Patients with lung cancer may have hoarse voice due to compression of laryngeal nerve, metastasis of lung cancer to the lung lymph nodes, etc., as follows: a. Cancer compression of laryngeal nerve: Lung cancer masses in the upper lung may directly compress the laryngeal nerve around the esophagus and trachea, resulting in hoarseness, choking and coughing. Lymph node metastasis in lung cancer: the enlarged lymph nodes due to metastasis may also compress the laryngeal nerve, leading to hoarseness. Special types of lung cancer and mediastinal lung cancer: Firstly, since the mass occurs in the upper mediastinum, it is easy to compress the recurrent laryngeal nerve and lead to hoarseness. Secondly, peripheral nerve damage after chemotherapy. Many chemotherapy drugs for lung cancer have the side effect of peripheral nerve damage, such as paclitaxel and platinum system, which can damage the laryngeal nerve innervating the vocal cords and lead to hoarseness. Then, patients with lung cancer have poor immune system and acute pharyngitis caused by concurrent pharyngeal infection, which may lead to hoarseness.