People may be hoarse or have a lump in the neck or difficulty breathing or swallowing.
A biopsy is needed for diagnosis.
The prognosis depends on how advanced the cancer is.
Treatment is usually with surgery and/or radiation therapy, but sometimes chemotherapy is also used.
(See also Overview of Mouth, Nose, and Throat Cancers Overview of Mouth, Nose, and Throat Cancers Cancers of the mouth, nose, and throat develop in almost 65,000 people in the United States each year. These cancers are more common among men because males who smoke continue to outnumber females... read more .)
The larynx is the voice box, which includes the uppermost portion of the windpipe (trachea) and the vocal cords.
Locating the Larynx
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Most laryngeal cancers are squamous cell carcinomas, which means the cancer develops in the squamous cells that line the larynx.
Laryngeal cancer is a common cancer within the head and neck and is more common among men than women. Most people with laryngeal cancer are over 60 years of age. Smoking is the biggest risk factor, and over 95% of affected people smoke. Excessive use of alcohol also increases risk. The number of people who develop laryngeal cancer is decreasing most likely because of changes in smoking habits.
Cancers of the vocal cords usually cause symptoms earlier, spread less, and are cured more often than cancers of other parts of the larynx.
Symptoms of Laryngeal Cancer
Laryngeal cancer commonly originates on the vocal cords and rapidly causes hoarseness. A person who has been hoarse for more than 2 to 3 weeks should seek medical attention.
Cancers originating in other parts of the larynx develop more slowly and first cause symptoms other than hoarseness, such as
Weight loss
Throat pain
Ear pain
"Hot potato" voice (speaking as if a hot object is being held in the mouth)
Difficulty swallowing or breathing
Sometimes, however, a lump in the neck resulting from the cancer's spread to a lymph node Lymphoid organs The immune system is designed to defend the body against foreign or dangerous invaders. Such invaders include Microorganisms (commonly called germs, such as bacteria, viruses, and fungi) Parasites... read more (metastasis Overview of Cancer A cancer is an abnormal growth of cells (usually derived from a single abnormal cell). The cells have lost normal control mechanisms and thus are able to multiply continuously, invade nearby... read more ) may be noticed before any other symptoms.
Diagnosis of Laryngeal Cancer
Laryngoscopy
Biopsy
Imaging tests for staging
To diagnose laryngeal cancer, a doctor initially examines the larynx with a thin, flexible viewing tube used for direct viewing of the larynx (laryngoscope Endoscopy A large number of tests are widely available. Many tests are specialized for a particular disorder or group of related disorders (which are usually described with the appropriate disorders in... read more ) and removes a tissue sample for examination under a microscope (biopsy Biopsy Cancer is suspected based on a person's symptoms, the results of a physical examination, and sometimes the results of screening tests. Occasionally, x-rays obtained for other reasons, such as... read more ). A biopsy is most often done in the operating room with the person under general anesthesia General anesthesia Surgery is the term traditionally used to describe procedures (called surgical procedures) that involve manually cutting or stitching tissue to treat diseases, injuries, or deformities. However... read more . If cancer is present, the person also may undergo staging tests Staging Cancer Cancer is suspected based on a person's symptoms, the results of a physical examination, and sometimes the results of screening tests. Occasionally, x-rays obtained for other reasons, such as... read more to determine how far the cancer has spread, including a
Prognosis for Laryngeal Cancer
The larger the laryngeal cancer is and the more it has spread, the worse the prognosis. If the tumor also has invaded muscle, bone, or cartilage, cure is less likely. About 85 to 95% of people with small vocal cord cancers that have not spread anywhere (metastasized) survive for 5 years, compared with fewer than 45% of those who have laryngeal cancers that have spread to the local lymph nodes. For people who have cancers that have spread beyond the local lymph nodes, the chance of surviving longer than 5 years is about 35%.
Treatment of Laryngeal Cancer
Surgery
Radiation therapy
Chemotherapy
Treatment of laryngeal cancer depends on the stage and the precise location of the cancer.
Early-stage cancer treatment
For early-stage cancer, doctors may use either surgery Surgery for Cancer Surgery is a traditional form of cancer treatment. It is the most effective in eliminating most types of cancer before it has spread to lymph nodes or distant sites (metastasized). Surgery may... read more or radiation therapy Radiation Therapy for Cancer Radiation is a form of intense energy generated by a radioactive substance, such as cobalt, or by specialized equipment, such as an atomic particle (linear) accelerator. Radiation preferentially... read more . When the vocal cords are affected, doctors may prefer radiation therapy over surgery because it may preserve the person's normal voice. However, for very early-stage laryngeal cancers, doctors may prefer microsurgery over radiation therapy, because it can be as effective and, unlike radiation, can be completed in a single treatment. Microsurgery uses a laryngoscope (flexible viewing tube) that has either instruments or a high-energy beam of light (a laser beam) attached to it. Unlike traditional surgery using a scalpel that can affect the person's voice, microsurgery causes fewer problems with swallowing and speech.
Moderate-stage cancer treatment
For larger laryngeal tumors that may have spread slightly into nearby tissues, doctors may use radiation therapy combined with chemotherapy Chemotherapy and Other Systemic Cancer Treatments Systemic treatments are those that have effects throughout the body rather than being applied directly to the cancer. Chemotherapy is a form of systemic treatment that uses drugs to kill cancer... read more (called chemoradiation) instead of surgery, which can be as effective while having less of an impact on the person's voice. However, surgery still may be required to remove any cancer that remains after the chemoradiation therapy.
Advanced-stage cancer treatment
If laryngeal cancer has spread to the bone or cartilage, doctors usually prefer using surgery to remove part or all of the larynx and vocal cords, called a partial or total laryngectomy, followed by radiation therapy and sometimes chemotherapy. If the cancer is too advanced for surgery or radiation therapy, chemotherapy can help reduce the pain and the size of the tumor but is unlikely to provide a cure.
Side effects of treatment
Surgical or nonsurgical treatment almost always has significant side effects.
Radiation may cause skin changes (such as inflammation, itching, and loss of hair), scarring, loss of taste, dry mouth, and, occasionally, destruction of normal tissues. People whose teeth will be exposed to the radiation treatments must have dental problems corrected and any unhealthy teeth removed prior to radiation treatment, because radiation makes any subsequent dental work more likely to fail and severe infections of the jawbone may occur.
Chemotherapy typically causes a variety of side effects, depending on the drug used. These side effects may include nausea, vomiting, hearing loss, and infections.
Surgery, other treatments, and the tumor itself may affect swallowing and speaking. In such cases, rehabilitation is necessary. A number of methods have been developed that allow people without vocal cords to speak, often with good results. Depending on the specific tissues affected, reconstructive surgery may be done.
More Information
The following English-language resource may be useful. Please note that THE MANUAL is not responsible for the content of this resource.
American Cancer Society: Laryngeal and hypopharyngeal cancer
