Thanks a lot for your input. This is most likely to be reflux laryngitis. This can even happen in people with no acid reflux symptoms and still the acid can affect their vocal cords. In his case he is already a diagnosed case of acid reflux disease so its more likely that the acid reflux is causing inflammation of the vocal cords. Cancer is least likely with this presentation. He should get this check by an ENT surgeon who can do a flexible laryngoscopy. I do see a lot of patients with voice change secondary to acid reflux so as per his past history and current symptoms the reflux laryngitis is most likely. Getting nexium is right step but along with that he can suggest his doctor to give him tab domperidone which is pro kinetic agent and reduces the time for which the food stays in the stomach, this resultantly reduces the acid production. Lastly one most important thing is hurting voice which is a symptom of laryngitis rather than a cancer and its something which make me sure to say that its not a cancer. So please reassure him that he doesn't need to get worried at all. I wish him all the best for a good health. Our discussion is always open so please anything any time, you will find me helpful. Your excellent feedback will be appreciated.