There are certain instances when losing your voice or going hoarse is a cause for concern. The one we already spoke about is if you use your voice suddenly and forcefully and go very hoarse, that would be concern for a vocal cord hemorrhage and should be evaluated right away. That is typically not associated with pain. The other reasons for concern, there are malignant or cancerous processes that can happen to the voice box, especially in patients with a smoking history. Anyone who has associated trouble swallowing, unintentional weight loss, that sort of thing, needs to be evaluated sooner rather than later. Any smoker who has hoarseness that's lasting more than two to three weeks should be evaluated.