What is laryngeal cancer?
Laryngeal cancer is cancer of the larynx, part of the throat. Cancer happens when specific cells grow uncontrollably. As the cells multiply, they invade and damage the body. In laryngeal cancer, these cancerous (malignant) cells start in the larynx (voice box).
What is the larynx?
The larynx is in your throat. It’s also known as the voice box. The larynx helps us speak, breathe and swallow. Our vocal cords are part of the larynx.
The larynx is mostly made up of cartilage, a flexible tissue that makes a supportive framework. The larynx has three parts:
What does the larynx do?
The larynx helps us:
What are the risk factors for laryngeal cancer?
Smoking or using other tobacco products greatly increases your risk of developing laryngeal cancer. Drinking alcohol, especially a lot of it, also raises your risk. And using alcohol and tobacco together increases the risk even more.
Other risk factors for laryngeal cancer include:
SYMPTOMS AND CAUSES
What causes laryngeal cancer?
Researchers don’t know what causes laryngeal cancer. But if you have risk factors such as tobacco or alcohol use, you have a much higher chance of developing laryngeal cancer.
Some forms of HPV (human papillomavirus), a sexually transmitted disease, can cause laryngeal cancer.
What are the symptoms of laryngeal cancer?
It’s easy to mistake symptoms of laryngeal cancer for other conditions. If you experience these symptoms, talk to your healthcare provider for an accurate diagnosis:
If you have these symptoms, seek medical attention right away:
DIAGNOSIS AND TESTS
How is laryngeal cancer diagnosed?
Your healthcare provider asks you about your symptoms and medical history. They do a physical exam, examining your throat and neck. After the initial exam, you’ll most likely need other tests to confirm a diagnosis.
What other tests help diagnose laryngeal cancer?
Other diagnostic tests include:
Part of diagnosis is staging the cancer. Your care team will figure out how severe the disease is — how far the tumour has grown and if and where it has invaded in the body.
Laryngeal cancer can sometimes invade the thyroid, esophagus, tongue, lungs, liver and bones. Stages of laryngeal cancer include:
MANAGEMENT AND TREATMENT
Who helps diagnose and treat laryngeal cancer?
A laryngeal cancer care team often consists of multiple providers from different fields:
What is the treatment for laryngeal cancer?
Treatment for laryngeal cancer includes:
You may have more than one treatment. For example, people sometimes have chemotherapy or radiation therapy after surgery to destroy any remaining cancer cells.
What laryngeal surgery procedures are available?
Surgery removes cancer. The goal of laryngeal cancer surgery is to remove the tumour while preserving your function. The surgeon may need to remove part or all of the larynx. Surgical procedures include:
How does the care team figure out the best treatment for laryngeal cancer?
For early laryngeal cancer, your care team will likely recommend surgery or radiation therapy. Research has shown that both are effective. Your team will base the decision on several factors, including:
PREVENTION
Can I prevent laryngeal cancer?
You can’t prevent all cancer. But you can lower your risk for developing cancer, including laryngeal cancer, by living a healthy lifestyle:
How do I know if I’m at risk?
If you have any of the risk factors for laryngeal cancer — for example, if you smoke or had head and neck cancer in the past — talk to your healthcare provider. They can help you take steps to lower your risk of developing cancer.
Is there screening for laryngeal cancer?
There’s no regular screening test for laryngeal cancer. But talk to your healthcare provider if you have hoarseness, other voice changes or a persistent cough. Early detection catches cancer early, when it’s easiest to treat.
OUTLOOK / PROGNOSIS
What happens after laryngeal cancer treatment?
After your treatment, you continue to have follow-up appointments with your healthcare provider to make sure you’re recovering well. Your provider will:
What’s the outlook for people with laryngeal cancer?
The outlook differs for people, depending on factors such as the cancer’s stage and your age and general health. Generally, early laryngeal cancer has a better cure rate. Advanced cancer that spreads to other areas has a poorer survival rate.
But even advanced laryngeal cancer can be cured. If it comes back, it usually happens within the first two or three years after treatment. After five years, there’s very low risk of cancer returning.
LIVING WITH
How do I take care of myself if I have a total laryngectomy?
If you smoke, it’s important to quit. Don’t smoke before or during treatment, and stay tobacco-free even after you finish treatment. People who smoke after treatment have a higher chance of developing another type of cancer. But patients who stop smoking have a much lower risk of cancer. Smoking also prevents you from healing completely, and it may cause worse side effects from treatment.
Will I have a stoma?
