Laryngeal cancer is a type of cancer that starts in the larynx (voice box). The larynx helps you breathe, speak, and swallow. It houses your vocal cords, which create the sound of your voice.
Laryngeal cancer can be curable, especially if it’s diagnosed and treated early. But even for more advanced forms of this cancer, the outlook can be favorable.
The larynx has three main parts, and laryngeal cancer can start in any one of them.
Supraglottis (upper part of the larynx): About 35 percent of laryngeal cancers start here. The supraglottis includes the epiglottis, which is a piece of cartilage that prevents food from getting into your windpipe when you swallow. It also houses a joint that helps the vocal cords move when you speak.
Glottis (middle part of the larynx): Around 60 percent of laryngeal cancers start here. This is where the vocal cords are located.
Subglottis (lower part of the larynx): Only about 5 percent of laryngeal cancers start here.
Laryngeal cancers are also categorized based on the type of cells in which the cancer starts. Most laryngeal cancers are squamous cell carcinomas. This means they develop in the thin, flat squamous cells that line the larynx. Some less common types of laryngeal cancers include:
Adenocarcinoma: This cancer affects the glandular cells of the larynx.
Neuroendocrine carcinoma: A type of cancer that starts in neuroendocrine cells that help control hormones and other functions. It’s typically aggressive.
Salivary gland cancer: It starts in the glands that make saliva.
Sarcomas: These are cancers that develop in muscle, cartilage, or other soft tissues of the larynx.
Sarcomatoid carcinoma: It has features of both squamous cell carcinomas and sarcomas. This type tends to grow and spread quickly.
Verrucous carcinoma: A variant of squamous cell carcinoma, this slow-growing cancer looks like a warty growth.
Symptoms of laryngeal cancer often mimic those of other conditions. At first glance, the signs may be mistaken for something as simple as the common cold.
Here are some symptoms to watch out for:
Hoarseness or voice changes that don’t go away
A persistent sore throat or cough
A lump in your throat or neck
Trouble swallowing or painful swallowing
Ear pain
Trouble talking
Shortness of breath or trouble breathing
Coughing up blood
Laryngeal cancer occurs when normal cells in the voice box change and grow out of control. Certain factors can increase your chances of developing the cancer. Risk factors for laryngeal cancer include:
Smoking Smoking and tobacco use is the largest risk factor for laryngeal cancer. Over time, harmful chemicals in tobacco damage the larynx.
Heavy Alcohol Use Drinking a lot (more than one drink daily), especially combined with smoking, can greatly increase your risk of laryngeal cancer.
HPV Some forms of the HPV virus, which can cause changes in throat cells, can lead to cancer.
Age This type of cancer is more common in people ages 55 and older.
Sex Men are five times more likely to develop laryngeal cancer than women. Higher rates of smoking and drinking in men may be part of the reason.
History of Head and Neck Cancer People who have had head and neck cancer in the past are more likely to develop it again.
Exposure to Harmful Chemicals Being exposed to substances, like asbestos, nickel, wood dust, mustard gas, or others could increase the chances of developing cancer in the larynx.
Gastroesophageal Reflux Disease (GERD) People with GERD have a higher risk of laryngeal cancer.
There is no screening test for laryngeal cancer, but detecting it early can lead to a better outcome.
Doctors diagnose laryngeal cancer by using different tests. At first, they may perform a physical exam to look at the throat and neck. Other tests used to diagnose laryngeal cancer include:
Laryngoscopy A thin, lighted tube is placed into the throat to examine the larynx and vocal cords.
Biopsy A small piece of tissue is removed and sent to a laboratory to be viewed under a microscope and tested. The results can confirm whether or not you have cancer.
Staging Laryngeal Cancer
Laryngeal cancer is staged based on the extent of the disease in the body. Laryngeal cancer stages include:
Early laryngeal cancer: This includes stages 0, 1, and 2. Generally, the tumor is small, and the cancer hasn’t spread outside of the larynx.
Advanced laryngeal cancer: Stages 3 and 4 are considered advanced. The tumor is larger and affects the vocal cords or has spread to other areas of the body.
