What Is Laryngeal Cancer?

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The larynx is the tube that connects the bottom of the throat to the windpipe (trachea). It is divided into three sections called the supraglottis, glottis, and subglottis.

Structures in the larynx include the:

  • Epiglottis: A flap of tissue that closes to prevent food from entering the trachea
  • Vocal cords: Two bands of muscle that open and close

Laryngeal cancer can develop anywhere inside this space.

Healthcare worker checking man's throat

Getty Images

Laryngeal Cancer Symptoms

One of the most common symptoms that develop with laryngeal cancer is hoarseness or a change in the voice. When a tumor develops near the vocal cords, it can keep the cords from opening and closing properly, changing the sound of the voice.

Other symptoms that can be present in laryngeal cancer may include:

  • Sore throat
  • Pain with swallowing
  • Difficulty swallowing
  • Ear pain
  • Shortness of breath
  • Weight loss
  • Lump in the neck

Causes

Laryngeal cancer can develop in any part of the larynx, but it most commonly develops in the area of the glottis, the middle part of the larynx, where the vocal cords are located.

There is no specific cause of laryngeal cancer, but there are some risk factors associated with it.

These risk factors include:

  • History of tobacco use
  • History of heavy alcohol use
  • Previous human papillomavirus (HPV) infection
  • More than 55 years old
  • Male gender
  • Frequent exposure to wood dust or chemicals at work

Diagnosis

When someone presents to their healthcare team with symptoms as listed above, they can be evaluated in multiple ways.

  • History and physical: A detailed history may be taken to evaluate for any risk factors that may be present. A physical exam entails looking into the mouth and throat to see if any causes for the symptoms are found. The neck may be examined for any lumps or swelling.
  • Laryngoscopy: This is a test that can be done to look further into the throat. It is usually done by an otolaryngologist (ENT), with a special mirror and light. It can also be performed using a long thin camera that is inserted into the nose and moved down to the throat to get a better visualization of the larynx. These two procedures may be done in the ENT office. The third type of laryngoscopy must be done in the operating room, with a rigid scope that allows for even better evaluation of the areas in the head and neck. During the procedures, biopsies may be taken to test for cancer.
  • Biopsy: Once a biopsy is taken, the tissue is sent to a laboratory to evaluate for the presence of cancer cells. If cancer is found, other testing is done to further classify cancer and look for certain characteristics cancer may have. A biopsy may also be taken of any enlarged lymph nodes in the area to see if cancer is present in them.
  • Imaging tests: Imaging studies such as computed tomography (CT), magnetic resonance imaging (MRI), or positron emission tomography (PET) may be done to determine exactly where the cancer is located and to find out if it has spread to other areas of the body.

When all of the biopsies and imaging studies are completed, the oncologist will officially diagnose laryngeal cancer and give it a stage.

The final stage depends upon:

  • The size of the initial laryngeal tumor
  • Its location in the larynx
  • The involvement of any lymph nodes with cancer
  • If cancer has spread to another area of the body

The stages range from stage I (early) to stage IV (metastatic).

Treatment

Treatment for laryngeal cancer can include many options including surgery, radiation, chemotherapy, or immunotherapy.

Some treatments may be done alone or in combination with other treatments. Each plan is individualized for the person being treated based on the stage of their cancer:

  • Surgery: Surgery is often done for any stage of laryngeal cancer. The type of surgery needed can vary. Depending upon the stage and location of laryngeal cancer, surgery may only need to remove a small area. If the tumor is larger or lymph nodes are involved, a surgeon may need to remove a larger area, which could potentially include the vocal cords. If vocal cords are removed, the ability to speak is lost. If a total laryngectomy is done, the entire larynx is removed. This would also require the need for a tracheostomy, a hole in the neck by which someone would be able to breathe. Surgery is often done before other treatments but may be done after chemotherapy or radiation in order to shrink the tumor and potentially be able to have a smaller surgery.
  • Radiation: During radiation, high-energy X-ray beams are directed at the tumor through a specialized machine. The beams of radiation kill cancer cells in their path but do not treat the whole body. The machine may rotate around the patient to provide radiation from multiple directions. Each treatment lasts only a few minutes but is typically done once a day for a few weeks, though each person’s treatment plan is individualized. Radiation may be done before surgery to try to shrink the tumor down for a smaller surgery, or after surgery to reduce the risk of cancer returning to that area.
  • Chemotherapy: During chemotherapy, medications are given to enter the bloodstream and work by damaging cancer cells at certain points in their reproductive cycle. These medications enter the bloodstream and can reach most areas of the body. Chemotherapy may be used before surgery in combination with radiation to help shrink the tumor to prevent the need for a total laryngectomy. It may also be given after surgery in combination with radiation to decrease the risk of cancer coming back. If cancer has spread to other areas of the body, chemotherapy is used to treat these areas. Most chemotherapy is given intravenously (IV), and depending on the medication used, may be given once a week or every few weeks.
  • Immunotherapy: Immunotherapy is used when laryngeal cancer has returned after treatment or if it has initially spread to other areas. Immunotherapy works by helping the immune system attack the laryngeal cancer cells. These medications are given through an IV in a schedule every two to six weeks depending on the immunotherapy used.

Prognosis

The prognosis for laryngeal cancer depends upon where the tumor is located and what stage it is, and generally the earlier it is caught, the better the prognosis.

5-Year Survival Rate
Location 5-year survival rate
Contained to glottis 78%
Located in subglottis 60%
Spread to local lymph nodes or structures 45%
Spread to distant areas in the body 42%

Coping

A diagnosis of laryngeal cancer may come with emotional and physical side effects. Many emotions can be present, ranging from fear, anger, anxiety, and sadness. Finding someone to talk to about these feelings can be helpful. It may not be a friend or loved one, but possibly a social worker, counselor, or support group.

Physical side effects may continue long after treatment for laryngeal cancer is complete, as surgery may permanently change the way someone looks, speaks, or eats. Finding a healthy way to cope with these changes is important.

A Word From Verywell

Being diagnosed with laryngeal cancer can be a difficult time in life. However, finding a cancer care team that is experienced in treating this type of cancer can help make the treatment more successful. Finding a good support system to help you through treatment is important as well.

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Article Sources
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