Could prolonged hoarseness be a sign of throat cancer?

I think that your dad should most definitely have his hoarse voice checked out to make sure it isn’t due to a more worrying cause like cancer.

I always advise anyone who has had a persistent hoarse voice for longer than 2 weeks to undergo a thorough checkup, even if he is a non smoker.

Anyone with a hoarse voice who smokes or is an ex smoker should not hesitate to have their throat and voicebox examined carefully as the chances of cancer or pre-cancer changes are much higher than in a non-smoker.

In addition to a persistent hoarse voice, other specific “red flag” danger symptoms of throat cancer to watch out for include:

• persistent sore throat
• feeling of something stuck inside the throat
• noisy breathing
• difficulty swallowing food and/or water, and
• even bringing up blood-stained secretions from the mouth or throat

Your dad should have a nasal endoscopy procedure done in clinic which involves using a flexible endoscope/camera to give a clear view of his throat, voicebox and airway.

This is a pain free and safe procedure which should only take less than 5 mins in experienced hands.

Of course, there may be a perfectly innocent and benign reason for your dad’s hoarse voice, but we won’t know that unless he gets it properly checked out by his friendly ENT doctor.

You can try and persuade your dad to seek help by trying to assuage his fears. Fearing it is a cancer, he may not want to seek treatment.

You can let him know that most of the time, the hoarseness can be from gastroesophageal reflux disease (GERD) which happens more in elderly, if there are irregular or late meals, intake of too much alcohol and sour, fried, oily or spicy foods.

After a simple flexible scope that goes through the nose down the throat, which really takes only 1 minute, the diagnosis is made in the clinic. I use a baby scope for adults who are worried about discomfort - it is only 2 mm in diameter, thinner than a noodle!

The patients are usually really surprised at how easy and pain free it is, and regret that they have waited for so long. Other common causes are an allergy causing postnasal drip phlegm or sinusitis.

Cancer of the lower throat and voice box is of course, an important cause of hoarseness, and must be excluded quickly, since this has been for more than a month. Cancer of the throat can be treated if it is detected early.

Late symptoms of cancer would be a worsening voice, impaired swallowing, blood in phlegm and breathing difficulty. When cancer has spread, there may be lumps in the neck. Most often again, there is no cancer, but on the voice box, there can be small nodules or polyps.When treated early, no surgery is required for these nodules or polyps.

Kind regards,

Dr Lynne Lim