Esophageal cancer can cause coughing and voice changes, most often hoarseness. The coughing occurs for several reasons, including damage caused by tumor growth. For some people, this may feel like a constant tickle that coughing may temporarily alleviate. For others, the damage is severe enough that they cough up mucus and even blood. Hoarseness usually occurs due to esophageal damage or when cancer spreads to the laryngeal nerves responsible for the larynx or voice box. Hoarseness can also develop after surgery for esophageal cancer due to irritation of the laryngeal nerves.

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