Laryngeal Cancer

Overview

Laryngeal cancer is a cancer that develops in the larynx, the voice box at the top of the windpipe. The larynx contains the vocal cords and plays a key role in speaking, breathing, and swallowing. Most laryngeal cancers are squamous cell carcinomas, which arise from the thin, flat cells lining the larynx.

Because even small tumors on the vocal cords can change the voice, laryngeal cancer is sometimes caught early when it causes lasting hoarseness. Smoking and heavy alcohol use are the most important risk factors, and together they raise the risk more than either alone. When found early, the outlook is generally good and the voice can often be preserved.

Symptoms

Symptoms depend on where in the larynx the cancer starts, but common signs include:

• A hoarse voice or other voice change lasting more than two to three weeks
• A persistent sore throat or cough
• Pain or difficulty swallowing
• A lump in the neck
• Ear pain on one side
• Noisy or difficult breathing as the tumor grows
• Unintended weight loss

Hoarseness that lasts beyond a few weeks, especially in someone who smokes, should always be checked by a doctor.

Causes

Laryngeal cancer develops when cells in the larynx accumulate genetic changes that cause them to grow uncontrollably. The strongest contributors are:

• Tobacco use: Smoking is the leading cause, and the risk rises with the amount and duration of smoking.
• Alcohol: Heavy drinking adds substantial risk, particularly when combined with smoking.

Other contributing factors include long-term exposure to certain workplace substances such as asbestos and wood dust, infection with some strains of human papillomavirus (HPV), and chronic acid reflux. In many cases, the cancer results from a combination of these influences over years.

Risk Factors

• Current or past smoking and other tobacco use
• Heavy alcohol consumption
• Older age and male sex
• Workplace exposure to asbestos, wood dust, or certain chemicals
• Infection with high-risk HPV strains
• Long-standing acid reflux

Diagnosis

If laryngeal cancer is suspected, evaluation may include:

• Laryngoscopy: A small lighted scope used to look directly at the larynx and vocal cords.
• Biopsy: Taking a tissue sample to confirm cancer and its type.
• Imaging: CT, MRI, or PET scans to see how far the cancer has spread and to plan treatment.

Treatment

Treatment is tailored to the cancer's location and stage and aims to cure the disease while preserving voice and swallowing when possible:

• Radiation therapy: Often used alone for early cancers and can preserve the voice.
• Surgery: Removing part or, in advanced cases, all of the larynx (laryngectomy); minimally invasive laser surgery may treat small tumors.
• Chemotherapy: Combined with radiation for more advanced disease.
• Targeted and immune therapies: Used in certain advanced or recurrent cancers.

After treatment, speech therapy and rehabilitation help people regain communication, especially if the voice box has been removed.

Prevention

• Do not smoke or use tobacco, and seek help to quit if you do
• Limit or avoid alcohol
• Use protective equipment around asbestos, wood dust, and industrial chemicals
• Manage chronic acid reflux
• Get any hoarseness lasting more than a few weeks evaluated

When to See a Doctor

See a doctor if you have hoarseness or a voice change that lasts more than two to three weeks, a persistent sore throat, trouble swallowing, or a lump in the neck. Seek urgent care if you develop noisy, difficult breathing or cannot swallow your saliva, as a tumor may be blocking the airway.

Related Topics

Frequently Asked Questions

References

1. National Cancer Institute (NCI). Laryngeal Cancer Treatment.
2. Mayo Clinic. Throat cancer — Symptoms and causes.
3. American Cancer Society. Laryngeal and Hypopharyngeal Cancer.
4. MedlinePlus, U.S. National Library of Medicine. Laryngeal cancer.