What Is Laryngeal Cancer?

• Supraglottis (upper part of the larynx): About 35 percent of laryngeal cancers start here. The supraglottis includes the epiglottis, which is a piece of cartilage that prevents food from getting into your windpipe when you swallow. It also houses a joint that helps the vocal cords move when you speak.

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• Glottis (middle part of the larynx): Around 60 percent of laryngeal cancers start here. This is where the vocal cords are located.
• Subglottis (lower part of the larynx): Only about 5 percent of laryngeal cancers start here.

• Adenocarcinoma: This cancer affects the glandular cells of the larynx.

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• Neuroendocrine carcinoma: A type of cancer that starts in neuroendocrine cells that help control hormones and other functions. It’s typically aggressive.

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• Salivary gland cancer: It starts in the glands that make saliva.
• Sarcomas: These are cancers that develop in muscle, cartilage, or other soft tissues of the larynx.
• Sarcomatoid carcinoma: It has features of both squamous cell carcinomas and sarcomas. This type tends to grow and spread quickly.

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• Verrucous carcinoma: A variant of squamous cell carcinoma, this slow-growing cancer looks like a warty growth.

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• Hoarseness or voice changes that don’t go away
• A persistent sore throat or cough
• A lump in your throat or neck
• Trouble swallowing or painful swallowing
• Ear pain
• Trouble talking
• Shortness of breath or trouble breathing
• Coughing up blood

• Smoking Smoking and tobacco use is the largest risk factor for laryngeal cancer.

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   Over time, harmful chemicals in tobacco damage the larynx.
• Heavy Alcohol Use Drinking a lot (more than one drink daily), especially combined with smoking, can greatly increase your risk of laryngeal cancer.
• HPV Some forms of the HPV virus, which can cause changes in throat cells, can lead to cancer.
• Age This type of cancer is more common in people ages 55 and older.
• Sex Men are five times more likely to develop laryngeal cancer than women. Higher rates of smoking and drinking in men may be part of the reason.
• History of Head and Neck Cancer People who have had head and neck cancer in the past are more likely to develop it again.
• Exposure to Harmful Chemicals Being exposed to substances, like asbestos, nickel, wood dust, mustard gas, or others could increase the chances of developing cancer in the larynx.
• Gastroesophageal Reflux Disease (GERD) People with GERD have a higher risk of laryngeal cancer.

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There is no screening test for laryngeal cancer, but detecting it early can lead to a better outcome.

• Imaging Scans like an X-ray, computed tomography (CT), magnetic resonance imaging (MRI), or positron emission tomography (PET) may be used to view the cancer in the body.
• Laryngoscopy A thin, lighted tube is placed into the throat to examine the larynx and vocal cords.
• Biopsy A small piece of tissue is removed and sent to a laboratory to be viewed under a microscope and tested. The results can confirm whether or not you have cancer.

Staging Laryngeal Cancer

• Early laryngeal cancer: This includes stages 0, 1, and 2. Generally, the tumor is small, and the cancer hasn’t spread outside of the larynx.
• Advanced laryngeal cancer: Stages 3 and 4 are considered advanced. The tumor is larger and affects the vocal cords or has spread to other areas of the body.

Treatment will depend on the cancer stage, where the cancer is located in the larynx, the person's overall health, and other factors. Sometimes, doctors will combine different therapies.

Surgery 

• Total Laryngectomy The entire larynx is removed, and the ability to breathe and talk is affected. A stoma (a permanent hole in your neck) will be placed to help with breathing, and speech and language therapy will be required to learn new ways of communicating with other people.

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• Partial Laryngectomy A part of the larynx is removed. People have the ability to talk after a partial laryngectomy.
• Hemilaryngectomy Half of the larynx is removed. This procedure saves the voice.
• Cordectomy All or part of a vocal cord is removed.
• Supraglottic Laryngectomy The upper part of the larynx is removed.
• Thyroidectomy All or part of the thyroid gland is removed.
• Laser Surgery A laser beam is used to remove the tumor.
  

Radiation

Medication Options

Different drug options are available for laryngeal cancer, including:

• Chemotherapy Various chemotherapy drugs are used to kill or slow the growth of cancer cells. Chemotherapy can be a primary treatment, or used alongside other treatments, such as radiation (chemoradiation), or before/after surgery.

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   Chemotherapy is often given in cycles, with breaks in between treatments, and may be given as one or more chemo drugs at a time.

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  Cisplatin (Platinol) and carboplatin (Paraplatin) are common chemo drugs used to treat laryngeal cancers.

