked out. They typically affect middle-aged and elderly people, and are usually linked to tobacco and alcohol use.

Sometimes, lesions are a mix of red and white, referred to as erythroleukoplakias or “speckled leukoplakias.” Although the lesions most commonly occur on the floor of the tongue, they can also develop on tissues behind the back teeth, including the upper throat.

Throat Ulcers

A classic sign of oral cancer is a persistent rough patch that looks like a sore and has a raised border. Unlike some ulcers and other lesions like canker sores, these are minimally painful.

A Lump in the Throat

A primary tumor of the throat can appear as a nodular mass on the floor of the mouth, tongue, tonsil, or wall of the throat. The mass will tend to be irregular, fixed, and relatively painless, but can interfere with swallowing and make you feel like you have something caught in your throat. This is most common in people with a long history of smoking.

A Lump in the Neck

Metastasis is the spread of cancer from its original location. Head and neck cancers can spread through the lymphatic system, which is another circulatory system of the body. In the lymphatic system, fluid flows to lymph nodes, where white blood cells act to remove or neutralize foreign substances and invaders such as bacteria, viruses, and cancer cells.

If throat cancer spreads through the lymph vessels, it will likely land in the lymph nodes of the neck. There, it can produce non-tender masses (lymphadenopathy) and then seed new tumors in other parts of the body.

When a primary tumor grows to a large size, it can cause difficulty swallowing or talking, earaches, headaches, spitting up blood, and sometimes partial airway obstruction.

A Swollen Tongue

Some throat cancers, specifically those associated with a human papillomavirus (HPV) infection, cause a swollen tongue.

Infection with HPV is one of the major causes of throat cancer. About 10% of men and 3.6% of women have oral HPV. Many cases clear on their own, but some persist for years, which is when cancer can develop.

HPV-related oropharyngeal cancers are limited to the throat, while those caused by smoking, tobacco use, or other environmental triggers are found in the mouth and lips as well.

The characteristic symptoms of HPV-associated throat cancer include a swollen tongue, tiny lumps inside the mouth, and mouth numbness. The persistence of symptoms is a telltale sign, particularly in younger people who do not smoke.

Human papillomavirus is an infection that we can prevent. The HPV vaccine is very safe and effective at preventing infections, genital warts, and precancers.

Hardened Tissues

Another type of throat cancer, submucous fibrosis, is defined by the hardening of mucosal tissues. It is most often caused by the chewing of betel nut in Southeast Asian cultures, but also sometimes seen in people who chew tobacco.

Submucous fibrosis is typically a precancerous disorder, but can become malignant in between 1.5% and 15% of cases.

These lesions typically start in the mouth and gums, but can also involve the throat. They can cause burning sensations after eating spicy foods, and cause pain when eating and difficulty opening the mouth.

Advanced Symptoms

Coughing up blood is extremely rare. It can result from timor cells eroding into blood vessels. This is a sign of end-stage disease with a grim prognosis. An additional symptom is loose teeth, which can develop as the tumor spreads to the bones of the jaw and teeth.

You may also notice changes in the voice if cancer spreads to the larynx. Large primary tumors can prevent swallowing, leading to poor nutrition. Weight loss and persistent fatigue may result from this or be the result of widespread metastasis.

A Word From Verywell

Symptoms alone cannot diagnose throat cancer. If you’re worried about cancers of the head and neck, perform periodic oral self-exams. Making regular dental visits can also be a good way to monitor for any unusual growths or lesions.

A diagnosis of throat cancer is made after much testing and examination by your doctor. Tests will include a physical exam, where your doctor will use their hands to feel for swollen lymph nodes and other nodules. They’ll also test to see if you have HPV.

They will do an endoscopy (a procedure in which a tiny camera is fed into your mouth through a tube), a biopsy of any suspicious lesions, and imaging like a computed tomography (CT) scan or magnetic resonance imaging (MRI).

If you’re a smoker and have unusual or persistent symptoms aligned with those above, speak to your doctor about getting further testing.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. National Cancer Institute. Oropharyngeal cancer treatment (adult) (PDQ®)–patient version.
2. Centers for Disease Control and Prevention. HPV and oropharyngeal cancer.
3. National Institutes of Health, National Cancer Institute, Surveillance, Epidemiology, and End Results Program. Oral cavity and pharynx cancer—cancer stat facts.
4. World Health Organization International Agency for Research on Cancer. Leukoplakia.
5. World Health Organization Interational Agency for Research on Cancer. Erythroplakia.
6. Centers For Disease Control and Prevention. Reasons to get vaccinated against HPV.
7. Shih YH, Wang TH, Shieh TM, Tseng YH. Oral submucous fibrosis: a review on etiopathogenesis, diagnosis, and therapy. Int J Mol Sci. 2019;20(12):2940. doi:10.3390/ijms20122940
8. American Association of Oral and Maxillofacial Surgeons. Warning signs of oral cancer.

