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Laryngeal Cancer

Cancer experts at UT Southwestern Medical Center have the experience and training needed for complex head and neck cancers such as laryngeal cancer. We offer comprehensive care to diagnose and treat the disease, with specialized services to help patients and their families throughout treatment.

As the only National Cancer Institute-designated comprehensive cancer center in North Texas, we deliver the best cancer care available today and push to discover new treatments. NCI designation means we offer patients the ability to participate in the broadest possible range of clinical trials, with access to potential therapies not available at other facilities.

Experienced Care for Laryngeal Cancer

Cancer that develops in the voice box (larynx) is called laryngeal cancer. The larynx is vital for breathing, talking, and swallowing and prevents food, drinks, and other objects from going into the windpipe and into the lungs.

Laryngeal cancer is a type of head and neck cancer, and almost all laryngeal cancers are squamous cell carcinomas. Squamous cells are thin, flat cells that make up the lining of the larynx and many other parts of the body.

At the Harold C. Simmons Comprehensive Cancer Center, we have surgeons, doctors, nurses, and other providers who specialize in treating cancers of the head and neck. Our team for laryngeal cancer care includes ear, nose, and throat (ENT) specialists; radiation and medical oncologists; oral and reconstructive surgeons; physical and occupational therapists; and speech pathologists.

Causes and Risk Factors of Laryngeal Cancer

Patients can help prevent laryngeal cancer by avoiding certain risk factors. Not everyone with risk factors will go on to develop laryngeal cancer. Also, people without known risk factors can develop the disease. Risk factors include:

  • Age, with most people being diagnosed over age 55
  • Alcohol use
  • Tobacco use
  • Exposure to and inhalation of certain substances such as asbestos, wood dust, paint fumes, and certain industrial chemicals

Risk factors can increase the chances of developing laryngeal cancer. Learn more about head and neck cancer awareness and prevention.

Symptoms of Laryngeal Cancer

Some people do not experience any symptoms, and some symptoms can occur simultaneously with other conditions. Patients should see their doctors if they experience any of these symptoms that persist:

  • Changes in the voice, such as hoarseness
  • Choking
  • Difficulty breathing or obstructed airway
  • Difficulty or pain when swallowing
  • Ear pain
  • Enlarged lymph node or lump in the neck
  • Fatigue
  • Sore throat or feeling of something being stuck in the throat
  • Unexplained weight loss

Stages of Laryngeal Cancer

Cancer staging is the process doctors use to determine how large a tumor is, whether cancer has spread, and, if so, how far. The stages of laryngeal cancer include:

Stage 0 (Carcinoma in Situ)

The lining of the larynx contains abnormal cells, which might become cancer and spread into nearby normal tissue. 

Stage I: Cancer has formed

Cancer has formed. Stage I laryngeal cancer depends on where cancer began in the larynx:

  • Supraglottis: Cancer is in only one area of the supraglottis, and the vocal cords can move normally.
  • Glottis: Cancer is in one or both vocal cords, and the vocal cords can move normally.
  • Subglottis: Cancer is only in the subglottis. 

Stage II: Cancer is only in the larynx

Stage II laryngeal cancer also depends on where cancer began in the larynx:

  • Supraglottis: Cancer is in more than one area of the supraglottis or surrounding tissues.
  • Glottis: Cancer has spread to the supraglottis and/or the subglottis, and/or the vocal cords cannot move normally.
  • Subglottis: Cancer has spread to one or both vocal cords, which might not move normally.

Stage III: Depends on whether cancer has spread from the supraglottis, glottis, or subglottis

In stage III cancer of the supraglottis:

  • Cancer is in only the larynx and the vocal cords cannot move, and/or cancer is in tissues next to the larynx. Cancer might have spread to one lymph node on the same side of the neck as the original tumor, and the lymph node is 3 centimeters or smaller; or
  • Cancer is in one area of the supraglottis and in one lymph node on the same side of the neck as the original tumor. The lymph node is 3 centimeters or smaller, and the vocal cords can move normally; or
  • Cancer is in more than one area of the supraglottis or surrounding tissues and in one lymph node on the same side of the neck as the original tumor. The lymph node is 3 centimeters or smaller.