Treatment will depend on the cancer stage, where the cancer is located in the larynx, the person's overall health, and other factors. Sometimes, doctors will combine different therapies.
Surgery
Surgery to remove the tumor is a common treatment for laryngeal cancer. The type of surgery performed depends on where the cancer is located and how advanced it is. Surgical options for laryngeal cancer include:
Total Laryngectomy The entire larynx is removed, and the ability to breathe and talk is affected. A stoma (a permanent hole in your neck) will be placed to help with breathing, and speech and language therapy will be required to learn new ways of communicating with other people.
Partial Laryngectomy A part of the larynx is removed. People have the ability to talk after a partial laryngectomy.
Hemilaryngectomy Half of the larynx is removed. This procedure saves the voice.
Cordectomy All or part of a vocal cord is removed.
Supraglottic Laryngectomy The upper part of the larynx is removed.
Laser Surgery A laser beam is used to remove the tumor.
Radiation
Radiation is a treatment that uses beams of energy (such as high energy X-rays) to kill cancer cells in the body. The goal is to target the tumor while preserving healthy tissue. External beam radiation is most commonly used, where a machine outside the body delivers the energy beams.
If the cancer is small and caught early, radiation may be used as the primary treatment, without the need for surgery. Radiation is also used after surgery to kill any remaining cancer cells, or to treat cancer that has come back after treatment. It may also be used in people who are unable to have surgery, and to ease symptoms in people with advanced laryngeal cancer.
Medication Options
Different drug options are available for laryngeal cancer, including:
Chemotherapy Various chemotherapy drugs are used to kill or slow the growth of cancer cells. Chemotherapy can be a primary treatment, or used alongside other treatments, such as radiation (chemoradiation), or before/after surgery. Chemotherapy is often given in cycles, with breaks in between treatments, and may be given as one or more chemo drugs at a time. Cisplatin (Platinol) and carboplatin (Paraplatin) are common chemo drugs used to treat laryngeal cancers.
Targeted Medicines With targeted therapy, medicines focus on proteins on cancer cells that help them grow. Cetuximab (Erbitux) is a targeted drug that zeros in on and blocks epidermal growth factor receptor (EGFR), a protein that promotes cancer cell growth. Cetuximab might be combined with radiation for more advanced cancers when chemotherapy isn’t an option, or combined with chemotherapy if the cancer has returned or spread to other areas.
Immunotherapy This type of treatment uses your body’s own immune system to fight the cancer. The immunotherapy medicines pembrolizumab (Keytruda) and nivolumab (Opdivo) are sometimes used for laryngeal cancer. They work by blocking a protein called PD-1. The PD-1 protein stops immune cells from attacking other cells in the body. By blocking this protein, the immune cells are encouraged to attack the cancer cells.
Clinical Trials
Clinical trials are research studies that scientists conduct to determine the safety and effectiveness of new therapies. Participating in a trial may give you the opportunity to try a treatment that isn’t available otherwise. Ask your doctor if you’re interested in volunteering for a study. You can also search for studies you might be eligible for on ClinicalTrials.gov.
Complementary and Integrative Therapies
Complementary and integrative therapies won’t cure cancer, but they may help you feel better. Certain approaches can lessen treatment side effects, boost energy, and improve sleep. Always talk to your doctor before trying any new therapy.
Some complementary and integrative therapies to consider include:
Adopting healthy habits can also lower your risk of laryngeal cancer. Here are some strategies.
Don’t smoke, or quit smoking if you do.
Don’t drink, or limit your alcohol consumption. The Centers for Disease Control and Prevention (CDC) recommends that you restrict alcohol consumption to no more than two drinks a day for men and one drink a day for women. There is no safe amount of alcohol consumption when it comes to affecting health or cancer risk — even small amounts could increase risk of cancer or other health complications.
Eat a healthy diet. Include lots of fruits and vegetables and avoid heavily-processed foods.
Avoid exposure to harmful chemicals, if possible.
