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Back to Oncology Diseases
Cancer of the larynx
Cancer of the larynx also may be called laryngeal cancer. Cancer
can develop in any part of the larynx. Most cancers of the larynx
begin in the glottis. The inner walls of the larynx are lined with
cells called squamous cells. Almost all laryngeal cancers begin in
these cells. These cancers are called squamous cell carcinomas.
If cancer of the larynx spreads (metastasizes), the cancer cells
often spread to nearby lymph nodes in the neck. The cancer cells can
also spread to the back of the tongue, other parts of the throat and
neck, the lungs, and other parts of the body. When this happens, the
new tumor has the same kind of abnormal cells as the primary tumor in
the larynx. For example, if cancer of the larynx spreads to the lungs,
the cancer cells in the lungs are actually laryngeal cancer cells. The
disease is called metastatic cancer of the larynx, not lung cancer. It
is treated as cancer of the larynx, not lung cancer. Doctors sometimes
call the new tumor "distant" disease.
Risk factors for cancer of the larynx
People with certain risk factors are more likely to get cancer of
the larynx. A risk factor is anything that increases your chance of
developing this disease.
Studies have found the following risk factors:
- Age. Cancer of the larynx occurs most often in people over the
age of 55.
- Gender. Men are four times more likely than women to get cancer
of the larynx.
- Race. African Americans are more likely than whites to be
diagnosed with cancer of the larynx.
- Smoking. Smokers are far more likely than nonsmokers to get
cancer of the larynx. The risk is even higher for smokers who drink
alcohol heavily. People who stop smoking can greatly decrease their
risk of cancer of the larynx, as well as cancer of the lung, mouth,
pancreas, bladder, and esophagus. Also, quitting smoking reduces the
chance that someone with cancer of the larynx will get a second
cancer in the head and neck region. (Cancer of the larynx is part of
a group of cancers called head and neck cancers.)
- Alcohol. People who drink alcohol are more likely to develop
laryngeal cancer than people who don’t drink. The risk increases
with the amount of alcohol that is consumed. The risk also increases
if the person drinks alcohol and also smokes tobacco.
- A personal history of head and neck cancer. Almost one in four
people who have had head and neck cancer will develop a second
primary head and neck cancer.
- Occupation. Workers exposed to sulfuric acid mist or nickel have
an increased risk of laryngeal cancer. Also, working with asbestos
can increase the risk of this disease. Asbestos workers should
follow work and safety rules to avoid inhaling asbestos fibers.
- Other studies suggest that having certain viruses or a diet low
in vitamin A may increase the chance of getting cancer of the
larynx. Another risk factor is having gastroesophageal reflux
disease (GERD), which causes stomach acid to flow up into the
esophagus.
However, most people who have these risk factors do not get cancer
of the larynx.
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Symptoms and signs
The symptoms of cancer of the larynx depend mainly on the size of
the tumor and where it is in the larynx. Symptoms may include the
following:
- Hoarseness or other voice changes
- A lump in the neck
- A sore throat or feeling that something is stuck in your throat
- A cough that does not go away
- Problems breathing
- Bad breath
- An earache
- Weight loss
These symptoms may be caused by cancer or by other, less serious
problems. Only a doctor can tell for sure.
Diagnosis of laryngeal cancer
If you have symptoms of cancer of the larynx, the doctor may do
some or all of the following exams:
- Physical exam. The doctor will feel your neck and check your
thyroid, larynx, and lymph nodes for abnormal lumps or swelling. To
see your throat, the doctor may press down on your tongue.
Indirect laryngoscopy.
- Direct laryngoscopy. The doctor inserts a thin, lighted tube
called a laryngoscope through your nose or mouth. As the tube goes
down your throat, the doctor can look at areas that cannot be seen
with a mirror. A local anesthetic eases discomfort and prevents
gagging. You may also receive a mild sedative to help you relax.
Sometimes the doctor uses general anesthesia to put a person to
sleep. This exam may be done in a doctor's office, an outpatient
clinic, or a hospital.
- CT scan. An x-ray machine linked to a computer takes a series of
detailed pictures of the neck area. You may receive an injection of
a special dye so your larynx shows up clearly in the pictures. From
the CT scan, the doctor may see tumors in your larynx or elsewhere
in your neck.
- Biopsy. If an exam shows an abnormal area, the doctor may remove
a small sample of tissue. Removing tissue to look for cancer cells
is called a biopsy. For a biopsy, you receive local or general
anesthesia, and the doctor removes tissue samples through a
laryngoscope. A pathologist then looks at the tissue under a
microscope to check for cancer cells. A biopsy is the only sure way
to know if a tumor is cancerous.
Staging of laryngeal cancer
To plan the best treatment, your doctor needs to know the stage, or
extent, of your disease. Staging is a careful attempt to learn whether
the cancer has spread and, if so, to what parts of the body. The
doctor may use x-rays, CT scans, or magnetic resonance imaging to find
out whether the cancer has spread to lymph nodes, other areas in your
neck, or distant sites.
Treatment of laryngeal cancer
People with cancer of the larynx often want to take an active part
in making decisions about their medical care. Your doctor may refer
you to a specialist who treats cancer of the larynx, such as a
surgeon, otolaryngologist (an ear, nose, and throat doctor), radiation
oncologist, or medical oncologist. Early stages of this disease may be
curable by surgery and or radiotherapy. Late stages usually require
chemotherapy
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