Hoarseness and/or a sore throat are extremely common symptoms of ailments that are usually very minor: Upper respiratory tract infection, the common cold, the flu, tonsillitis and laryngitis are familiar to everyone and can be managed either at home or by a visit to the family doctor. However, if these symptoms persist more than a few days, a physician should always be consulted. Treatment will usually consist of antibiotics and sometimes an antihistamine or a decongestant. Most minor ailments will respond to these medicines and have disappeared by the time of the follow up visit. But if the symptoms persist, and especially if the person has a history of smoking, a thorough evaluation of the entire mouth, throat, back of tongue and voice box (larynx) is imperative. This evaluation is vital because the larynx cannot be seen simply by looking in the mouth. The first sign of cancer of the voice box may be hoarseness or a chronic sore throat and if not discovered at an early stage, the tumor can progress from small and easily curable to large and usually fatal. This evaluation is best performed by the ear, nose and throat specialist (otolaryngologist).

The otolaryngologist is the cancer specialist for this part of the body and has received extensive training in the diagnosis and management of all types of diseases in the throat and larynx. He or she will listen to the symptoms and perform a special examination. By gently pulling on the tongue and reflecting light off a head mirror, the larynx can easily be visualized. All the structures in the throat can be seen by this technique including the back of the tongue, the voice box and the entrances to both the wind-pipe and the food pipe. Any medical problem which has symptoms related to this area should have this examination performed. Usually, an immediate diagnosis can be made and a treatment plan discussed. If a cancer is suspected, a biopsy may be recommended.

"Doc, do I have cancer?" In most cases, and especially if the person does not smoke, the answer is no. I have seen hundreds of patients with throat cancer and virtually everyone has a history of smoking. Cancer of the throat or cancer of the voice box is extremely rare in people who don't smoke. Moreover, numerous other causes exist for hoarseness or a persistent sore throat. Sinus drainage, allergy problems, voice strain, vocal cord polyps, nasal obstruction and persistent regurgitation of stomach acid into the back of the throat are just a few of them. But cancer can NEVER be excluded without a complete examination of the throat and larynx, so see your family doctor for persistent symptoms. Ask for a referral to an ENT doctor if things don't improve. And above all, STOP SMOKING!