Recently, I saw a news article, “External ear canal cancer caused by ear-pulling”, and when I saw this headline, I was a bit tearful. As an otolaryngologist, I really want to say a few words, “Can pulling out ears cause cancer? Don’t be ridiculous. Let’s start with external ear canal cancer, the name sounds scary. Yes. How many people get it? Quite, quite few. In the professional literature available in China, there are no reports of more than 100 cases, and even more than 50 cases are extremely rare. Beijing Tongren Hospital, which is the leading otology hospital in the north, has only treated 32 cases of external ear canal cancer from 2003 to 2011. According to the Shanghai Eye, Ear, Nose and Throat Hospital, the annual incidence of external ear canal cancer is one in a million, and many otologists may not come across a single case in their entire career. I’m lucky to have come across three cases, none of which were due to the “love” of ear-pulling. The number of people who like to pull out their ears is impossible to estimate, at least a million times more than the number of patients with external ear canal cancer. Think about how many “ear pullers” there are in Sichuan, the capital of China. Some people are even going to declare it as “intangible cultural heritage”. If we follow the news that “ear-pulling causes cancer”, Sichuan should be number one in the country for external ear canal cancer, but what about the results? Well, of course not. What is the correlation between such a common daily practice and a disease with such a low incidence? At least in the otologic literature, no one has ever suggested that “ear-picking” is a cancer-causing factor, so I say, stop it. Should you pull out your ears or not? I always tell my patients that it is good to take out their ears, but it is not good to take out your ears. If your ears are itchy and you have a lot of ear wax, there is no harm in pulling them out. As long as you don’t use anything like toothpicks, hairpicks, or matchsticks that can damage the skin of the ear canal, you’ll be fine. Some people who never pull out their ears sometimes have earwax that becomes a hard lump and blocks the outer ear canal, so don’t do it by yourself. Hospitals have ear drops for softening earwax, so you can soak it and have your ear doctor clean it out. We are not at liberty to comment on the ear pullers, but depending on their equipment, it is not impossible for some skilled people to handle ear wax. But after all, they are not medical professionals, so it is better for us to weigh more. Back to the topic, what exactly is the cause of this external ear canal cancer? Well, it is a mystery. Because the incidence rate is so low, and there is no unified and clear factor among the rare patients, the cause of external ear canal cancer has not been clearly stated in academia until today. If you experience bleeding from the external ear canal, ear pain, or ear stuffiness, get it checked by an otologist as soon as possible instead of using ear drops to deal with it randomly. Even if it is external ear canal cancer, early detection and timely treatment through surgery and radiotherapy and chemotherapy can still be quite satisfactory. In one of the earliest cases of external ear canal cancer that I encountered, the tumor was found in time, and radiotherapy was administered after removal of the tumor through the ear canal. After treatment, there was no change in the appearance of the ear, only that the hearing was worse. He would visit me every year and no one could tell that he was a cancer patient.