Laryngeal cancer

Laryngeal cancer occurs when the genetic material of cells in the larynx become damaged or changed, producing mutations that affect normal cell growth and division. The abnormal cells then replicate, causing cancer. If undetected, the cancer can spread beyond the voice box and move to other parts of the body.

Laryngeal cancer is an uncommon type of cancer. In the UK, there are about 2,300 new cases of laryngeal cancer each year. The condition is rare in people under 40, with most cases affecting people aged 60 years or over, and is four times more common in men than women.

Symptoms of laryngeal cancer

Most laryngeal cancers develop near the vocal cords, so one of the first noticeable symptoms is often a change in the sound of your voice, such as sounding unusually hoarse or finding it difficult to speak. Other symptoms include:

• Pain when swallowing or difficulty swallowing
• A lump or swelling in your neck
• Persistent cough
• Bad breath
• Earache
• Breathlessness
• A high-pitched wheezing noise when breathing
• Unexplained weight loss
• Fatigue and weakness

If you have been experiencing any of these symptoms for more than three weeks, or if you have any concerns about similar symptoms, it is essential that you see your doctor as your chances of recovery are much higher if your cancer is diagnosed early.

How is laryngeal cancer diagnosed?

Your consultant or oncologist will advise you on which tests are relevant to your individual symptoms. Because laryngeal cancer is rare, and the symptoms could indicate a wide range of other conditions, diagnosing the disease involves a large number of different tests. These include:

• A physical examination of the inside and outside of your throat for abnormalities, such as lumps and swellings
• A Nasendoscopy, which involves a small, flexible tube with a light and video camera at one end (endoscope) being inserted into one of your nostrils and passed into the back of your throat, so the images from the endoscope are displayed on a monitor
• A Laryngoscopy, which involves using an endoscope to examine your larynx, which is inserted through the mouth. This allows medical staff to see the larynx in greater detail and is usually done under anaesthetic
• A biopsy, where cell samples are taken for examination for signs of cancer, and can usually be done at the same time as a nasendoscopy or laryngoscopy. Alternatively, if you have a lump in your neck, a needle and syringe can be used to remove a tissue sample. This is known as fine-needle aspiration

If the results of the biopsy show you have cancer and there’s a risk it may have spread, you’ll probably be referred for further testing to assess how widespread the cancer is.

Treatment of laryngeal cancer

Patients with laryngeal cancer are treated by a specialist multidisciplinary team. This team works together to create a treatment plan to suit the individual needs of the patient. Laryngeal cancer can be treated in a variety of ways, depending on the severity of the cancer. Treatments include:

• Surgery, which could be:
  
  • An Endoscopic Resection: involves a surgeon removing cancer with a laser or small surgical instruments
  • A Partial Laryngectomy: removing the affected part of the larynx. This operation in now uncommon in the UK as most surgeons prefer to do an Endoscopic Resection whenever possible
  • A Total Laryngectomy: usually used to treat advanced laryngeal cancer, involves removing the entire larynx, and potentially any nearby lymph nodes that have been affected by the cancer
• Radiotherapy: where high-energy rays are used to destroy the cancer cells
• Chemotherapy: where chemical agents used to destroy and prevent cancer cells from spreading to different areas