<s>[INST] Hello doctor(s),Im a 22 year old Male - Ive been coughing for about a year, and recently started having gagging episodes 10-15 times a day. Ive been given Proton Pump Inhibitors. For the past few days, Ive been experiencing a strange back pain when I swallow food. No Dysphagia though, just Odynophagia. So far its been found that I do NOT have H pylori, or ulcers, or gallstones etc. But we still havent done an endoscopy. Im being told to wait 4 weeks to get that done. My concern is, do my symptoms resemble esophegal cancer? And is 4 weeks a lot of time for this possible cancer to develop? Im so anxious I havent been to work in a week and its destroying my mind. ANy advice would help so much .... [/INST] Hi, Thanks for writing in. A constant cough and back pain in a young male is not likely to be a cancer. Such acute symptoms are more likely to be due to infection in the throat. Please continue taking proton pump inhibitors. If the odynophagia increases then you should go back to your doctor and get examined for an oral examination and probably a neck CT scan to know if there is any abscess which is evolving. If there is significant infection then treatment is with a short course of antibiotics. Endoscopy is done when the infection has been treated and the inflammation is reduced and is safe to do after 4 weeks in your case. In my opinion, the first possibility is an acute pharyngitis or infection of the upper esophagus. Please do not worry. </s>