Laryngeal Cancer

The larynx (voice box) is located at the top of the trachea (windpipe). The larynx contains the vocal cords. Vocal cords vibrate and allow us talk and sing.

The opening to the larynx is covered by a large muscular flap called the epiglottis. The epiglottis covers the windpipe when we swallow, to prevent food from entering the trachea. The muscles of the larynx also help close the opening to the airway. This closing function is so important that seven of the eight muscles in the larynx are used for closure.

The remaining muscle (the cricoarytenoideus dorsalis) opens the airway. If the muscle stops functioning properly, the airway cannot remain open for breathing. This can cause roaring or gasping episodes, which may become life-threatening.

In cancer of the larynx (laryngeal cancer) malignant cells develop in the tissue of the larynx. Most laryngeal cancers form in the flat cells (squamous cell) that line the inside of the larynx.

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Symptoms

  • A persistent sore throat or cough
  • Pain or problems swallowing
  • Ear pain
  • A lump in the neck or throat
  • A hoarse voice or other voice changes
  • Blood tinged sputum when coughing

Causes and Risk Factors

  • More common in people over age 50
  • Men are four times more likely than women to develop laryngeal cancer
  • Tobacco use is the most important risk factor (95 percent of people who develop laryngeal cancer are smokers)
  • Heavy alcohol drinkers have an increased risk. People who smoke and drink may have 100 times the risk, according to the American Cancer Society.
  • Other less common risk factors include acid reflux, exposure to the human papilloma virus (HPV), weakened immune system, and intense exposure to wood dust or certain chemicals

About 11,000 new cases of laryngeal cancer are diagnosed each year.

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Diagnosis

To make a diagnosis, your doctor will ask questions about your symptoms and medical history. A physical exam of the throat and neck also is needed. Your doctor will feel for swollen lymph nodes in the neck, and look down your throat with a small, long-handled mirror to check for abnormal areas.

Other tests may be used for diagnosis:

Laryngoscopy - The doctor examines the larynx with a laryngoscope (a thin, lighted tube).

Endoscopy - A procedure to look at the organs and tissues inside the body and to check for abnormal areas. An endoscope (a thin, lighted tube) is inserted through an incision in the skin or an opening in the body, such as the mouth. The surgeon will remove tissue samples and lymph nodes for a biopsy if needed.

Computed tomography scan (CT or CAT scan) - A special type of X-ray that makes a series of detailed pictures of the inside the body. A computer is linked to the X-ray machine. Dye may be injected into a vein or swallowed in a pill to help the organs or tissues show up on the X-ray. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.

Magnetic resonance imaging (MRI) - An imaging machine that uses a magnet, radio waves, and a computer to make detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).

Biopsy - A biopsy is the removal of cells or tissues, which are viewed under a microscope, to check for signs of cancer.

Barium swallow - A barium swallow test consists of a series of x-rays of the esophagus and stomach. The patient drinks a liquid that contains barium (a silver-white metallic compound). The liquid coats the esophagus and stomach, and x-rays are taken. This procedure is also called an upper GI series.

Fine Needle Aspiration Biopsy (FNA) - A thin needle is placed into a lump in the neck. The cells are aspirated, and then examined under a microscope to determine if the lump is cancerous.

PET scan - PET scan helps determine if a tumor has spread to other areas in the body. During a positron emission tomography scan (PET), a small amount of radioactive sugar (glucose) is injected into a vein. The scanner makes computerized pictures of the areas inside the body. Cancer cells absorb more radioactive glucose than normal cells, so the tumor is highlighted on the pictures.

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Treatments

There are three methods of cancer treatment:

Most treatments use two or more of these methods. If a cure is not possible, the goal may be to prevent the tumor from growing or spreading for as long as possible (palliative treatment). Palliative treatment also helps to relieve symptoms.

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