The most common and earliest manifestation of carcinoma of the glottis is:

Patients with glottis cancer, or cancer that grows on the true vocal cords, often presents first with hoarseness. This occurs because even a slight interference with the vibrating function of the vocal cords can produce voice changes. Hence, any long-standing hoarseness or voice changes should prompt a laryngeal examination. If hoarseness is ignored or if advanced disease occurs, airway obstruction, pain, or difficulty swallowing can result.