In stage III cancer of the glottis:

  • Cancer is in only the larynx and the vocal cords cannot move, and/or cancer is in tissues next to the larynx. Cancer might have spread to one lymph node on the same side of the neck as the original tumor and the lymph node is 3 centimeters or smaller; or
  • Cancer is in one or both vocal cords and in one lymph node on the same side of the neck as the original tumor. The lymph node is 3 centimeters or smaller and the vocal cords can move normally; or
  • Cancer has spread to the supraglottis and/or the subglottis, and/or the vocal cords cannot move normally. Cancer has also spread to one lymph node on the same side of the neck as the original tumor, and the lymph node is 3 centimeters or smaller.

In stage III cancer of the subglottis:

  • Cancer is in the larynx and the vocal cords cannot move. Cancer might have spread to one lymph node on the same side of the neck as the original tumor, and the lymph node is 3 centimeters or smaller; or
  • Cancer is in the subglottis and in one lymph node on the same side of the neck as the original tumor. The lymph node is 3 centimeters or smaller; or
  • Cancer has spread to one or both vocal cords, which might not move normally. Cancer has also spread to one lymph node on the same side of the neck as the original tumor, and the lymph node is 3 centimeters or smaller. 

Stage IV: Has three substages: IVA, IVB, and IVC. Each substage is the same for cancer in the supraglottis, glottis, or subglottis

In stage IVA:

  • Cancer has spread through the thyroid cartilage and/or has spread to tissues beyond the larynx such as the neck, trachea, thyroid, or esophagus. Cancer might have spread to one lymph node on the same side of the neck as the original tumor, and the lymph node is 3 centimeters or smaller; or
  • Cancer has spread to one lymph node on the same side of the neck as the original tumor, and the lymph node is larger than 3 centimeters but not larger than 6 centimeters, or has spread to more than one lymph node anywhere in the neck with none larger than 6 centimeters. Cancer might have spread to tissues beyond the larynx, such as the neck, trachea, thyroid, or esophagus. The vocal cords might not move normally.

In stage IVB:

  • Cancer has spread to the space in front of the spinal column, surrounds the carotid artery, or has spread to parts of the chest. Cancer might have spread to one or more lymph nodes anywhere in the neck, and the lymph nodes might be any size; or
  • Cancer has spread to a lymph node that is larger than 6 centimeters and might have spread as far as the space in front of the spinal column, around the carotid artery, or to parts of the chest. The vocal cords might not move normally.

In stage IVC, cancer has spread to other parts of the body, such as the lungs, liver, or bones. 

Diagnosis of Laryngeal Cancer

UT Southwestern’s experienced cancer specialists conduct a thorough evaluation, which includes a:

  • Physical exam
  • Discussion of personal and family medical history
  • Discussion of symptoms and risk factors

To confirm a diagnosis, our doctors might recommend one or more tests, such as:

  • Laryngoscopy: We sometimes use a scope (a thin, flexible tube with a lighted camera), which is inserted through the nose for a closer look into the throat.
  • Videostroboscopy: Similar to a laryngoscopy, this test uses a scope with a video camera to record the larynx as the patient produces various sounds. We use videostroboscopy to view vibration abnormalities that can help detect cancer and determine the size and location of a tumor.
  • Barium swallow: The patient swallows liquid barium, a substance that shows up on X-rays, and then X-rays are taken. Barium swallows can show abnormalities in the throat and evaluate swallowing.
  • Computed tomography (CT) scan: CT uses specialized X-rays with or without a contrast agent to produce cross-sectional 3D images of the throat.
  • Magnetic resonance imaging (MRI) scan: MRI uses radio waves and a strong magnet, with or without a contrast agent, to produce detailed images of the throat. MRI can also show whether cancer has spread to lymph nodes in the neck.
  • Positron emission tomography (PET)/CT scan: Using small amounts of radioactive materials and a special camera, PET scans produce highly detailed images that can detect cancerous cells. At UT Southwestern, we use combined PET and CT scanning equipment to produce enhanced images that can help detect abnormal tissue that might be cancerous. PET scanning shows bodily functions such as blood flow and sugar metabolism, and CT scans provide detailed anatomical information for organs, bones, soft tissue, and blood vessels.
  • Biopsy: Our doctors take a small tissue sample that a pathologist analyzes under a microscope for the presence of cancer. We perform biopsies using a needle or during a laryngoscopy, using a special tool on the scope.

