Cancer of the Larynx

(Laryngeal Cancer, Vocal Cord Cancer, Cancer of the Glottis, Throat Cancer)

In this factsheet:
• The Facts on Cancer of the Larynx
• Causes of Cancer of the Larynx
• Symptoms and Complications of Cancer of the Larynx
• Diagnosing Cancer of the Larynx
• Treating and Preventing Cancer of the Larynx

The Facts on Cancer of the Larynx

The larynx, also called the voice box or Adam's apple, is the part of the body that allows humans to produce sounds and speech. The larynx contains the vocal cords (glottis), which vibrate when air passes through. The epiglottis is a small flap of cartilage found at the top of the larynx. The epiglottis protects the airways by keeping food and saliva from going down the trachea (the "windpipe" tube that leads to the lungs).

Cancer of the larynx can occur on the glottis (most laryngeal cancers are there), the supraglottis (the area above the vocal cords that includes the epiglottis), or the subglottis (the area that connects the larynx to the trachea).

Cancer of the larynx affects more men then women, although more women are developing it today due to an increase in smoking in the female population.

Causes of Cancer of the Larynx

Although the exact cause of cancer is unknown, some known risk factors for cancer of the larynx include:

• smoking: The risk of laryngeal cancer increases up to 30 times for smokers. The heavier the person smokes, the higher the risk. Second-hand smoke is also considered a hazard.
• alcohol: Heavy drinkers more than double their risk for this type of cancer, and combining smoking with alcohol can increase the risks even more than either drinking or smoking alone.
• gastroesophageal reflux disease (GERD): In GERD, the stomach acid backs up into the esophagus, causing a burning pain. Although not definitively proven, researchers have found that irritation from longstanding GERD is related to higher chances of laryngeal cancer.
• poor nutrition: Many people who abuse alcohol also have poor nutritional habits, but some research also suggests that not getting enough vitamins might be a risk factor.
• human papillomavirus (HPV): The virus that can cause genital warts can also develop into certain cancers. Mothers may pass the virus on to their children when they're born. It settles in the larynx, developing into growths called laryngeal papillomas later on in life. These growths may develop into cancer.
• race: Laryngeal cancer is found twice as often among people of African descent than among Caucasians.
• gender: More men than women are diagnosed with cancer of the larynx.
• age: This type of cancer is usually detected in people between 50 and 75 years old.
• weakened immune system: People with weak immune systems (due to diseases such as AIDS or medications that lower immunity to viruses) are more susceptible to laryngeal cancer.
• toxic exposure: These risk factors include being exposed to wood dust, asbestos, or many types of chemicals that can increase the chances of cancer.
• voice overuse: People who use their voices a lot, such as singers, may develop polyps (lumps of tissue) that can become cancerous if not removed.

Symptoms and Complications of Cancer of the Larynx

The symptoms of laryngeal cancer depend on where in the larynx the tumour is located. Cancer on the vocal cords can often be detected early because the main symptom is hoarseness. Most people go hoarse from time to time, but if the hoarseness doesn't go away in two weeks, it should be checked.

Symptoms that the cancer has spread or is occurring in another part of the larynx include:

• a cough that doesn't go away
• persistent sore throat
• breathing difficulties, or feeling that something is catching in the throat
• ear pain (pain from deep in the throat can be felt in the ear)
• a lump or mass in the neck or throat
• coughing up of blood

There are a few complications that can result from laryngeal cancer.

Airway obstruction: Any tumour or swelling in the airway can cause a blockage, making breathing difficult. If treatment involves total removal of the larynx, a tracheostomy (surgery to create an artificial airway in the trachea) is then performed to improve breathing.

Disfigurement: Removing the tumour and surrounding tissue could leave some disfigurement of the throat and neck. Muscles might be removed as well, making neck movement more difficult. If a tracheostomy was performed, the stoma (opening in the throat) is sometimes permanent.

Difficulty eating: After surgery, it may become difficult to swallow certain consistencies of food. Those undergoing radiotherapy may have trouble swallowing or even chewing. Chemotherapy can cause nausea and vomiting. A good, healthy diet is vital when recuperating from cancer, so it's important that adequate nutrition be maintained throughout the treatment.

Cancer spread: It's possible that the cancer may spread to other areas of the body.

Voice loss: Treatment that involves removing the entire larynx makes normal speech impossible. In this case, alternate methods of speaking need to be learned. These are:

• esophageal speech: This is the most basic form of alternate speech, which is done by swallowing air and creating sound by expelling it.
• tracheoesophageal puncture (TEP): A small one-way valve is placed between the trachea and esophagus. By taking in air through their stoma into the lungs, then covering their stoma (from the tracheostomy), sounds can be made through the mouth.
• electrolarynx: When you hold this electronic device next to the skin of the throat or the corner of the mouth, it produces a mechanical voice. Muscle movements stimulate the machine to make sounds.

While these new methods of speech are being learned, other ways of communicating will be needed. This might mean keeping a "magic slate" or pad and pencils easily available. It's important to plan ahead to help avoid frustration after surgery.

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