A loss of voice or hoarseness after a concert or a cold, it happens to everyone. But what happens when this timbre change persists for no apparent reason? Far from always being harmless, a change in the voice can sometimes reveal the presence of an ENT tumor. An update with Dr. Gérald Kierzek, emergency physician and medical director of True Medical, on the reflexes to adopt.
Why can cancer change voice tone?
The change in voice, or dysphonia, is explained by the very location of certain tumors. When cancer cells develop in the ENT area, they directly disrupt the phonation mechanism.
“Several cancers can modify the voice, especially cancers of the larynx, vocal cords, throat and sometimes the upper part of the esophagus, or even cancers of the neck which compress the nerves of the voice” underlines Dr Gérald Kierzek.
The alteration of skin tone or sound intensity comes from a direct physical obstacle. “The voice changes because the tumor directly affects the vocal cords, interferes with their vibration, or blocks the passage of air and food, which can cause a hoarse, hoarse, or weaker voice.specifies the doctor.
Warning signs: when should you be concerned and consult?
The main trap of this symptom is to trivialize it or find an erroneous alternative cause. Dr Kierzek insists that we should not “put this down to reflux, for example” an error of interpretation that he himself has observed in his practice.
The time factor is the absolute criterion here. “You should consult if the hoarseness lasts more than two to three weeks, especially if it sets in gradually and does not go away with the usual treatments.“, warns the medical director of True Medical.
Other clinical manifestations should also prompt you to make an appointment quickly with your general practitioner or an ENT specialist:
- Discomfort or difficulty swallowing (dysphagia);
- Persistent pain in the throat or radiating to the ear;
- A stubborn cough or difficulty breathing;
- The presence of blood in the sputum;
- A feeling of tightness in the throat or the appearance of a mass (lump) in the neck;
- Unexplained weight loss.
From diagnosis to biopsy: how are the examinations carried out?
When faced with a suspicion of a tumor of the upper aerodigestive tract, the care pathway is well codified in order to make a precise diagnosis and assess the extent of the disease.
“Diagnosis begins with a clinical examination of the mouth, throat and neck, followed by laryngoscopy or endoscopy to directly view the vocal cords and the suspicious area. explains Dr. Kierzek. If an anomaly is detected, medical imaging examinations become necessary. “This examination is often completed with a CT scan or MRI to assess the extent of the tumor and the condition of the lymph nodes.
Finally, the final and essential step remains the anatomopathological analysis. Our expert reminds us that a “biopsy is the essential test to confirm cancer under the microscope”.
What are the treatment options depending on the stage of the disease?
Therapeutic management will depend on the exact nature of the tumor, its size, its location and its degree of spread. The earlier the detection, the more conservative the treatments.
For cancer of the larynx or vocal cords, the medical strategy adapts to evolution.
“Treatment depends on the stage: it can range from very localized surgery or laser treatment to radiotherapy, sometimes combined with chemotherapy for more advanced forms.” explains the emergency doctor.
In situations where the disease is more aggressive, “more serious surgery may be necessary, sometimes with a temporary or permanent tracheotomy.
For cancers of the throat or upper aerodigestive tract in general, “the strategy is also based on surgery, radiotherapy and/or chemotherapy depending on the size of the tumor, its location and lymph node involvement” concludes Dr Gérald Kierzek