Your outlook will depend on the stage of your cancer, where it’s located, the treatments you receive, your overall health, and other factors. Luckily, most laryngeal cancers are diagnosed at an early stage, when they are more curable.
Five-year survival rates are often used to predict how long people with different types of cancer will live. Keep in mind that these are only estimates based on existing data. Every situation is unique, and these predictions may not apply to you.
Researchers track five-year survival rates for laryngeal cancer based on whether the cancer is:
Localized This means it hasn’t spread outside of the larynx.
Regional The cancer has spread outside the larynx to nearby structures or lymph nodes.
Distant The cancer has spread to distant organs in the body.
When it comes to laryngeal cancer, the location of the tumor in the larynx also affects survival rates. The five-year survival rates for laryngeal cancers found in the supraglottis are:
Localized 61 percent
Regional 46 percent
Distant 30 percent
The five-year survival rates for laryngeal cancers found in the glottis are:
Localized 84 percent
Regional 52 percent
Distant 45 percent
The five-year survival rates for laryngeal cancers found in the subglottis are:
Localized 59 percent
Regional 38 percent
Distant 44 percent
Complications are secondary health problems that develop due to the cancer itself or the treatments you receive. You may experience many severe issues. Or, you might just have a few mild complications. It will depend on how advanced your disease is and the treatments you have.
Here are some possible complications of laryngeal cancer and its treatments:
Trouble speaking or swallowing
Hypothyroidism (your thyroid gland doesn’t produce enough thyroid hormone)
Dry mouth
Tooth decay
Muscle stiffness in the jaw, neck, or shoulders
Thickening of the skin or tissues
Bleeding
Infection
Lymphedema (a buildup of lymph fluid)
Nerve damage
Fatigue
Your medical team can suggest ways to help manage these problems. For example, therapy helps you improve speech and swallowing. You’ll learn exercises that help strengthen the muscles in your tongue, mouth, and throat.
According to the American Cancer Society, about 13,020 new cases of laryngeal cancer are diagnosed in the United States each year. Around 3,910 people die from the disease each year.
Most people with laryngeal cancer are 55 years of age or older. The average age at diagnosis is about 66. Laryngeal cancer is much more common in men than in women.
Black men are more likely to develop laryngeal cancer and die from it than white men. Researchers aren’t sure exactly why this racial disparity exists, but they believe genetic, environmental, and socioeconomic factors may all play a role. Additionally, delays in diagnosis and treatment could contribute to poorer outcomes.
Some conditions that are closely related to laryngeal cancer include:
Human papillomavirus (HPV):Human papillomavirus is group of more than 150 related viruses that can affect various parts of your body, including your skin, mouth, throat, and genitals.
Head and neck cancer: Cancers that develop in the head and neck area of the body.
Gastroesophageal reflux disease (GERD):GERD is a condition where stomach acid flows back up into your throat.
Hypothyroidism: In hypothyroidism, your body doesn’t make enough thyroid hormone.
Living with laryngeal cancer can be challenging. Here are some resources to help you through your cancer journey.
SPOHNC provides support and education for people with head and neck cancers. They are dedicated to raising awareness and meeting the needs of cancer patients via their resources and publications. One way they do this is by providing useful information about clinical trials and products.
This organization gives advice and support for people affected by throat cancer. Their goal is to lessen the impact of throat cancers on individuals and the society at large.
This group provides up-to-date educational information and activities to promote awareness about head and neck cancers. Their peer-to-peer program matches mentors with patients, survivors, and caregivers to give one-on-one emotional support.
Changing Faces is a UK-based organization that provides support and information for people who have suffered from facial disfigurement due to cancer. They provide mental health and well-being support. Additionally, they offer skin camouflage services.
Laryngeal cancer affects your voice box, which helps you breathe, speak, and swallow.
Symptoms of laryngeal cancer, such as hoarseness or sore throat, may be mistaken for a cold or allergies.
The outlook for people with laryngeal cancer depends on where it’s located and how soon it’s detected and treated. Generally, people with early-stage laryngeal cancer have a better chance of being cured, but even more advanced stages can have a favorable outlook.
