Laryngeal cancer is a rare form of throat cancer that develops in the larynx, commonly known as the voice box. This cancer begins when a cell within the larynx mutates and starts to multiply rapidly.
The voice box is a vital structure that houses the vocal cords, enabling us to speak. It also functions as a crucial valve, opening to allow breathing and closing to prevent food or drink from entering the trachea (windpipe).
The central portion containing the vocal cords.
The area situated above the vocal cords.
The area located below the vocal cords and above the trachea.
Nearly all laryngeal cancers originate in the lining of the structure, which is composed of thin, flat cells called squamous cells. For this reason, most cases are classified as squamous cell carcinoma.
A risk factor is anything that increases an individual's likelihood of developing a specific disease. Key risk factors for laryngeal cancer include:
Individuals who use tobacco have a significantly increased risk.
Frequent consumption of large amounts of alcohol is another major risk factor.
Males are more likely to develop laryngeal cancer than females.
Most cases are diagnosed in people over the age of 55, and it is rarely found in those under 45.
The condition is more common in Black and white people compared to Hispanic and Asian populations.
Gastric reflux is also a risk factor for laryngeal cancer.
Symptoms of laryngeal cancer may include:
This is the most common symptom and occurs when a tumour affects the vocal cords.
A sore throat that does not go away may indicate laryngeal cancer.
This can result from swollen lymph nodes.
Trouble swallowing food or liquids may be a symptom.
Persistent ear pain may be associated with laryngeal cancer.
Ongoing bad breath can be a symptom of laryngeal cancer.
Important Note: It is important to remember that these symptoms do not definitively mean you have cancer. However, if you experience any of these, it is essential to discuss them with your doctor, as they may indicate other health issues.
Early and accurate diagnosis of laryngeal cancer is crucial, as it significantly increases the chance of successful treatment while helping to preserve a patient's quality of life, including their ability to speak and swallow.
If you have symptoms suggestive of laryngeal cancer, your doctor will perform a thorough examination and ask questions about your health, lifestyle (including smoking and drinking habits), and family medical history.
The following tests are used to diagnose laryngeal cancer, determine if it has spread (staged), and monitor the disease's response to treatment:
This is often the first diagnostic test. A doctor passes a small, flexible camera through the nose to examine the larynx. This procedure helps the doctor determine if a biopsy is required.
A biopsy is the only way to definitively diagnose throat cancer. It involves doctors retrieving suspected cancerous tissue for microscopic study. Different methods are used depending on the tumour's location:
Imaging exams help to precisely locate the suspected cancer, check for spread, and monitor the disease's progression and treatment response. These may include:
These tests are used to assess the throat's function, which is critical for treatment planning. Types of swallowing tests include:
Staging is the process of determining the extent of the disease and whether it has spread. This information is essential for doctors to decide on the most appropriate treatment and determine the outlook for recovery.
SSCHRC offers personalised laryngeal cancer treatment to maximise the chances of a cure while maintaining a special focus on the patient's quality of life. As the oropharynx is critical for speaking, breathing, and swallowing, treatment plans often prioritise preserving these functions alongside eliminating the cancer.
If the disease is detected early, the patient may receive radiation therapy, sometimes combined with chemotherapy. Patients with more advanced disease may require surgery.
Surgical options for laryngeal cancer include:
This procedure removes only the cancerous area of the larynx, preserving as much healthy tissue as possible to maintain function. Patients can usually still speak normally after a partial laryngectomy, though with some degree of hoarseness.
The entire larynx, including the vocal cords, is removed. Patients will require a permanent opening (stoma) in the neck to breathe through and will need assistance from speech pathologists to learn new methods of communication.
This procedure involves removing lymph nodes from the neck. As lymph nodes are part of the immune system and are often the first site for cancer to spread, a neck dissection is frequently performed concurrently with a total or partial laryngectomy.
Radiation therapy uses focused, powerful beams of energy to destroy cancer cells. Various techniques are employed to accurately target the tumour while minimising damage to surrounding healthy tissue. Types of radiation therapy include:
This technique focuses multiple radiation beams of varying intensities directly onto the tumour for the highest possible dose. A variation of IMRT is Volumetric Modulated Arc Therapy (VMAT), which uses a rotating treatment machine to deliver radiation from multiple angles.
This advanced approach uses a specialised device to adjust treatment on a daily basis, which can reduce side effects and effectively treat tumours that change shape or position.
Also known as stereotactic ablative radiotherapy, SBRT precisely targets tumours with very high doses of radiation by using several beams of various intensities aimed at the tumour from different angles.
Chemotherapy involves the use of drugs to kill cancer cells, control their growth, or relieve disease-related symptoms. Treatment may consist of a single drug or a combination of two or more, depending on the cancer type and its rate of growth.
Targeted therapy drugs are specifically designed to stop or slow the growth or spread of cancer at a cellular level. Cancer cells depend on specific molecules (often proteins) to survive, multiply, and spread. Targeted therapies are designed to interfere with, or target, these molecules or the cancer-causing genes that produce them.
These are a type of immunotherapy that works by preventing the body's immune system from 'turning off' before the cancer is fully eliminated. For laryngeal cancer, immune checkpoint inhibitors are currently approved for use only in Stage IV disease and may be used alone or combined with other treatments such as surgery or radiation.
Because throat cancer and its treatments can affect a person's ability to eat, drink, and speak, as well as their appearance, SSCHRC offers a range of therapies and services to help patients adjust to and overcome these challenges:
SSCHRC speech pathologists and audiologists provide the most advanced techniques for restoring speech after cancer treatment.
Experts in the Speech Pathology and Audiology Section are dedicated to evaluating and treating patients who experience difficulty eating, drinking, and swallowing after treatment.
Our renowned reconstructive surgeons can perform procedures to help restore a patient's appearance impacted by throat cancer treatment.
SSCHRC dentists specialise in designing implants and performing procedures to help patients restore appearance and function when their teeth and jaw are damaged by the disease or its treatments.
A dedicated survivorship clinic addresses the long-term needs of head and neck cancer patients.
Regular follow-up appointments and screenings are vital after treatment due to the high risk of the cancer returning (recurring) in the throat or other areas of the head and neck. Patients are advised to see their doctors every three to six months for the first two years after treatment, as most recurrences happen within this period. Furthermore, throat cancer patients are strongly urged to abstain from smoking and drinking alcohol both during and after treatment, as these habits can reduce the effectiveness of treatment, worsen side effects, and significantly increase the chance of the cancer returning.