By Jennifer Welsh
Jennifer Welsh is a Connecticut-based science writer and editor with over ten years of experience under her belt. She’s previously worked and written for WIRED Science, The Scientist, Discover Magazine, LiveScience, and Business Insider.

Slideshow: Anatomy of a Sore Throat

We all know that raw, scratchy feeling in the back of the throat. It could just be dry winter air, seasonal allergies, or a plain old cold. But it also could be a bacterial condition, like strep, or a viral infection or something else. Only your health care provider can tell for sure. But you can look for a few signs on your own.

Take a Good Look

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Grab a flashlight, look in the mirror, and say, “Ahhh.” You could find some important clues. You might see white dots or patches in the back of your throat. Your tonsils — the bumps on either side at the back of your throat — might be red and swollen, too. These could be signs of bacterial infection like strep throat or oral thrush, or a viral infection like oral herpes or mononucleosis. They also might be something else, like tonsil stones, which are painful calcium deposits on your throat.

Do You Have Cold Symptoms?

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If you have a cough and drippy nose along with your sore throat, that could be good news. You may feel crummy, but you’re less likely to have a serious infection. You probably just have a common cold virus and post-nasal drip.

Do You Have a Fever?

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Colds can cause a fever, but it’s usually just a mild one. If you have a sore throat and a fever over 101 F, it’s more likely to be a throat infection like strep than a simple cold. But these don’t always raise your temperature — so watch for other symptoms.

Are Your Lymph Nodes Swollen?

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The most common reason is infection — viral or bacterial. Lymph nodes trap and destroy germs, and they can swell up when they start to fight an infection. You might feel them under your jaw or on either side of your neck. But it doesn’t always mean anything serious. Even the common cold can cause swollen lymph nodes.

How Much Does It Hurt?

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When a cold causes your sore throat, it can be plenty painful, but it usually goes away after a couple of days. Bacterial infections, like strep throat, tend to cause more severe pain that doesn’t get better. With strep, it may hurt so much that you can barely swallow. Sometimes, it can cause nausea, loss of appetite, headaches, or stomach pain as well.

Is There a Rash?

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A rash on your neck and chest that sometimes spreads to the rest of your body can be a sign of a group of bacterial infections called streptococcal infections. The most minor of these is strep throat, but they also include more serious ones, like scarlet fever, bacteremia (bacteria in the blood), and toxic shock syndrome. They all need to be treated by a doctor — usually with antibiotics — as soon as possible.

Bacterial Infections

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They may feel the same, but a common sore throat and bacterial infections are very different. Most sore throats are caused by viruses, like the cold virus. No medication will cure a cold virus — you have to let your body heal on its own. But antibiotics can fight a bacterial infection, such as strep, and stop it from spreading.

Colds & Antibiotics: Just Say No

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If you have a sore throat from a cold, antibiotics won’t help at all. They only help against bacteria not viruses. Taking antibiotics when you don’t really need them has a risk, too. Too much exposure to antibiotics can turn regular bacteria into “super bugs” that don’t respond to treatment.

Rapid Strep Test

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To figure out if strep — the most common bacterial throat infection — is causing your sore throat, your doctor may use a rapid strep test. Results are ready in 5 to 10 minutes, but the test doesn’t pick up all cases of strep. If yours is negative, your doctor may send a throat culture to the lab to be sure. That’s more thorough, but you won’t get the results for a few days.

Antibiotics for Strep

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If you do have a positive strep test, your doctor will give you oral antibiotics. You’ll probably feel better in a day or two, but don’t stop taking the medication — finish the whole course, which is usually 10 days. If you stop too soon, some of the bacteria could survive and get you sick again. You’ll still be contagious up to 24 hours after you start antibiotics, so wash your hands often to protect people around you. And throw away your toothbrush.

Home Care for Sore Throats

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No matter the reason for your sore throat, simple home remedies can make you feel better. One thing that might work is a saltwater gargle. Just mix half a teaspoon of salt into a glass of water, then gargle, and spit it out. It can keep your throat moist, help with swelling, and ease that raw, scratchy feeling.

Humidifier or Vaporizer

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Steam from a humidifier or vaporizer can keep your scratchy throat moist and cut down on pain. You can also lean over a sink with hot running water. Drape a towel over your head to trap the steam, and breathe deeply. Try this for 5 to 10 minutes several times a day.

