Laryngeal Cancer: Symptoms & Treatment

The larynx, commonly called the voice box, is an approximately 5-cm hollow tube in the neck that contains the vocal cords and allows us to make sounds. Laryngeal cancer is a cancer of the larynx. Approximately 12,500 people are diagnosed with laryngeal cancer each year in the United States, and 4,000 Americans die from it every year. Please continue reading to learn about the symptoms and treatment options for laryngeal cancer.

What are the risk factors for developing laryngeal cancer?

Some types of HPV (human papillomavirus), which causes a sexually transmitted disease, are known to cause laryngeal cancer. Other known risk factors for developing cancer of the larynx include:

Smoking tobacco
Frequent alcohol use
Occupational exposure to machines and harmful substances such as asbestos, wood dust, nickel, sulfuric acid mist, and industrial mustard gas
Age above 55 years
Male gender (men are 5 times more likely to develop laryngeal cancer than women)
History of head and neck cancer (approximately 25% of people who had head and neck cancer in the past can develop one again)

What are the first signs of laryngeal cancer?

Many of the signs and symptoms of laryngeal cancer are nonspecific and can be mistaken for other, less dangerous conditions. The first sign of laryngeal cancer is frequently a persistent hoarse voice that lasts for two weeks or longer. Other symptoms of laryngeal cancer can include sore throat, cough, pain with swallowing, dysphonia (trouble speaking or making sounds), a lump in the throat, and ear pain.

More serious symptoms include difficulty breathing or swallowing, noisy or high-pitched breathing, coughing up blood, and globus (a sensation of something being stuck in your throat).

How is laryngeal cancer diagnosed?

Healthcare providers can diagnose laryngeal cancer based on your medical history, symptoms, physical exam, and diagnostic tests such as imaging studies (computerized axial tomography (CT) and nuclear magnetic resonance imaging (MRI)), laryngoscopy for direct examination of the larynx, PET scan to find cancer cells in the body, and a fine needle aspiration biopsy to remove tissue samples for examination in the laboratory. If cancerous tissue is found and laryngeal cancer is diagnosed, doctors also use these methods to stage the cancer (find out how severe it is) and make plans for treating laryngeal cancer accordingly.

Note: There is a difference between laryngeal and hypopharyngeal cancer. A laryngeal cancer affects the larynx (voice box), while a hypopharyngeal cancer affects the lower part of the pharynx (throat) and is located just above the esophagus (food pipe).

What are the stages of laryngeal cancer?

Early laryngeal cancer (stages 0, 1, and 2) is a small tumor that has not spread beyond the larynx. Late-stage laryngeal cancer (stages 3 and 4) is a larger tumor that involves the vocal cords or has spread to nearby lymph nodes in the neck or other parts of the body.

How treatable is cancer of the larynx?

How treatable is laryngeal cancer depends on the stage of the cancer. Early-stage laryngeal cancer is treatable because the cancer cells have not spread to the surrounding tissues and lymph nodes in the neck. However, it may not be possible to cure more advanced laryngeal cancer where the cancerous cells have spread to other parts of the body such as the tongue, trachea (windpipe), esophagus (food pipe), thyroid gland, lungs, liver, and bones. That is why it is important to have laryngeal cancer diagnosed early by seeking medical care for symptoms such as persistent cough or hoarseness.

What is the most effective laryngeal cancer treatment?

Your cancer care team will recommend one or more of the following to treat laryngeal cancer:

Radiation therapy using high-dose radiation to kill cancer cells while minimizing damage to surrounding normal cells and healthy tissue.
Chemotherapy using drugs to slow or stop the growth of cancerous cells.
Immunotherapy or biologic therapy to help your immune system fight cancer.
Targeted therapy to target cancer cells and stop them from multiplying.
Surgical procedures to remove the tumor. For most laryngeal cancers, head and neck surgeons can preserve the larynx and your ability to speak and swallow. However, advanced laryngeal cancer may require a total laryngectomy (surgical removal of the entire larynx) to treat cancer.
If an advanced laryngeal cancer is incurable, doctors may prescribe treatments to relieve symptoms.

What are the treatment cures for laryngeal cancers?

Whether it is possible to cure laryngeal cancer depends on the stage and whether all the cancer can be removed.

Early laryngeal cancer, i.e., stage 0 cancers, are almost always glottic cancers involving the vocal cords. They are diagnosed early due to voice changes and are usually curable with radiation therapy and/or endoscopic surgery.
Stage 1 and 2 laryngeal cancers can usually be treated without major surgery using radiation therapy and partial laryngectomy. Glottic cancers may be treated with surgical procedures like cordectomy (removal of the vocal cords), radiation therapy, and/or chemoradiation. Supraglottic cancers are more likely to spread to the lymph nodes and may require more extensive surgery and lymph node dissection.
Stage 3 and 4 advanced laryngeal cancers almost always require total laryngectomy. Treatment options include surgery, chemotherapy, radiation therapy, chemoradiation, targeted therapy with drugs like cetuximab, and immunotherapy.

What is the survival rate for laryngeal cancer?

The survival rate for laryngeal cancers depends on various factors, including the location and stage of the cancer. The 5-year survival rate for the most common type of laryngeal cancer, which is glottic cancer (involving the middle part of the larynx and the vocal cords), is as follows:

Localized glottic cancer: 84%
Regional spread: 52%
Distant spread: 45%
All stages combined: 77%

This means that people with early cancers are, on average, 84% as likely to live for 5 years as people who don’t have cancer. Survival rates for all stages of cancers involving the supraglottis (upper part) and subglottis (lower part) of the larynx are 45% and 49%, respectively.