Hoarseness

Reviewed by: HU Medical Review Board | Last reviewed: February 2024 | Last updated: February 2024

Hoarseness (also called dysphonia) is when your voice sounds raspy or strained. Hoarseness is very common. In fact, about 1 in 3 people will experience hoarseness at some point. People who smoke or use their voice extensively at work are more likely to have hoarseness. People with lung cancer also may have hoarseness as a symptom.1,2

Most cases of hoarseness are not due to cancer. But if you have a hoarse voice for more than 3 weeks, contact your doctor. Hoarseness that does not improve can be a sign of lung cancer.1,2

Common lung cancer symptoms

The most common symptoms of lung cancer include cough, difficulty breathing, and coughing up blood or blood-tinged mucus. Hoarseness also can be a warning sign of lung cancer.3,4

Other lung cancer symptoms to be aware of include:5,6

  • Decreased appetite
  • Feeling tired or weak
  • Weight loss
  • Chest pain
  • Lung infections that do not improve
  • Wheezing
  • Lump in the neck
  • Back pain

Why does hoarseness occur with lung cancer?

There are 2 bands of tissue in your throat called vocal cords (also called vocal folds). The vocal cords open and close when you talk. As air from the lungs moves across the vocal cords, they vibrate and create sound. Hoarseness results from swelling of the vocal cords or damage to the nerves that control them.2

Hoarseness in people with lung cancer can be due to:1,7

  • Vocal cord irritation from persistent coughing
  • A tumor pressing on the vocal cords or the nerves that control them

How is hoarseness diagnosed and treated?

Doctors specializing in ear, nose, and throat (ENT) problems evaluate and treat hoarseness. Be prepared to tell your doctor about your hoarseness and any other related symptoms.1

Your doctor will likely check for any head or neck lumps. They also may order 1 or more of the following tests:1,2

  • Laryngoscopy – A procedure to look at the vocal cords with a small video camera (often done in the doctor’s office)
  • Videostroboscopy – A test that uses a video camera and strobes of light to look at the vocal cords while you talk
  • CT scan – An imaging test that uses a series of X-rays to get detailed images of body tissues
  • MRI – An imaging test that uses a magnet to get detailed images of structures inside your body
  • Biopsy – A procedure to look at a piece of tissue under a microscope

Treatment for hoarseness varies depending on the cause. Lung cancer treatments such as surgery, radiation, chemotherapy, or a combination are the first steps for managing hoarseness due to cancer. If you have ongoing hoarseness, your doctor may recommend speech therapy.1,2

Ways to manage hoarseness due to vocal cord irritation at home include:1

  • Rest your voice
  • Do not smoke
  • Avoid alcohol, caffeine, and spicy food
  • Drink plenty of water (check with your doctor if you have a fluid restriction

When to see your doctor

If your hoarseness does not improve after 3 weeks, see your doctor. This is especially important if you currently or previously smoked. Call your doctor right away if you notice the following:1

  • Pain when you speak or swallow
  • Difficulty breathing or swallowing
  • Coughing up blood or bloody mucus
  • A lump in your neck
  • A complete loss of your voice

Treatment for lung cancer is most effective when the condition is diagnosed early. But lung cancer often goes undetected in the earliest stages. If you have persistent hoarseness or other symptoms, get checked by your doctor right away, especially if you have a history of smoking. Though people who smoke are at higher risk of lung cancer, they are often less likely to seek medical help for cough or hoarseness.3

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