The human voice is a powerful, versatile tool we use to communicate, convey emotion, express identity, share and bond, sing and laugh and for other purposes. Most of us take our voices for granted until something – such as unexplained hoarseness – causes them to change.
Dr. Gisela Wagner, a board-certified otolaryngologist at Health First, says, “Although the causes of hoarseness are frequently benign, it’s important to check with your medical provider if it doesn’t clear on its own in two weeks.”
The incidence of oral cavity and oropharyngeal cancer have increased over the past 30 years – an increase mainly attributed to cancers caused by human papillomavirus (HPV) infections.
The CDC says HPV is now identified as a probable cause for up to 70 percent of all oropharyngeal cancers in the United States.
Explains Dr. Wagner, “The HPV vaccine didn’t become widely available until 2006, so many of the people developing it now were unprotected from the easily transmitted virus for many years.”
Cancer MD Anderson likens the link between HPV and throat cancer to that of chickenpox and shingles. Like chickenpox, everyone is exposed to HPV early in life. Some people exposed to chickenpox will develop shingles later in life. Similarly, some people exposed to HPV will develop oropharyngeal cancer.
Still, hoarseness does not necessarily mean you have cancer.
Dr. Wagner says, “Hoarseness often results from laryngitis – inflammation and swelling of the vocal cords.
“Most often it’s acute, developing quickly and resolving on its own in a few days. But if it doesn’t, you need to determine why you got it. Common causes include voice overuse and GERD.”
She adds that smoking and alcohol use are major causes of voice problems. “Smoking can cause chronic coughing, chronic laryngitis, polyps and cancer.
“Alcohol, too, can contribute to chronic laryngitis and cancer, and it can also damage vocal cord tissue.”
Another cause of voice change: As you age, it’s normal for your vocal cords to lose tension and fullness. This condition is known as presbylaryngis, and the effects of inhalers that many older people use for health reasons can contribute to the problem.
DukeHealth has five tips to help minimize age-related voice issues.
1. Be aware. Even if you haven’t begun experiencing voice changes, knowing the signs can help you nip them in the bud. Are you being asked to repeat yourself more often, having to strain your voice to be heard? Be proactive: It can help you keep your voice stronger in the long run.
2. Maintain your overall health. Conditions that affect breathing, like asthma, allergies and COPD, can affect your voice. Maintaining good lung function is vital to keeping your voice strong. Regular exercise helps increase overall stamina, build muscle tone and improve posture – all of which contribute to a healthier voice.
3. Practice good vocal hygiene. The larynx should stay moist and flexible, so drink six to eight glasses of water a day. Limit caffeine and alcohol, which dry out your throat. Use a humidifier at home to keep the air moist. And, of course, don’t smoke.
4. Use it or lose it. Like the rest of the body, the voice needs exercise to keep it in good shape. If you live alone, read aloud, talk to pets, join a choir, or sing in the shower. Look for social opportunities and participate in conversation.
5. Voice therapy. Many older adults with voice problems can benefit from professional help. A comprehensive voice evaluation can rule out any other causes for voice issues (like tumors or lesions).
Dr. Wagner adds, “Vocal fatigue is very real. As the day goes on, the changes in your voice become more apparent. In the most extreme cases, your ENT may recommend a physical therapist to work with you.
“While many throat and hoarseness problems clear in their own, it’s important to recognize signs that should encourage you to get medical attention,” says Dr. Wagner.
“If your hoarseness is accompanied by other symptoms, such as a sore throat, cough, or a lump in your neck, it could indicate an infection, inflammation, or a more serious underlying issue, like laryngeal cancer.”
Get evaluated if your voice symptoms are paired with:
- A chronic cough or throat clearing
- Visible swelling in your neck or throat
- Pain when talking or swallowing
Gisela Wagner, MD, received her medical degree from the University of Texas, Galveston. She has a B.S. in biochemistry from Harding University, completed a mini fellowship in laryngology at the University of Texas Health Sciences Center, and completed an otolaryngology residency and a general surgery internship at Oklahoma University. She is a board-certified otolaryngologist. Her office is located at Health First Medical Group Gateway, 1223 Gateway Dr., Melbourne. Call 321-729-8079 for an appointment.
