Is a Hoarse Voice a Sign of Cancer?

Usually not. Most hoarseness comes from a cold, voice strain, or acid reflux, and it clears up within about two weeks. The American Cancer Society advises seeing a doctor if hoarseness or other voice changes do not improve within two weeks. It can occasionally be a sign of cancer of the voice box or throat, so lasting hoarseness is worth getting checked.

A hoarse voice from a cold or a night of shouting usually fades on its own within a couple of weeks. Hoarseness that hangs on past that point, gets worse, or comes with other symptoms is the pattern doctors want to see. Other symptoms to mention include a sore throat that does not go away, pain or trouble swallowing, ear pain, or a lump in the neck.

Tobacco use and heavy alcohol use both raise the risk of cancers of the voice box and throat. If you smoke, drink heavily, or have done so in the past, mention it clearly when you describe your hoarseness. Your doctor may want to examine your voice box sooner rather than waiting to see if the hoarseness clears on its own.

Laryngitis is an inflamed voice box, usually from a virus. It is one of the most common causes of a hoarse voice. It typically improves within one to two weeks. Overusing your voice can strain the vocal cords too. Shouting, singing, or talking for long stretches are common culprits. Acid reflux can irritate the voice box, especially overnight. Allergies and dry air can also leave your voice sounding rough.

Your doctor asks how long the hoarseness has lasted. They ask if it is getting better or worse. They ask about your smoking and drinking history. If hoarseness has lasted more than two weeks, the next step is usually a look at your voice box itself. This can be done with a small mirror. More often today, doctors use a thin, flexible camera called a laryngoscope. It passes gently through the nose. The exam is quick. It is often done right in the clinic. If the doctor sees anything abnormal, a biopsy follows. That means removing a small tissue sample to check under a microscope. NCI puts the usual turnaround at up to 10 days for the pathologist's report to reach your doctor.

A laryngoscopy that looks normal is very reassuring, since it lets the doctor see the vocal cords directly. If hoarseness continues despite a normal exam, or new symptoms develop, follow up rather than assuming nothing more needs to be done.

If a biopsy does find cancer, continuing to smoke or drink heavily during treatment lowers the odds of a cure. The National Cancer Institute notes that patients with laryngeal cancer who keep smoking and drinking are less likely to be cured and more likely to develop a second tumor. Stopping, even after diagnosis, is one of the most useful things a patient can do for their own outcome.

• Call 911 or go to an emergency department if your breathing becomes hard or noisy, or you cannot swallow your own saliva.
• Call your care team the same day if a rough voice comes with coughing up blood, or with pain that shoots toward your ear when you swallow.
• Call your care team within a day or two if hoarseness has run past two weeks, or has been joined by a lump in the neck, trouble swallowing, or weight loss you did not plan.

• My voice has been hoarse for about [how long] — should it be checked?
• Could this be reflux or voice strain?
• Do I need my voice box examined?
• Given my smoking or drinking history, how concerned should I be?

• American Cancer Society — Signs and Symptoms of Laryngeal and Hypopharyngeal Cancer
• National Cancer Institute — Laryngeal Cancer Treatment (PDQ)
• National Cancer Institute — Surgical Pathology Reports