“There’s a lump in my throat — I’m sure it’s cancer”

Globus pharyngeus is a POSITIVE clinical diagnosis: a persistent MIDLINE lump/tightness sensation present BETWEEN meals, characteristically EASED by eating/swallowing food (the opposite of an obstructing tumour), with throat-clearing, WITHOUT true dysphagia, weight loss, pain, voice change or neck lump — functional, commonly linked to reflux, post-nasal drip, anxiety and the throat-clearing habit. The skill is reasoned, confident reassurance that explains WHY the pattern (especially eased-by-eating) points away from cancer — NOT a dismissive "it’s nothing" — but ONLY after explicitly excluding the red flags (true dysphagia/odynophagia, persistent/progressive symptoms, neck lump, hoarseness, weight loss, lateralised symptoms, otalgia, smoking/alcohol/older-age), whose presence would change the pathway under NICE NG12: true dysphagia → suspected cancer pathway referral for oesophageal cancer; hoarseness or a neck lump at 45+ → a suspected cancer pathway referral for laryngeal cancer. The examinable hidden agenda is health anxiety triggered by a colleague’s throat-cancer diagnosis and a demand for "all the tests" for certainty; address the specific fear directly, treat the contributing reflux/throat-clearing and the anxiety, resist an anxiety-feeding battery of tests (without refusing appropriate referral if red flags emerge), and safety-net PRECISELY so reassurance is safe — a clearly marked exit.