01

In this article

  • Voice change lasting over three weeks should be examined
  • Painful swallowing, ear pain or a neck lump may occur
  • Earlier diagnosis broadens treatment options
02

Assessment and treatment

  • Flexible laryngoscopy
  • Biopsy and imaging of suspicious disease
  • Stage-based surgery, radiotherapy and/or systemic treatment
QUICK FACTS

At a glance

Definition: Persistent hoarseness is a common early sign of voice-box cancer; tobacco and alcohol are major risk factors.

Key takeaways

  • Voice change lasting over three weeks should be examined
  • Painful swallowing, ear pain or a neck lump may occur
  • Earlier diagnosis broadens treatment options

Clinical steps

  1. Flexible laryngoscopy
  2. Biopsy and imaging of suspicious disease
  3. Stage-based surgery, radiotherapy and/or systemic treatment

Red flags: Breathing difficulty, noisy breathing, coughing blood or a rapidly growing neck lump needs urgent assessment.

Quick FAQ: When should I see an ENT specialist?

Breathing difficulty, noisy breathing, coughing blood or a rapidly growing neck lump needs urgent assessment.

EXPERT INSIGHT

How I assess this in clinic

I first clarify duration, severity, whether symptoms are one-sided or bilateral, and their effect on daily life. I then perform a focused ENT examination and compare the findings with voice change lasting over three weeks should be examined.

Endoscopy or audiometry is not required for everyone. I advise endoscopy when the nose, sinus, throat or voice box needs direct assessment, and audiometry/tympanometry when hearing or middle-ear function is in question.

A common misconception is that every ENT problem needs an antibiotic or an operation. Treatment should instead follow the diagnosis, functional impact, examination findings and evidence-based indications.

Do not wait when: Breathing difficulty, noisy breathing, coughing blood or a rapidly growing neck lump needs urgent assessment.

ReferencesHead and Neck Cancers—Patient InformationUS National Cancer InstituteCancerWorld Health Organization

For patient education; not a substitute for individual diagnosis or treatment.