LPR (Laryngo-Pharyngeal-Reflux) vs Throat cancer

Dear Ask The Doctor: Male, 41 Non-smoker. I used drink every night since last 18 years and used eat late just before sleeping. Drinking has come down from heavy (200-250 ml of whiskies) earlier to much less (about 90-150 ml) since last 3-4 years. Since last 3-4 years I get occasionally chest compression, feeling bloated etc with excessive burping, which had worsened in last 6 months or so. Occasionally feels dizzy during such attacks which usually happens by noon and then subside by late evening. All test on cardiac functions including TMT were normal but for slight hypertension. Stomach burn was not much there, only seen in last 2-3 months. I got a flu about a month back, which went away in couple of days. Two days later noticed sore throat and pain with hoarseness of the voice (which happens to me every time I get cold). Stopped alcohol completely since then. Throat pain went away, but since noticed sore throat and feeling of something inside the throat which is occasionally conspicuous when eating some solid food (but not always) with a after taste coming to the mouth. Went to two ENTs. Two weeks back, first one did mirror laryngoscopy and said there is a swelling in the arytenoid area and attributed it to reflux without even knowing my history of GERD. Advised me to continue with Omeprezole and abstinence from alcohol. Since the soreness did not go I saw another ENT about 10 days back. He also attributed it to LPR and said the area looked swollen and has mucous. He prescribed Nexium 40 mg once along with citrezine 10 mg and domperidone 10 mg. Asked me to consult after a month and advised diet control etc. I have stopped the medicines other than Nexium. been on a bland diet, stopped. First few days since starting Nexium, felt better all gas burping etc. were gone and throat soreness felt reduced and voice became normal. 3-4 days later sore was back and so was the burping etc. Still overall feel better since stopping alcohol. Now to my question. How do one distinguish between LPR and Throat cancer? Can ENTs without doing a direct scopy verify if this LPR or Cancer? Can they say by looking through the mirror at the nature of swelling and rule out cancer? This is driving me mad...I have this feeling I am losing time if it is actually cancer by not doing a direct laryngoscopy or endoscopy.. I specifically asked both ENTs about the possibility of cancer and both seem to think it look like reflux. But having not done a direct scopy, can they say this? What do you advise?

Dear Peter: Common throat cancer symptoms include persistent sore throat, difficulty swallowing, change in the sound of your voice, having to clear the throat frequently, lump in the throat, abnormal breathing sounds etc. all of which may also be present with LPR. However, detailed history, clinical examination and investigations including direct laryngoscopy and endoscopy, are the best supportive measures to confirm the cause and rule out the other. You may want to consult a gastroenterologist to rule out any possibility of GERD, esophagitis, hiatus hernia or esophageal cancer and accurate treatment.