Is a Sore Throat a Sign of Cancer?

Usually not. Colds and other infections cause almost all sore throats, and they clear up within a week or two. A sore throat that will not go away, especially with other symptoms, can occasionally be a sign of throat cancer. That pattern is worth checking.

A sore throat from a cold usually improves within a week or two, often alongside other cold symptoms like a runny nose or cough. A sore throat that lasts longer than that, with no other cold symptoms to explain it, is the pattern doctors want to know about. Pain or trouble swallowing, ear pain, a lump in the neck, and a hoarse or changed voice are other symptoms worth mentioning alongside a lasting sore throat.

Tobacco use and heavy alcohol use both raise the risk of cancers of the throat and voice box. If you have used tobacco or alcohol heavily, mention this clearly, since it changes how your doctor weighs a lasting sore throat. HPV, a common virus, is also linked to a rising number of throat cancers, including in people with no history of smoking or drinking.

Viral infections, including the common cold and flu, cause the great majority of sore throats. Strep throat, a bacterial infection, causes a sore throat that often comes with fever and is treated with antibiotics. Allergies and dry air, especially in winter, can irritate the throat too. Acid reflux can cause a chronic sore throat, especially one that is worse in the morning.

Your doctor asks how long the sore throat has lasted and whether you have other symptoms, like ear pain or a neck lump. A physical exam, including a look at the back of your throat, is the first step. For strep, a quick swab test can confirm the diagnosis in minutes. If a sore throat lasts more than two to three weeks with no infection found, or if you have risk factors like smoking, the next step is usually a closer look at the throat and voice box with a thin, flexible camera called a laryngoscope. If anything looks abnormal, a biopsy — taking a small tissue sample to check under a microscope — follows. Results usually take about a week.

A negative strep test rules out one common cause but not every cause of a lasting sore throat. If your sore throat continues for weeks despite a negative strep test and no other explanation, ask about a closer exam of the throat rather than assuming it will simply pass.

• Call 911 or go to an emergency department if you cannot swallow, or you are drooling because you cannot. Do the same if breathing is hard or makes a high-pitched noise. The NHS treats each of these as an emergency.
• Call 911 or go to an emergency department if you have the signs the NHS links to sepsis: shivering with mottled or blue-tinged skin, confusion, very fast breathing, or passing no urine all day.
• Call your care team without delay, at any hour, if you run a temperature of 100.4°F (38°C) or higher while on chemotherapy, or with any other reason your immune system is weakened. That is a medical emergency. If you cannot get through to them fast, go to an emergency department and tell staff your immune system is low.
• Call your care team the same day if you have a fever with no weakened immunity behind it, or you feel hot and shivery, or you are peeing much less than usual.
• Call your care team within a day or two if the soreness has run past two to three weeks and no infection explains it. Call too if you now have a lump in the neck, ear pain, a changed voice, or weight loss you did not plan.

• My sore throat has lasted [how long] — should it be examined further?
• Could this be strep, reflux, or a virus?
• Given my smoking or drinking history, should my throat be examined directly?
• What symptoms should prompt an urgent visit?

• American Cancer Society — Signs and Symptoms of Laryngeal and Hypopharyngeal Cancer
• National Cancer Institute — Laryngeal Cancer Treatment (PDQ)
• CDC — Basic Information About HPV and Cancer
• NHS — Sore throat
• NHS — Sepsis