Cancer of the Larynx

Cancer of the voice box (larynx) is sometimes called throat cancer. Most of the time it affects the vocal cords. These are smooth, fiberlike cords. They stretch across the opening of the larynx. Cancer occurs when cells in the larynx become abnormal and start to grow out of control. It usually starts in the very thin, flat cells (squamous cells) on the outside of the larynx. Cancer cells can spread and form a mass of cells called a tumor. The tumor may spread deeper into the larynx, or it may spread to other areas of the body (metastasize).

RISK FACTORS

The exact cause of cancer of the larynx is not known. However, some risk factors make this more likely:

  • Use of cigarettes, cigars, pipes, smokeless (chewing) tobacco, and snuff. This is the biggest risk factor of cancer of the larynx.

  • Male gender.

  • Age of 50 years or older.

  • Frequent use of alcohol.

  • Human papillomavirus (HPV) infection.

  • Reflux esophagitis. Reflux esophagitis is the inflammation of the esophagus caused by regular backup of acid from the stomach into the esophagus.

SYMPTOMS

  • A change in your voice. It may sound muffled or hoarse.

  • A lump on your neck.

  • A sore throat that does not go away.

  • Difficulty swallowing. It might hurt to swallow.

  • Ear pain.

  • Difficulty breathing, especially when doing exercise. Your breathing may be noisy (stridor), especially when you breathe out or breathe in very strongly.

DIAGNOSIS

To diagnose cancer of the larynx, your caregiver may perform the following exams:

  • A physical exam of your larynx. Your caregiver may use a mirror with a long handle or a thin, flexible tube with a tiny light and camera at the end (fiberscope) to see the back of your throat or your larynx. Your caregiver may also check for a sore or lump in other areas of your mouth, throat, and neck.

  • Removal and exam of a small number of cells (biopsy) from your larynx or a lump in your neck. These cells are checked for cancerous formations under a microscope.

  • Imaging exams, such as X-rays of your larynx and neck. The images can show if there is an abnormal mass.

If you do have cancer, your caregiver will stage your cancer. Staging provides an idea of how advanced your cancer is. The stage of your cancer will depend on how much your cancer has grown and if it has metastasized. The meaning of the stage depends on the type of cancer. For cancer of the larynx:

  • Stage I means the cancer is growing only on a vocal cord. It has not metastasized.

  • Stage II means the cancer has spread just above or below the vocal cord. The vocal cord might not be able to move like it should.

  • Stage III means the cancer is affecting movement of the vocal cords. It may have spread to a lymph node or lymph gland on the same side of your neck as the cancer. (Lymph is a fluid that carries white blood cells all over your body. White blood cells fight infection.)

  • Stage IV means the cancer has spread to nearby areas. It may have spread heavily into your lymph glands.

TREATMENT

Treatment for cancer of the larynx can vary. It will depend on the stage of your cancer and your overall health. Treatment options may include:

  • Radiation therapy. This uses waves of nuclear energy to kill cancer cells on your larynx. It may be used for stage I and stage II cancers.

  • Surgery to remove the cancer cells. If you have stage III or stage IV cancer, surgery to remove your voice box (laryngectomy) may be necessary. If this is done, you may need to learn to use a device to speak again. You also may have a permanent hole (laryngectomy stoma) in your neck for breathing.

  • A combination of surgery, radiation, and drugs that kill cancer cells (chemotherapy). This may be used for stage III and stage IV cancers.

  • Additional surgery to make it easier for you to swallow and talk. This may be needed if the cancer has spread to the lymph nodes or other parts of the neck.

SEEK MEDICAL CARE IF:

  • You have trouble swallowing, or you lose weight without trying.

  • Your voice changes in any way, or you have difficulty speaking.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You start having pain in your throat or neck.

  • You have bleeding in your throat or mouth.

  • Your throat or neck swells.

  • You have difficulty swallowing.

  • You have difficulty breathing.

  • You have a fever.