Warm Compress

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Try a warm water bottle or heating pad against the outside of your throat. Or wet a towel with hot water to make your own warm compress. It can help soothe tender lymph nodes in your neck.

Soothing Foods

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If you need an excuse to eat ice cream, a sore throat is a great one. The cold has a numbing effect, and the creamy texture makes it easy to swallow. Other soothing foods include milkshakes, gelatin, and hot soup. If your sore throat is especially painful, stay away from crunchy or spicy foods.

Hydration

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If you have a fever and don’t drink enough fluids — because it hurts to swallow — it can make you dehydrated. Choose drinks that are easy on your throat: Water and warm tea are good choices. Stay away from citrus drinks, though, because they may sting your sore throat.

Pain Relievers

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Over-the-counter medicines like acetaminophen, ibuprofen, or naproxen can help dull the pain of a sore throat. But be careful if you’re taking something for a cold or the flu — some of those medications already include a painkiller. You don’t want to take a double dose.

Sore Throat Sprays and Lozenges

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You can soothe a painful sore throat with a numbing spray or lozenge. (But don’t give lozenges to small children.) Carry a travel-size throat spray in your purse or briefcase for relief on the go. Sucking on ice chips can also bring some relief.

Decongestants

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If you have a cold — and fluid draining from your nose irritates your throat — you could try a decongestant nasal spray or oral decongestant. They help dry up postnasal drip and give your throat some relief. Just follow the directions and don’t take them longer than recommended. If you use any other regular medications — or have high blood pressure or heart problems — check with your doctor first.

Lingering Sore Throat

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If it lasts longer than a week or gets worse, check with your doctor, even if you had a negative strep test. A throat swab may miss bacteria, so you may need another one. A sore throat that doesn’t go away could also be a sign of acid reflux, mononucleosis, or another condition.

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American Academy of Otolaryngology – Head and Neck Surgery: “Sore Throats.”

Bradley University: “A ‘superbug’ approach to antibiotics.”

CDC: “Sore Throat,” “Symptom Relief.”

Cleveland Clinic: ““Group A Streptococcal Infections.”

HealthyChildren.org: “When a Sore Throat is a More Serious Infection.”

Mayo Clinic: “Swollen lymph nodes.”

National Cancer Institute, National Institutes of Health: “Eating Problems and Ways to Manage Them.”

National Institute of Allergy & Infectious Diseases, National Institutes of Health: “Strep Throat.”

New Health Advisor: “White Spots on Throat”

Rutgers Health Services: “Cold & Flu.”

University of Michigan: “Infectious Mononucleosis.”

Wisconsin Department of Health Services: “Streptococcal Pharyngitis.”

White Spots on Throat – Causes and Symptoms

White spots on throat area can be quite alarming, especially if you are experiencing other symptoms. The exact cause varies, but medical conditions like: tonsillitis, mononucleosis, oral thrush and strep throat appear to contribute to it development and progression. White spots on the throat may be accompanied by difficulty swallowing, bad breath, weight loss, chest pain, sore throat and/or fever.

Conditions, associated with white spots on the throat, should not be overlooked, mainly because they can present a significant threat to your health and well-being. It is important to contact your doctor if you notice white spots on your throat, especially if you also have a high fever. This article examines the causes and symptoms associated with white spots on the throat.

Small white patches on the back of the throat

Causes of White Spots on Throat

A variety of factors can contribute to the development of white spots on the throat. It is important to fully understand the various causes then treating this condition. In addition, understanding the possible causes can help lower your risk of developing white spots on the throat.

The following conditions can cause you to have white spots on your throat:

Tonsillitis

Your tonsils consist of the tissues located in the back of your throat. Healthy tonsils are pinkish/red in color, but white spots can develop on them, if you contract tonsillitis. To put it simply, tonsillitis occurs when your tonsils become inflamed and swollen. Your swollen tonsils may also be accompanied by swallowing difficulties, a high fever, a sore, itchy throat, a stiff neck, migraines/headaches and/or raspy voice. If the tonsillitis is caused a bacterial infection, you doctor may prescribe antibiotics, but if the tonsillitis is viral, then home care may be the only treatment required. Chronic episodes of tonsillitis may require a tonsillectomy (removal of your tonsils).

Mononucleosis

Mononucleosis, also known as mono, is a contagious, viral infection that can cause white patches on the throat. This condition can cause symptoms for months and tends to be associated with severe fatigue and a sore throat. If you have mononucleosis, you may notice yellow or white spots on the back of your throat (where your tonsils reside). It is important to note that a strep throat infection that refuses to go away, even with treatment, can signal mononucleosis.

