An early manifestation of laryngeal cancer is?

KPSC Staff Nurse - 2016

Medical & Surgical Nursing

Easy

Appeared in: KPSC Staff Nurse - 2016

Explanation

The most common and earliest sign of laryngeal cancer is persistent hoarseness, especially if it lasts longer than two weeks.
This symptom arises because tumors located on the glottis (the area of the vocal cords) directly interfere with the cords' ability to vibrate properly, altering the voice.
Unlike other symptoms, hoarseness can appear even when the tumor is very small, making it a critical early warning sign.
While cancers in other parts of the larynx (supraglottic or subglottic) may not cause hoarseness early on, glottic cancer is the most common type.

Option A: Stomatitis is inflammation and sores in the mouth. It is not a direct symptom of cancer within the larynx (voice box).
Option B: Airway obstruction is a sign of advanced disease. It occurs when the tumor has grown large enough to physically block the airway, which is a late-stage complication and a medical emergency.
Option D: Dysphagia (difficulty swallowing) is typically a later symptom. It occurs as the tumor enlarges and begins to press on or invade the esophagus or interfere with the swallowing mechanism.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Early clinical manifestations of laryngeal cancer as background academic context rather than a clinical decision trigger.
A key nursing responsibility is patient education on risk factors for laryngeal cancer, primarily smoking and heavy alcohol use. Nurses must strongly advise patients to seek medical evaluation for any hoarseness lasting more than two weeks.
Prompt referral to an otolaryngologist (ENT specialist) for laryngoscopy is crucial for early diagnosis and can significantly improve the prognosis.
What if? If a patient with risk factors for laryngeal cancer presents with a painless lump in the neck but no hoarseness, the priority shifts. This could indicate metastasis from a primary tumor in the supraglottic or subglottic region, which are often asymptomatic in early stages. The workup would still be urgent.

How to Approach the Question

First, identify the core of the question: it asks for the 'early manifestation' of 'laryngeal cancer'. The keyword 'early' is critical.
Think about the anatomy of the larynx (voice box) and its primary function, which is voice production via the vocal cords.
Consider how a cancerous growth would affect this function. A tumor directly on a vocal cord would interfere with its vibration, causing a voice change (hoarseness) even when small.
Evaluate the other options in the context of tumor growth. Airway obstruction and difficulty swallowing (dysphagia) are caused by a large mass effect, which implies a more advanced, later-stage tumor.
Conclude that hoarseness is the most logical early sign because it relates directly to the primary function of the most commonly affected part of the larynx.

Concept Tested & Keywords

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