Laryngeal cancer is a rare cancer; it accounts for less than 1% of all cancer diagnoses. However, it accounts for nearly a third of all head and neck cancer diagnoses. If you or a loved one has been diagnosed with it, you may have questions about everything from treatment to survivorship. Researchers at the OSUCCC – James actively study head and neck cancers like laryngeal cancer to better understand them. Our team of cancer experts is here to help you understand this disease and to answer any questions you or those supporting you may have.
What is laryngeal cancer?
Laryngeal cancer occurs in the larynx, which is also commonly referred to as the “voice box.” The larynx produces sounds of your voice and helps protect your air passages when you swallow.
Larynx cancer occurs when cancerous cells form in the tissues that line the larynx. Most laryngeal cancers form in the glottis or middle part of the voice box. However, a tumor can form in any part of the larynx. The larynx is separated into three regions.
The three regions of the larynx include:
- Supraglottis – located above the vocal cords
- Glottis – contains the vocal cords and located in the center of the larynx
- Subglottis – area below the vocal cords
Laryngeal cancer can affect one or more of these regions and the tumor's location can influence its treatment.
Types of laryngeal cancer
There are different types of laryngeal cancer.
The most common type is a form called squamous cell carcinoma. Over 90% of laryngeal cancers are squamous cell carcinomas. This type of cancer occurs in squamous cells, which line the larynx’s surface in tissue called the epithelium. The epithelium is a layer of tissue that protects the larynx.
Other less common types of larynx cancer include adenocarcinomas, lymphomas and sarcomas (chondrosarcomas). At the OSUCCC – James, we see and treat a variety of laryngeal cancers and have experts on our team who have experience in managing these rare cases.
What causes laryngeal cancer?
The exact causes of laryngeal cancer are unknown.
Laryngeal cancer occurs when cells replicate and grow out of control. They form a mass (tumor) starting in one of the three regions of the larynx, but in some cases, that can spread to other areas. Our cells contain instructions called “DNA” that tell cells how to grow. In healthy cells, these instructions tell cells to grow and reproduce at a normal rate.
However, in some people, the cell’s DNA may change over time, causing a mutation. When this happens, cells can grow incorrectly and out of control, resulting in a cancerous tumor.
We’re still studying laryngeal cancer, so the exact reasons why this happens in some people and not in others isn’t fully understood. However, researchers know that risk factors play a role in it.
Laryngeal cancer risk factors
A risk factor is anything that increases the likelihood of developing a condition. There are some risk factors you can influence and others you can’t.
Some of the major risk factors for laryngeal cancer include:
- Tobacco use: Smoking cigarettes or using other forms of tobacco greatly increases the chances of developing laryngeal cancer. More than 70% of all laryngeal cancer diagnoses are caused by smoking cigarettes. If you currently smoke cigarettes or use tobacco of any kind, you should quit to reduce the likelihood of developing it. Secondhand cigarette smoke also increases the likelihood of developing laryngeal cancer.
- Excessive alcohol use: Moderate to heavy alcohol use is also associated with laryngeal cancer. Alcohol can irritate and damage the epithelial lining of the larynx, making it more vulnerable to cellular changes. The more alcohol you drink, the higher your risk of developing laryngeal cancer. Those who smoke cigarettes and drink alcohol in excess are at the greatest risk.
- HPV infection: If you’ve been diagnosed with the human papillomavirus (HPV), you’re at an increased risk of developing laryngeal cancer. HPV is the most common sexually transmitted infection and there are over 200 types of it. HPV 16 and 18 are the types often associated with laryngeal cancer diagnoses. HPV can infect the cells of the larynx and cause them to grow abnormally, leading to precancerous or cancerous lesions. HPV is highly transmittable but the likelihood of passing it to others can be reduced by getting vaccinated with Gardasil 9 and practicing safer sex.
- Age: Laryngeal cancer is often diagnosed in people aged 55 years and older. The average diagnosis age is 66 years old. The older you are, the greater the risk of cancer occurring.
- Sex: Males assigned at birth are more likely to develop laryngeal cancer than females assigned at birth. Diagnoses in males are nearly four times higher than in females.
- Previous environmental exposure: If you’ve been previously exposed to different chemicals, you’re at an increased likelihood of developing laryngeal cancer. These substances include Agent Orange, wood dust, paint fumes, asbestos, nickel fumes and diesel exhaust.
If you have one or more risk factors for laryngeal cancer, you should speak with your doctor.
