Earliest symptom of carcinoma of vocal cord is:

Appeared in: Haryana CHO -2023

Explanation

Hoarseness is the cardinal and earliest symptom of cancer affecting the true vocal cords (glottic cancer).
The primary function of the vocal cords is phonation (voice production). Even a small lesion on the edge of a vocal cord can interfere with its ability to vibrate and close properly.
This interference directly results in a change in voice quality, such as roughness, raspiness, or a lower pitch.
Unlike other symptoms, hoarseness appears when the tumor is still very small and localized, making it a critical sign for early detection.

Option A: Pain (including odynophagia or otalgia) is not an early symptom. It typically indicates that the tumor has grown larger and is invading deeper structures or nearby nerves.
Option B: While a chronic cough can be associated with laryngeal cancer, it is a non-specific symptom and is not considered the earliest sign. It usually develops later due to irritation or as a protective mechanism against aspiration.
Option C: Dyspnea (difficulty breathing) is a late and ominous sign in laryngeal cancer. It signifies that the tumor has grown large enough to cause a significant obstruction of the airway.

Clinical Relevance

Nursing practice connection: Knowing Early clinical manifestations of laryngeal cancer helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
A nurse's primary role is to recognize that persistent hoarseness (lasting more than 2 weeks) is a major red flag for laryngeal cancer, warranting an urgent referral to an ENT specialist.
Patient history taking is crucial. Nurses should always ask about smoking and alcohol use in patients with voice complaints, as these are the biggest risk factors.
Post-treatment, nurses play a key role in helping patients manage voice changes, potential swallowing difficulties, and care for a stoma if a laryngectomy is performed.

How to Approach the Question

First, identify the core of the question: it asks for the 'earliest' symptom of a specific location, the 'vocal cord'.
Consider the primary function of the anatomical part mentioned. The vocal cords' main job is to produce sound by vibrating.
Reason that any disease process directly on the vocal cords will first affect their primary function.
Evaluate the options based on this reasoning. Hoarseness is a direct problem with sound production.
Contrast this with the other options. Pain, cough, and dyspnea are generally symptoms of a larger, more advanced problem causing mass effect, nerve invasion, or airway obstruction.
Conclude that the symptom most directly related to the organ's function (hoarseness) will appear earliest.

Concept Tested & Keywords

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E6 Medicine Harrison 22e Part 1 p. 652-654

E6 Medicine Davidson Principles Practice 24e p. 644-646

Practise the full Haryana CHO -2023

Attempt every question from this paper in a timed mock, then review the full solution for each one.