The earliest manifestation of laryngeal cancer in a long-history smoker is typically which symptom?

• A. Hoarseness
• B. Dyspnea
• C. Dysphagia
• D. Weight Loss

Answer: (A)

The earliest sign is a change in voice because many laryngeal cancers start on the vocal cords themselves (the glottis). A tumor on the cords disrupts their normal vibration, so the voice becomes hoarse or raspy even when the person doesn’t have a sore throat. This change tends to appear before the tumor grows large enough to cause airway narrowing or swallowing problems. Dyspnea (breathing difficulty) and dysphagia (swallowing trouble) typically come later as the cancer expands or involves surrounding structures, and weight loss is a nonspecific late symptom. In a long-history smoker, persistent hoarseness warrants evaluation with laryngoscopy and biopsy to detect cancer early.