I Have a Lump in My Throat

If you have a lump in your throat every time you swallow or even every time you talk, what is going on there? Could this be a sign of throat cancer?

When a patient comes into my office complaining "I feel a lump in my throat," they are typically very worried. The patient will generally point to the middle of their neck usually just below the Adam’s apple. The medical term for a lumplike sensation in the throat is a “globus” sensation, like you have a globe of the Earth stuck in the back of your throat. Often this lump has been there a while and seems to be getting worse. It may be felt every time you swallow or even every time you talk. What is going on? Could this be a sign of throat cancer?

What’s typically going on is that the lump in your throat is a result of some type of vocal cord tissue swelling. The vocal cords have a front part (the Adam’s apple) and a back part (sitting on or near the spine). The area between the back of the vocal cords and where the spine exists is normally very tight, so even the slightest bit of swelling in this region can result in a sensation of fullness or like something is sitting in the throat--causing the lump in throat feeling. Another fact about this area (also known as the posterior larynx) is that it sits right above the entrance to the esophagus. The esophagus is a long thin muscular tube that connects the throat to the stomach.

One of the most common causes of swelling in this area is acid reflux coming up from the stomach and burning the posterior larynx. The acid reflux effectively causes an acid burn of the throat tissues resulting in swelling that feels like a golf ball is stuck in the throat.  Often the postnasal drip patients feel is actually normal secretion from the nose and sinuses that backs up because of the tissue swelling in this area of the larynx. 

Other common causes of posterior laryngeal swelling are allergies and infections. Less commonly, a lumplike sensation in this area can signify tumor growth. Not so long ago, there was a commonly applied medical diagnosis called globus hystericus, defined as a lumplike sensation in the throat thought to be caused by anxiety. Today, because of sophisticated imaging capabilities, often all one has to do to determine the source of the sensation is to have an ear nose and throat doctor have a look at the area with an ultrathin flexible scope. So if you are experiencing a lumplike sensation in your throat, please see your doctor.

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