Having a hoarse voice, or hoarseness, can be a less-known sign of lung cancer. Hoarseness may accompany more common symptoms like coughing (including coughing up blood), chest pain, and shortness of breath. Hoarseness can also be a side effect of lung cancer treatment. However, many other conditions can cause hoarseness, too.

If you or a loved one suddenly has a hoarse voice that doesn’t go away, talk to a health care provider to see what could be causing it. Here’s what you need to know about hoarseness and lung cancer.

How Does Hoarseness Affect People With Lung Cancer?

Hoarseness occurs when your voice sounds different from usual. It may seem rougher, breathy, or raspy. Some people find that their voice becomes higher or lower when they’re hoarse or that their volume changes. One MyLungCancerTeam member put it this way: “I had issues with my voice since Sunday night and sounded more like the godfather.”

Ability To Speak

Having a hoarse voice can make it hard to carry on conversations. “I have developed a hoarse voice for about a month now,” one member of MyLungCancerTeam said. “It is hard for me to speak or to have a conversation.”

Social Activities

Sometimes, hoarseness affects a person’s singing voice, too, making it harder for them to participate in activities they love. “It seems some days my voice is good and others I am hoarse or not singing as well,” shared a member of MyLungCancerTeam. “I am feeling sad about that because I don’t understand why it happens.”

Another added, “I used to play and sing with friends here in the area, but … my voice was ruined by the radiation.”

Losing activities like these can feel like a major loss, on top of other losses that lung cancer can bring.

Anxiety

Hoarseness can also lead to fear. When you know hoarseness is a symptom of lung cancer, experiencing it can bring on anxiety. Such was the case for a member who had an upcoming positron emission tomography (PET) scan: “I’m going for a PET scan in two weeks. I’m very worried and scared because my voice goes hoarse on and off.”

Being unable to communicate normally, missing out on favored activities, and becoming extra anxious can all affect your quality of life. Thus, it’s important to understand how hoarseness and lung cancer can be connected and what you can do to manage this symptom.

How Is Lung Cancer Connected to Hoarseness?

Hoarseness can be connected to both lung cancer and some treatments for the condition.

Lung Cancer Treatments and Hoarseness

Radiation is one type of treatment that can cause hoarseness, as several MyLungCancerTeam members have discussed. One said, “Radiation treatment seems to have affected my throat — thought it might be getting better, but now my voice is getting deeper.”

“The radiation treatment that affected my throat is slowly improving, but the voice is still hoarse,” another member added. “Hope it gets back to normal soon.”

Immunotherapy

Although hoarseness isn’t specifically listed as a side effect of immunotherapy, immunomodulators can cause breathing issues and coughing, as well as swollen lymph nodes and a stiff neck. Since all these drugs can affect the throat, it makes sense that some MyLungCancerTeam members report problems with their voice after this treatment.

One explained, “I’m having a few side effects from immunotherapy, like losing my voice and having a cough.”

“I take my immunotherapy,” said another member. “A side effect is I lose my voice.”

Chemotherapy

Chemotherapy may cause hoarseness, as well. This type of treatment can have other effects on the throat and the mouth, too, like causing painful sores.

Lung Cancer Surgery

Some types of lung cancer surgery and their complications may cause hoarseness. “One of my biggest problems was my throat,” shared A MyLungCancerTeam member who experienced hoarseness after surgery. “I was told that mine was a difficult intubation because the intubation tube used in my lung surgery was larger than what is normally used, and I have a small airway. … To this day, my voice will sometimes go out on me, and sometimes I am hoarse.”

If you or your loved one is undergoing treatment for lung cancer or has had surgery and is now experiencing hoarseness, talk to your cancer care team to see if these might be related.

Lung Cancer and Hoarseness

Lung cancer itself may cause hoarseness, usually because the voice box gets injured or irritated. This could be caused by a persistent cough, or the cancer could spread to the throat or the lymph nodes around it. “I have cancer in my lymph nodes of my throat and a tumor in my chest that has affected my larynx, and my voice changed,” one MyLungCancerTeam member explained.

Lung cancer that metastasizes (spreads) to the neck is rare. If metastasis to the neck happens, it usually occurs in the later, advanced stages of the disease. It’s unlikely that you’ll develop hoarseness from tumors that have spread if you’re in the early stages.

What Else Can Cause Hoarseness?

Even if you or your loved one has a lung cancer diagnosis, hoarseness may be caused by something else. Other possible causes include:

• Allergies, asthma, or sinus problems
• Gastroesophageal reflux disease (GERD, or acid reflux)
• The result of using your voice differently than usual
• Nodules, polyps, warts, or cysts on your vocal cords
• Hemorrhage in or paralysis of the vocal cords
• Too much muscle stress on the vocal cords
• Neurological problems that affect the vocal cords
• Normal aging
• Smoking, especially if done for a long time

You should work with a health care provider to find out the cause of your hoarseness. That way, you can choose the best treatment options for your specific case.

How To Manage Hoarseness

If you’re experiencing new or prolonged hoarseness and you’ve been diagnosed with lung cancer, talk to someone at your cancer center right away. If this is a symptom you’re managing at home, you can take some steps to help your voice.

• Get treatment that corresponds to the cause of your hoarseness — perhaps medication, a medical procedure, or rest.
• Stop smoking, and avoid secondhand smoke as much as possible can.
• Don’t strain your voice. Use a microphone if necessary, and don’t speak too long or too loud.
• Keep your vocal cords hydrated by drinking water and using a humidifier.
• Avoid spicy foods and beverages with caffeine or alcohol, which can make hoarseness worse.

Be sure to follow any additional recommendations from your doctor.

Sometimes, hoarseness will pass in a few days or after you finish your lung cancer treatment. Other times, you may need to seek out temporary or permanent vocal cord repair procedures. These approaches will vary based on what your oncology team sees when they look at your vocal cords. They should be able to offer medical advice about which procedures would be best for you.

Talk With Others Who Understand

MyLungCancerTeam is the social network for people with lung cancer and their loved ones. On MyLungCancerTeam, more than 13,000 members come together to ask questions, give advice, and share their stories with others who understand life with lung cancer.

Are you experiencing hoarseness and wonder if it’s connected to lung cancer? Share your experience in the comments below, or start a conversation by posting on your Activities page.