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• Targeted Medicines With targeted therapy, medicines focus on proteins on cancer cells that help them grow. Cetuximab (Erbitux) is a targeted drug that zeros in on and blocks epidermal growth factor receptor (EGFR), a protein that promotes cancer cell growth. Cetuximab might be combined with radiation for more advanced cancers when chemotherapy isn’t an option, or combined with chemotherapy if the cancer has returned or spread to other areas.

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• Immunotherapy This type of treatment uses your body’s own immune system to fight the cancer. The immunotherapy medicines pembrolizumab (Keytruda) and nivolumab (Opdivo) are sometimes used for laryngeal cancer. They work by blocking a protein called PD-1. The PD-1 protein stops immune cells from attacking other cells in the body. By blocking this protein, the immune cells are encouraged to attack the cancer cells.

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Clinical Trials

Clinical trials are research studies that scientists conduct to determine the safety and effectiveness of new therapies. Participating in a trial may give you the opportunity to try a treatment that isn’t available otherwise. Ask your doctor if you’re interested in volunteering for a study. You can also search for studies you might be eligible for on ClinicalTrials.gov.

Complementary and Integrative Therapies

Complementary and integrative therapies won’t cure cancer, but they may help you feel better. Certain approaches can lessen treatment side effects, boost energy, and improve sleep. Always talk to your doctor before trying any new therapy.

• Acupuncture
• Exercise
• Massage
• Deep breathing
• Meditation or relaxation exercises
• Music therapy
• Yoga or tai chi

• Don’t smoke, or quit smoking if you do.
• Don’t drink, or limit your alcohol consumption. The Centers for Disease Control and Prevention (CDC) recommends that you restrict alcohol consumption to no more than two drinks a day for men and one drink a day for women.

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   There is no safe amount of alcohol consumption when it comes to affecting health or cancer risk — even small amounts could increase risk of cancer or other health complications.

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• Eat a healthy diet. Include lots of fruits and vegetables and avoid heavily-processed foods.
• Avoid exposure to harmful chemicals, if possible.

• Localized This means it hasn’t spread outside of the larynx.
• Regional The cancer has spread outside the larynx to nearby structures or lymph nodes.
• Distant The cancer has spread to distant organs in the body.

• Localized 61 percent
• Regional 46 percent
• Distant 30 percent

• Localized 84 percent
• Regional 52 percent
• Distant 45 percent

• Localized 59 percent
• Regional 38 percent
• Distant 44 percent

Complications are secondary health problems that develop due to the cancer itself or the treatments you receive. You may experience many severe issues. Or, you might just have a few mild complications. It will depend on how advanced your disease is and the treatments you have.

• Trouble speaking or swallowing
• Hypothyroidism (your thyroid gland doesn’t produce enough thyroid hormone)
• Dry mouth
• Tooth decay
• Muscle stiffness in the jaw, neck, or shoulders
• Thickening of the skin or tissues
• Bleeding
• Infection
• Lymphedema (a buildup of lymph fluid)
• Nerve damage
• Fatigue

• Human papillomavirus (HPV): Human papillomavirus is group of more than 150 related viruses that can affect various parts of your body, including your skin, mouth, throat, and genitals.
• Head and neck cancer: Cancers that develop in the head and neck area of the body.
• Gastroesophageal reflux disease (GERD): GERD is a condition where stomach acid flows back up into your throat.
• Hypothyroidism: In hypothyroidism, your body doesn’t make enough thyroid hormone.

Living with laryngeal cancer can be challenging. Here are some resources to help you through your cancer journey.

Support for People With Oral and Head and Neck Cancer (SPOHNC)

SPOHNC provides support and education for people with head and neck cancers. They are dedicated to raising awareness and meeting the needs of cancer patients via their resources and publications. One way they do this is by providing useful information about clinical trials and products.

The Throat Cancer Foundation

This organization gives advice and support for people affected by throat cancer. Their goal is to lessen the impact of throat cancers on individuals and the society at large.

Head and Neck Cancer Alliance

This group provides up-to-date educational information and activities to promote awareness about head and neck cancers. Their peer-to-peer program matches mentors with patients, survivors, and caregivers to give one-on-one emotional support.

Changing Faces 

Changing Faces is a UK-based organization that provides support and information for people who have suffered from facial disfigurement due to cancer. They provide mental health and well-being support. Additionally, they offer skin camouflage services.

• Laryngeal cancer affects your voice box, which helps you breathe, speak, and swallow.
• Symptoms of laryngeal cancer, such as hoarseness or sore throat, may be mistaken for a cold or allergies.
• The outlook for people with laryngeal cancer depends on where it’s located and how soon it’s detected and treated. Generally, people with early-stage laryngeal cancer have a better chance of being cured, but even more advanced stages can have a favorable outlook.