This is a patient information article on laryngeal cancer.
What is Laryngeal cancer?
Laryngeal cancer is one type of throat cancer involving the larynx or the voice box. This is because the normal cells in this area have changed into abnormal cells and are now growing out of control.
Who gets Laryngeal cancer?
Men are more likely to suffer from laryngeal cancer (up to 4 times more likely than women). Also older people are at higher risk with laryngeal cancer being rare in people under the age of 40.
What are the causes?
A cancer is thought to start from a normal cell that starts behaving abnormally where it starts to multiply out of control. The exact reason why a cell starts to behave abnormally is unclear. Some people can develop cancer with no apparent cause. However, there are some factors that can increase the risk of developing laryngeal cancer.
Current or previous smokers and those who consume alcohol are at higher risk of laryngeal cancer. With smoking and alcohol consumption, the risk increases the more tobacco is smoked or with more alcohol consumption (wyss 2013, Hashibe M et al. 2007).
Other risk factors for laryngeal exposure include exposure to some chemicals (such as asbestos), or exposure to human papillomavirus (HPV).
What are the symptoms?
Depending on the exact location of cancer, symptoms may vary. Also, some of these symptoms may be caused by other conditions that are not related to laryngeal cancer.
Some patients may experience:
- Cough, or coughing up blood
- Difficulty swallowing
- Change in voice (hoarse voice)
- Ear pain
- Noisy or difficulty breathing
How is it diagnosed?
If your family doctor is concerned about laryngeal cancer, they will refer you to an ENT surgeon. ENT surgeon will take a history and do an exam. As part of their exam, they may also look down into your through using a fiber optic camera or scope. Depending on what they find, they may take a small sample and have it examined under microscope to confirm the diagnosis.
Your ENT surgeon may also organise other investigations such as scans (e.g. CT, MRI, or CT-PET) or other forms of biopsy (such as ultrasound guided needle biopsy). These help examine the size of the cancer in the larynx, and also look for evidence of it spreading to other locations such as lymph glands.
What are the potential complications?
Depending on location and size of the cancer, there may be some potentially serious complications. As the larynx is located on top of the wind pipe (trachea), narrowing may cause noisy breathing. Critical narrowing may cause the wind pipe to narrow to the extent that breathing becomes difficult. In this situation urgent intervention may be required.
Also as swallowing may become difficult, some people are not able to eat enough to meet their body’s energy requirements. Therefore they can lose significant amount of weight. This may impact the body’s ability to heal from surgery or other treatments.
It may be necessary to involve a dietician, or even insert a tube into your stomach (from your nose, or though the abdomen) and feed you though an alternative pathway to meet your body’s energy requirements. Finally, if the cancer spreads and involves a major blood vessel in the neck, it may cause significant bleeding that needs emergency intervention.
What are the treatment options?
Treatment for laryngeal cancer depends on the extent of the disease. Your doctor will discuss possible options with you including risks and benefits. Treatment often involves one or more of the following options:
Surgery: This is where the cancer is removed surgically. The extent of the surgery will depend on the location and also the size of the cancer. Depending on location and size of the cancer, it may be possible to remove the cancer through the mouth which involves no cutting on the outside. Other times, you surgeon may recommend removing part or all of the larynx.
Radiotherapy: This treatment replies on radiation to kill cancer cells. This radiation is usually delivered multiple times over a period, and it is very carefully planned as to minimise damage to the surrounding healthy tissue.
Chemotherapy: This group of medications kill cancer cells or stop them from growing.
Other treatments: The area of cancer treatment is rapidly evolving as new potential treatments are developed. Such treatments may include immunotherapy.
Can you prevent Laryngeal cancer?
Factors that could help reduced the risk of laryngeal cancer include smoke cessation, reduce or stop alcohol intake, the HPV vaccine, and stop exposure to chemicals that may cause cancer (e.g. asbestos).
What is the prognosis?
If laryngeal cancer is detected early, there is a good chance of cure. Following your treatment, your doctor will see you on regular basis to make sure the cancer has not come back. You may also require follow-up scans. It is important that you get in touch with your doctor if any of your symptoms get worse.
After treatment, some people can have ongoing problem with eating, swallowing, or talking. It may be important to have a number of health professionals, such as speech and language therapist or dentist, involved in your care to help you manage some of these.
Wyss A, Hashibe M, Chuang SC, Lee YC, Zhang ZF, Yu GP, et al. Cigarette, cigar, and pipe smoking and the risk of head and neck cancers: pooled analysis in the International Head and Neck Cancer Epidemiology Consortium. Am J Epidemiol. 2013;178(5):679.
Hashibe M, Brennan P, Benhamou S, Castellsague X, Chen C, Curado MP. Alcohol drinking in never users of tobacco, cigarette smoking in never drinkers, and the risk of head and neck cancer: pooled analysis in the International Head and Neck Cancer Epidemiology Consortium. J Natl Cancer Inst. 2007;99(10):777.
Author + Affiliation:
Dr Omid Ahmadi – Registrar, Department of Otolaryngology and Head & Neck Surgery, Waikato Hospital
Date of Publication +/- Review: