Coroner warns people who develop one small symptom to see a doctor urgently - because they might have cancer

People who develop a 'hoarse voice' should see a doctor urgently because it could be a sign of cancer , a coroner has warned.

Alison Mutch, a senior coroner in Manchester, has said there is a 'limited public awareness' of how a change in voice is as an indicator of the life-threatening disease.

It comes after the death of Stephen Stringer, 74, whose husky voice was not recognised as a 'potential cancer red flag' until the illness progressed to stage four.

Jamie Theakston, the co-host of Heart Radio Breakfast, was recently diagnosed with stage one laryngeal cancer. Other celebrities who have had throat cancer include Val Kilmer, Michael Douglas and Stanley Tucci.

At his inquest, it was heard Mr Stringer developed a 'hoarse voice' from January last year.

However, the 'nature' of the symptom - and its 'ongoing deterioration' - was not explored or 'noted as a potential cancer red flag' until October.

Writing to the Department of Health and Social Care, Ms Mutch said a number of different healthcare professionals failed to recognise the 'significance' of the symptom until it was too late.

In January 2024, almost a year after his vocal cords started to sound strained, he was formally diagnosed with stage four squamous cell carcinoma of the glottis.

Ms Mutch said he was 'treated palliatively' and noted that had he been referred for tests quicker - the 'detection' of his illness would have been sooner, increasing the treatment options available.

Mr Stringer sadly died on March 27 this year.

The coroner said this was because 'the significance of his symptoms including a prolonged period of hoarse voice was not appreciated until the cancer had progressed to stage four'.

Now, in a Prevention of Future Deaths Report, Ms Mutch highlighted several 'matters of concern' in light of his death.

She noted that an ENT (ears, nose and throat) consultant said that it was 'important' that patients who presented with a hoarse voice were questioned on 'how long it had been an issue'.

'In the absence of any clear cause such as a throat infection or where there was no clear response to treatment then a hoarse voice should be seen as a red flag symptom for laryngeal cancers and result in a referral on the two week wait,' she wrote.

'It was clear from the evidence at the inquest that unlike other cancer red flags such as blood in urine the significance of a persistent hoarse voice was not recognised by a number of different healthcare professionals who saw him.'

The coroner said that early detection of laryngeal cancers 'significantly improves' the outcomes of patients because 'far more treatment options are open to clinicians'.

She continued: 'There was also evidence that there is limited public awareness of how significant a change in voice can be and recognising it as a potential cancer symptom.

'Greater public awareness of symptoms of laryngeal cancers would ensure the public were better placed to seek help at an early stage.'

The coroner also noted how a 'number of different health professionals had input into his care'.

Ms Mutch said this meant that there was no one health professional who had good insight into his 'his overall deterioration and symptoms'.

And, the coroner also raised concerns over how a lack of clarity within the GP's electronic patient enquiry service, enforced by Derby and Derbyshire Integrated Care Board, which Mr Stringer used.

She added: 'Patients contacting the surgery had to select which stream within the practice their enquiry went to.

'It was not always clear from the headings whether the query would be seen by a GP or the admin team.'

The coroner said the information sent in by patients to the admin team would not go onto the patient record therefore was not seen by a doctor.

'The GPs at the practice were unaware of this and patients had no way of knowing that the information they had sent in was not in the patient record,' she added.

Squamous cell carcinoma of the glottis is a slow-growing cancer that affects the vocal cords and is one of the most common types of head and neck cancer

Ms Mutch, who also sent the report to The Secretary of State for Health and Social Care and Derby and Derbyshire Integrated Care Board, reminded them they have until December 10 to reply.