You may experience recurrent rashes, drowsiness, muscle aches, swollen lymph nodes, a lack of appetite and/or a swollen spleen, along with the white spots on the throat, fatigue and sore throat. Treatment may involve learning how to effectively manage your condition and/or any related infections. You can expect your fatigue to subside within a couple months.

White patches on throat caused by Mononucleosis. (Credit: James Heilman, MD)

Oral Thrush

If you happen to notice a white spot on the throat, you may be developing oral thrush. This condition is caused by a yeast infection in the mouth. It is most common in infants, but individuals with autoimmune disorders, low immune systems and/or those taking certain medications like corticosteroids are the most susceptible to oral thrush. If you have oral thrush you will develop white patches on the throat, mouth and/or tongue.

Along with the white patches on the throat, you may also experience a cracked mouth, breaks in the corners of your mouth, reduced taste and/or pain. This condition can quickly spread to your esophagus, if left untreated. Your doctor may treat your condition with an anti-fungal medication. He/she may also suggest that you consume plain yogurt (with live active cultures) to accelerate healing and combat future occurrences.

Strep Throat

A white spot on the throat may be the first sign that you have strep throat, a bacterial throat infection. Strep throat is the most common cause of white patches on the throat. This condition can also cause a yellow or white film and pus-filled white lumps on the tongue, mouth, tonsils and throat. In some cases, harmful bacteria can cause cracks in your mouth and/or on your throat and tonsils.

When you have strep throat, harmful bacteria, called streptococcal, collect in the crevices of your mouth, leading to white spots on the throat, a sore throat, white and red pus-filled lumps on the back of the throat, red spots on the roof of the mouth and/or throat, extreme fatigue, a fever, headaches/migraines, a swollen, stiff neck, vomiting and swallowing difficulties. It is important not to ignore strep throat symptoms because they can lead to serious complications like kidney malfunctions and/or rheumatic fever.

Strep bacteria consists of a hundreds of streptococcal bacteria strains – some more severe than others. If you have strep throat, your doctor will more than likely prescribe antibiotics to accelerate healing. He/she may also prescribe over-the-counter pain relievers and/or medicated throat sprays to ease throat soreness.

A case of Strep throat, culture positve. (Credit: James Heilman, MD)

Symptoms of White Spots on Throat

Here are some common symptoms you might experience:

• Difficulty Swallowing – If you have white spots on the back of your throat, you may have problems swallowing. White spots, caused by a yeast infection, can inflame your throat and restrict your throat passage way, resulting in swallowing difficulties. This symptom may present as a feeling that something is stuck at the back of your throat, reoccurring chest pain, a burning sensation in the throat and/or chest and/or throat pressure following a meal. Moreover, you can experience this symptom when excess candida in the mouth and esophagus causes your throat and/or tonsils to inflame. In severe cases, swallowing difficulties can lead to weight loss.
• Weight Loss – Another symptom that can occur as a result of white spots on the throat is weight loss. As mentioned before, white spots can cause inflammation in the mouth and on the throat and tonsils, which can affect your ability to swallow. Swallowing difficulties coupled with a loss of appetite can lead to weight loss. In addition, if the throat inflammation is caused by an overabundance of yeast, you run the risk of a restricted throat passageway, which can also lead to problems swallowing and weight loss.
• Chest Pain– You may experience chest pain when you have white spots on the back of your throat. It is not uncommon to experience chest pain under the breastbone, where the esophagus is located, when you have candida (an overabundance of bacteria) In fact, your chest pain and pressure may resemble heartburn and, in some cases, angina (heart pain).
• Oral Thrush -Oral thrush (an oral yeast infection) can occur when excess amounts of yeast collect in your mouth and then transfer onto your throat. If you have oral thrush, you may experience white spots on the throat. You may also suffer from throat and/or mouth pain, a loss of taste, white patches on the back of the throat, mouth and/or tongue, breaks at the corners of the mouth and/or bleeding around the gums. Furthermore, if you have oral thrush, your doctor may prescribe an antifungal medication to eradicate your symptoms and prevent future occurrences.
• Sore Throat -A sore throat is often associated with white spots on the back of your throat. A sore throat may cause you to experience pain upon swallowing. Moreover, the white spots can irritate and inflame your throat, which can aggravate your sore throat and lead to loss in appetite.
• Bad Breath -Do not be alarmed if you experience bad breath with your white spots on the throat – it is common. When you have an overgrowth of yeast, bacteria or fungus, it can cause an unpleasant odor in your mouth. Moreover, if you have chronic oral yeast infections, you may be able to identify the white spots and bad breath as symptoms of candida.
• Fever – It may seem strange, but white spots on the back of your throat can also be accompanied by a fever. A fever can occur when a yeast, fungal or bacterial infection spreads from your mouth, to your esophagus and finally into your blood stream.