Laryngeal Cancer Symptoms and Long-Term Impact

Laryngeal cancer is cancer of the larynx (sometimes called the voice box), which is an organ located in the front of the esophagus. It lies on top of the trachea and in front of the pharynx The larynx assists in breathing, speaking, and swallowing.

Laryngeal cancer can form a tumor, which may push on nearby structures surrounding the larynx, and it spread to other parts of the body. This article describes the symptoms and impact of laryngeal cancer.

Symptoms

The early symptoms of laryngeal cancer are also common with many other illnesses.

Some possible symptoms are:

• Hoarseness
• Sore throat
• Difficulty swallowing
• Difficulty breathing
• Hemoptysis (coughing up blood)
• Bad breath
• Earaches
• Weight loss

It is important to get medical attention if you experience any of these symptoms, especially if they persist beyond a few weeks.

How It Spreads

Cancer cells can enter the bloodstream or lymphatic system and be carried to other areas in the body. If it's not treated, laryngeal cancer can spread throughout the entire body; this is called metastatic cancer. When it spreads to the pharynx and back of the tongues, this is known as invasive cancer.

Causes and Risk Factors

Certain risk factors that make you more likely to get laryngeal cancer include:

• Age 55 years of age or older
• Male gender
• Smoking
• Drinking alcohol
• Having had a previous diagnosis of cancer in the head or neck
• Exposure to certain chemicals including asbestos, sulfuric acid, or nickel
• GERD (acid reflux)
• HPV infection

Toxin exposures, especially smoking, can cause the cells of the larynx to change and become cancerous. And other factors, such as HPV infection and GERD, can also damage the cells of the larynx, causing changes that may lead to cancer.

Having some of these factors does not necessarily mean that you will develop laryngeal cancer.

Diagnosis

There are several different tests used to diagnose laryngeal cancer. Your doctor may be able to feel lumps on your neck or swelling in the back of your throat—but these signs aren't always present with laryngeal cancer.

If necessary, other tests will be ordered and may include:

• Fiberoptic laryngoscopy: This test can be performed by an otolaryngologist (ear, nose, and throat surgeon) in the office. It's done with a scope, which is a very thin flexible instrument that's passed through the nose into the pharynx to see the larynx. The lining of the nose is numbed with a topical anesthetic to prevent any discomfort and gagging.
• Direct laryngoscopy: During this test, your doctor will use a laryngoscope (a tube with a light on the end which is inserted through your nose or your mouth) to visualize the larynx. The test requires sedation and it is usually done in a surgical center or hospital.
• CT Scan: This is an imaging test that can be used to visualize structures in the neck or other areas of the body.
• Biopsy: This is an invasive test in which a small sample of the concerning area is taken and visualized with a microscope to evaluate the characteristics of the cells.

Treatment

Treating laryngeal cancer may involve multiple medical experts including otolaryngologists, oncologists, and radiation oncologists.

The exact method of treatment will depend on your particular situation and often will involve surgery to remove as much of the cancer as possible. Depending on the stage of your cancer you may need to have a partial laryngectomy surgery or total laryngectomy surgery.

Local radiation of the cancer cells may be performed before surgery to reduce the size of the tumor or it can be performed after surgery to eradicate as many cancer cells as possible. Chemotherapy is used in some cases of laryngeal cancer.

Long-Term Impact

You may need to have a tracheostomy after your laryngeal cancer surgery. This is a tube that's placed in your neck so that you can breathe. A tracheostomy permanent.

Perhaps one of the most devastating side effects of laryngeal cancer is its effects on speech. If you have a permanent tracheostomy, you will have to learn how to speak in a new way. You will have lessons from a speech pathologist to help you learn to talk.

Some patients opt to use a mechanical larynx to speak. There are multiple kinds of mechanical devices to choose from. Some are powered by air and others by batteries. Some devices require you to hold them up against your throat while others are inserted into your mouth. You may have to try out more than one type with the assistance of your speech pathologist to find the right device for you.

Many patients who have a tracheostomy keep a pencil and a pad of paper nearby at all times to communicate as they are learning how to speak after surgery. And sign language may also be a viable option for you and your family.

While laryngeal cancer can be devastating, and the road to recovery may be long and hard, there are many resources to help you on your way. You will need the support of family and friends in addition to your medical team.