Though esophageal cancer can cause hoarseness, can it cause an actual loss of voice?

If you’ve experienced sudden-onset hoarseness and then a complete loss of voice, should you worry about the possibility of esophageal cancer?

The mechanical inability to speak is most commonly caused by laryngitis: inflammation of the voice box or larynx.

Common laryngitis can suddenly happen for no apparent reason, is benign and resolves on its own.

However, what if a stealthily growing cancerous tumor in the upper esophagus starts encroaching on a laryngeal nerve? The voice is dependent on the two laryngeal nerves.

“The way esophageal cancer can affect the voice is by invading the recurrent laryngeal nerves which control the vocal cords,” says Alex Little, MD, a thoracic surgeon with a special interest in esophageal and lung cancer.

“This is only possible if the tumor is in the neck (in the cervical esophagus), as that is where the recurrent nerves are,” continues Dr. Little

“It is theoretically possible for an esophageal cancer to do this, but it would have to be large enough to invade both nerves (which are on each side of the under-surface of the trachea and adjacent to the esophagus) — and in today’s world it would probably be diagnosed and treated before it could enlarge sufficiently to get both nerves.

“On the other hand, hoarseness due to the invasion of one of the recurrent nerves does occur, although not frequently, as most tumors are in the chest rather than the neck.”

If the loss of your voice is accompanied by unexplained, worrisome symptoms such as chest pain, shoulder pain, throat pain, a cough, fatigue and/or weight loss – you should consult with your physician, especially if the symptoms are persistent or getting worse.

Alex Little, MD, trained in general and thoracic surgery at the Johns Hopkins University School of Medicine; has been active in national thoracic surgical societies as a speaker and participant, and served as president of the American College of Chest Physicians. He’s the author of “Cracking Chests: How Thoracic Surgery Got from Rocks to Sticks,” available on Amazon.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.


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