Treatment for Laryngeal Cancer

Treatment options vary based on the stage of cancer and its size, location, and whether it has spread. Our doctors also work to preserve the larynx whenever possible. The most common treatments for laryngeal cancer are surgery and radiation therapy. 

We use the following treatment options for laryngeal cancer, sometimes in combination:

Surgery: Patients with early-stage laryngeal cancer might need only surgery, whereas advanced cancers might require more comprehensive treatments given after performing surgery, known as adjuvant therapy. Depending on the extent of the cancer, surgical options include:

  • Cordectomy to remove all or part of the vocal cords
  • Partial laryngectomy to remove part of the larynx, which can preserve the ability to talk
  • Total laryngectomy to remove the entire larynx and create a new opening for breathing, requiring patients to learn a new way to speak
  • Thyroidectomy to remove all or part of the thyroid gland, if cancer has spread there
  • Neck dissection to remove one or more lymph nodes or other tissues in the neck, if cancer has spread there

Radiation therapyOur doctors use radiation, treatment with high-energy waves such as X-rays or gamma rays, to treat cancer. Radiation or surgery is usually the first treatment option for laryngeal cancer, and these therapies can treat and sometimes definitively cure it. Radiation therapy can destroy cancer cells left after surgery, and it can also treat inoperable tumors.

Chemotherapy: Anticancer medications work to destroy cancer cells and prevent them from spreading. Sometimes we use chemotherapy after radiation therapy or surgery to destroy as many cancer cells as possible. Chemotherapy can also treat laryngeal cancer that has spread to other areas of the body (metastatic) or cancer that comes back after treatment (recurrent).

Chemoradiation: Chemotherapy given at the same time as radiation therapy is known as chemoradiation. We use it whenever possible to help patients avoid a laryngectomy (removal of the larynx) and preserve the voice and swallowing ability.

Immunotherapy: This type of medication enhances the immune system’s natural ability to destroy cancer cells. Sometimes we use chemoradiation as adjuvant therapy after performing surgery or radiation or for metastatic,or recurrent cancer.

Targeted therapy: Certain anticancer medications target a specific characteristic of a cancer cell, which can be detected through specialized testing. People whose cancers have these characteristics can be treated with targeted therapy, usually in combination with radiation or chemotherapy. Sometimes we use targeted therapy as adjuvant therapy after performing surgery or radiation or for metastatic or recurrent cancer.

Reconstructive surgery: Patients with advanced laryngeal cancer might need reconstruction after cancer surgery. Our plastic surgery and ENT experts work together to restore swallowing and other oral functions for a more natural appearance of the throat and neck.

For patients who are having radiation therapy for laryngeal cancer, we recommend having any necessary dental work done before treatment. Radiation treatment slows healing and can cause other side effects. Learn more about cancer and transplant dental care.

At UT Southwestern’s Harold C. Simmons Comprehensive Cancer Center, patients have access to every available treatment option, delivered by the most experienced head and neck cancer specialists in Dallas. Find out more about all the options we offer for head and neck cancer treatment.

Support Services

We offer a variety of head and neck cancer support services for patients and their families, such as:

Clinical Trials

As a medical research institution, UT Southwestern frequently conducts head and neck cancer clinical trials, giving our patients access to the latest treatments. Patients should speak with their doctors about the availability of clinical trials.

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We have a wide range of clinical trials open to patients with all stages of cancer. Search for opportunities to participate in a cancer study.

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