The possibility of malignant transformation of vocal cord nodules is very small. If cancerous transformation occurs, the patient will experience persistent hoarseness, as well as symptoms such as difficulty in breathing, difficulty in swallowing, persistent cough, and blood in the sputum. Vocal cord nodules are caused by prolonged improper use of the voice, shouting, or long-term irritation of the vocal cords by acid reflux. If patients do not undergo surgical treatment, the vocal cord nodules may continue to enlarge and undergo cellular mutations, leading to malignancy. At this point, patients may find cauliflower-like neoplasms or ulcers on the surface of the vocal cords. They will experience hoarseness, difficulty breathing, and difficulty swallowing. At this stage, it is necessary to perform a local biopsy. If a malignant tumor is confirmed, localized surgical treatment can lead to improvement.