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When there is a sign of hoarseness alone, the risk of throat (laryngeal) cancer is 2.7 percent, while in the presence of dyspnea, difficulty in swallowing, or ear pain while swallowing, this rate increases to over 5 percent

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However, despite some functional and molecular similarities between `anergic' and `tolerant' states, including the expression of the transcriptional regulator early growth response gene 2 ( Egr2 ) [9,37], these are not equivalent terms, given the existence of significant differences in functional characteristics and underlying molecular programs [9,38,39]