If you have a total laryngectomy, your surgeon will put a new airway in your throat called a stoma. The stoma helps you breathe. It may be permanent or temporary. Take care of your stoma:
Will I be able to use my voice after laryngeal cancer treatment?
If you had a laryngectomy (surgeons removed your larynx), you will need to learn a new way to speak. A speech language pathologist can help.
How can I speak after a laryngectomy?
Healthcare providers use three methods for helping people learn how to speak after a laryngectomy:
How do I breathe after a laryngectomy?
After a laryngectomy, you breathe by taking air in through a stoma, an opening made in your neck. Care for your stoma to keep it moist and free of mucus. Make sure to protect your trachea (windpipe) as well.
After surgery, you’ll be fitted with a stoma cover and filter (HME=heat and moisture exchange). This allows you to breath warmed and moisturized air, using your body’s own power. You’ll find this causes you to have less mucus and debris in the windpipe and minimizes coughing after surgery.
Will I be able to eat after a laryngectomy?
Right after the surgery, you won’t eat or drink anything by mouth. You’ll get your nutrition through a feeding tube. A few days after surgery, your healthcare provider will check to see if you can swallow food and liquid without a problem. Once you can swallow safely, you’ll start eating soft foods (puddings and pureed foods) and progress to a regular diet.
What should I ask my healthcare provider?
If you’ve been diagnosed with laryngeal cancer, ask your provider:
Minimally Invasive Procedures for Laryngeal Cancer
Minimally invasive procedures allow doctors to remove laryngeal cancer without making incisions in the neck.
Endoscopic Transoral Resection
In endoscopic transoral resection, a surgeon removes early laryngeal cancer through an endoscope—a thin, lighted tube with a lens at the tip that transmits images to a monitor. Doctors also use a microscope to get a precise view of the anatomy of the area. The procedure may be the only treatment needed for early laryngeal cancer.
During the procedure, the doctor inserts the endoscope through the mouth and into the larynx. He or she places small surgical instruments into the scope to remove the cancer. To spare as much of the vocal cords as possible, doctors may use a laser through the scope to remove or destroy small laryngeal tumours and precancerous tissue, called dysplasia. General anaesthesia is required.
If portions of the larynx need to be removed, they can often be reconstructed to restore your ability to speak.
Open Surgery for Laryngeal Cancer
If laryngeal cancer cannot be easily removed with a minimally invasive procedure, surgeons may perform open surgery, which involves making an incision in the neck. General anaesthesia is used.
Partial Laryngectomy
In a partial laryngectomy, surgeons remove a portion of the larynx while preserving as much of the vocal cords as possible. A partial laryngectomy may be an option in people with early cancer that has not spread.
Total Laryngectomy
For large tumours that affect most or all of the larynx, a total laryngectomy may be necessary. During this procedure, surgeons remove the entire larynx.
The larynx helps you breathe, so surgeons have to create a new pathway for air to flow in and out of the trachea, or windpipe. They connect the trachea to a small, surgically created hole in the neck called a stoma. Air flows in and out of the stoma and into the trachea. Doctors and nurses can help you adapt to using and caring for the stoma.
During or after the laryngectomy, surgeons may insert a small prosthesis connecting the trachea and oesophagus, which is the muscular tube that carries food from the mouth to the stomach, to help restore your voice. Highly trained speech therapists can teach you how to talk using this prosthesis.
The oesophagus is usually not affected by a total laryngectomy, so you can continue to swallow food normally.
Neck Dissection
Laryngeal cancer may spread to the lymph nodes—small organs that make and store lymphocytes, white blood cells that help fight infection—in the neck. If the results of testing show cancer in the lymph nodes, doctors may perform open surgery to remove them, in a procedure called neck dissection.
Doctors may also remove lymph nodes if they appear swollen. They send the nodes to a pathologist, who can determine whether they contain cancer.
Knowing whether the cancer has spread to the lymph nodes and surrounding tissues can help doctors determine whether radiation therapy or a combination of radiation and chemotherapy is necessary after surgery.
Recovery from Surgery for Laryngeal Cancer
Recovery from surgery depends on the type of procedure performed and whether reconstructive surgery is necessary. For example, if surgeons use an endoscopic approach for an early cancer, you may be able to go home the same day. An open surgery to remove large or complex tumours may require a hospital stay of a couple of days so doctors can monitor your recovery and manage any pain and discomfort with medication. If open surgery and reconstruction are necessary, you may remain in the hospital a few days longer.