Laryngeal cancer symptoms
Laryngeal cancer can present with different symptoms. It’s important to note that these symptoms may be like other illnesses that aren’t cancer. If you’re at risk of developing laryngeal cancer or have symptoms that last two weeks or more, you should see your doctor to determine an exact cause.
Symptoms of laryngeal cancer may include:
- Sore throat that doesn’t go away
- Difficulty swallowing or chewing food
- Ear pain
- Lump or bump in the throat or neck
- Vocal changes including hoarseness
- Trouble breathing
- Unexplained weight loss
If your doctor determines that you need further testing to determine a cause, they may order tests to form a diagnosis.
Laryngeal cancer diagnosis
Depending on your symptoms, experts at the OSUCC – James will do a physical exam to check overall health and to look for signs of disease. They’ll talk to you about your health habits, past illnesses and treatments to get an understanding of your history. This will include a comprehensive exam of the mouth, tongue, throat and neck.
After a thorough exam often including flexible nasal endoscopy, your doctor may also recommend additional tests including:
These tests may uncover an abnormal growth, mass or lesion, and if so, can help your specialists determine what the possible causes could be. These tests can also help your medical team to tailor an individualized treatment plan specifically for you. Your doctors may order a biopsy from any other area of concern as well. These samples are then sent to a lab where an OSUCCC – James pathologist will review them and form a diagnosis. The pathologist will share the reports with your doctor to determine the next steps for treatment.
Laryngeal cancer treatment
As experts at one of the highest volume cancer facilities in the nation, the OSUCCC – James Head and Neck Program team is experienced in treating head and neck cancers like laryngeal cancer. We offer a variety of treatments that are only offered here and no other facility in the region.
Your doctor may recommend one or more treatment approaches based on your condition. It’s important to remember that no two cases of laryngeal cancer are the same, so your treatment shouldn’t be either.
You may receive one or a combination of treatments, including:
- Surgery: Surgery for laryngeal cancer can greatly depend on several factors, including the location of the surgery and whether it has spread. There are a variety of surgeries that are offered for treatment, but the head and neck cancer team will determine what will work best for you. Your doctor may also recommend chemotherapy or radiation before or after surgery to help shrink a tumor before surgery or lessen the likelihood that cancer will return.
Surgeries for laryngeal cancer may include:
- Cordectomy: This procedure removes all or part of the vocal cords. This procedure will impact your ability to speak.
- Supraglottic laryngectomy: In this procedure, a surgeon removes the upper part of the voice box called the supraglottis and surrounding affected tissue.
- Partial laryngectomy: This procedure has the surgeon remove part of the larynx to save the vocal function and preserve your voice.
- Total laryngectomy: This surgery removes the entire larynx, including your voice box. Most people can swallow liquids or food after this surgery. This surgery will require you to have a permanent hole in the front of the neck so you can breathe.
- Radiation therapy: Radiation therapy uses high doses of radiation (intense X-rays) to kill cancer cells and reduce the size of a cancerous tumor. It may also be used after surgery to prevent a tumor from potentially returning.
- Proton therapy: The OSUCCC – James offers this form of radiation therapy that uses positively charged particles to kill cancerous cells. This minimizes the potential damage to surrounding tissues. Proton therapy can be effective for treating head and neck cancers like laryngeal cancer.
- Chemotherapy: Chemotherapy uses anti-cancer drugs to help shrink a tumor and kill off cancerous cells. These drugs are given at a frequency and dose as determined by your doctor. They can be given intravenously (IV) or taken by mouth in a pill or capsule form.
- Immunotherapy: Immunotherapy uses your body’s own cells to fight off laryngeal cancer. This procedure uses your body’s own cells to boost your immune system to fight off cancerous cells and stop them from coming back. It’s different than targeted drug therapy because it focuses on building your immune system. However, some targeted drug therapy can also be immunotherapy and vice versa.
- Clinical trials: Laryngeal cancer is a complex disease. At the OSUCCC – James, our team of experts is leading the way when it comes to the latest in cancer research. Our head and neck specialists oversee a variety of clinical trials to help understand the complexities of laryngeal cancer and the latest potential treatment options. At any given time, we have over 500 open clinical trials that you may be eligible to participate in. Your doctors will determine if you’re a candidate.
If you’ve been diagnosed with laryngeal cancer, would like a second opinion, please call The James Line at 800-293-5066 or 614-293-5066 to make an appointment.