Laryngeal cancer - diagnosis and treatment (2023)

To diagnose

To diagnose throat cancer, your doctor may recommend the following:

  • Use an endoscope to take a closer look at your neck.Your doctor may use a special lighted scope (endoscope) to take a close look at your throat during a procedure called an endoscopy. A camera at the end of the endoscope transmits images to a video screen, which your doctor monitors for signs of abnormalities in your throat.

    Another type of endoscope (laryngoscope) may be inserted into your larynx. You use a magnifying glass to help your doctor examine your vocal cords. This procedure is called laryngoscopy.

  • Taking a tissue sample for analysis.If abnormalities are found during an endoscopy or laryngoscopy, your doctor may insert surgical instruments through the endoscope to obtain a tissue sample (biopsy). The sample is sent to a laboratory for analysis.

    In the laboratory, specially trained doctors (pathologists) look for signs of cancer. The tissue sample can also be analyzedHPV, as the presence of this virus affects treatment options for certain types of throat cancer.

  • Imaging tests.Imaging tests, including computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET), can help your doctor determine the extent of your cancer beyond the surface of your throat or larynx.

staging

Once throat cancer has been diagnosed, the next step is to determine the extent (stage) of the cancer. Knowing the stage will help determine your treatment options.

The stage of laryngeal cancer is indicated by Roman numerals I through IV. Each subtype of throat cancer has its own criteria for each stage. Stage I throat cancer usually indicates a smaller tumor that is confined to one area of ​​the throat. Later stages indicate a more advanced cancer, with stage IV being the most advanced.

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More information

  • Throat cancer treatment at Mayo Clinic
  • computed tomography
  • TRM
  • Nadelbiopsie
  • Positron emission tomography
  • bone scan

Treatment

Your treatment options are based on many factors, such as the location and stage of your throat cancer, the type of cells affected, and whether the cells show signs of cancer.HPVinfection, your general health and your personal preferences. Discuss the benefits and risks of each of your options with your doctor. Together you can determine which treatments are best for you.

radiotherapy

Radiation therapy uses high-energy beams from sources such as x-rays and protons to deliver radiation to cancer cells, causing them to die.

Radiation therapy may come from a large machine outside your body (external beam radiation therapy), or radiation therapy may come from small radioactive seeds and wires that may be placed inside your body near your cancer (brachytherapy).

For small throat cancer or throat cancer that has not spread to lymph nodes, radiation therapy may be the only treatment needed. For more advanced throat cancer, radiation therapy may be combined with chemotherapy or surgery. Radiation therapy may be used for very advanced throat cancer to reduce signs and symptoms and make you feel better.

Operation

The types of surgery you may consider to treat your throat cancer depend on the location and stage of your cancer. Options may include:

  • Surgery for small throat cancer or throat cancer that has not spread to lymph nodes.Laryngeal cancer that is limited to the surface of the throat or vocal cords can be treated surgically through endoscopy. Your doctor may insert a hollow scope down your throat or larynx and then pass special surgical tools or a laser through the scope. With these tools, your doctor can scrape, ablate, or, in the case of lasers, vaporize very superficial cancers.
  • Surgery to remove all or part of the larynx (laryngectomy).For smaller tumors, your doctor may remove the part of your larynx that is affected by the cancer, leaving as much of the larynx as possible. Your doctor may be able to preserve your ability to speak and breathe normally.

    For larger, more extensive tumors, it may be necessary to remove the entire larynx. Your windpipe is then attached to a hole (stoma) in your neck to allow you to breathe (tracheostomy). If your entire larynx was removed, you have several options to restore your speech. You can work with a speech therapist to learn to speak without your voice box.

  • Surgery to remove part of the throat (pharyngectomy).For minor throat cancers, only small parts of the throat may need to be removed during surgery. The removed parts can be reconstructed to allow you to swallow food normally.

    Surgery to remove more of the throat usually involves removing the larynx as well. Your doctor may be able to reconstruct your throat so that you can swallow food.

  • Surgery to remove cancerous lymph nodes (neck dissection).If throat cancer has spread deep into the throat, your doctor may recommend surgery to remove some or all of the lymph nodes to see if they contain cancer cells.

Surgery carries the risk of bleeding and infection. Other potential complications, such as B. Difficulty speaking or swallowing depends on the specific procedure you are undergoing.

chemotherapy

Chemotherapy uses drugs to kill cancer cells.

Chemotherapy is often used along with radiation therapy in the treatment of throat cancer. Certain chemotherapy drugs make cancer cells more sensitive to radiation therapy. But the combination of chemotherapy and radiation therapy increases the side effects of both treatments.

Talk to your doctor about the side effects you are likely to experience and whether combination treatments offer benefits that outweigh these effects.

Targeted drug therapy

Targeted drugs treat throat cancer by taking advantage of specific defects in cancer cells that stimulate cell growth.

For example, the drug cetuximab (Erbitux) is a targeted therapy approved to treat throat cancer in certain settings. Cetuximab works by stopping the action of a protein that is found in many types of healthy cells but is more common in certain types of throat cancer cells.

Other targeted drugs are available and are being further studied in clinical trials. Targeted drugs can be used alone or in combination with chemotherapy or radiation therapy.

immunotherapy

Immunotherapy uses your immune system to fight cancer. Your body's disease-fighting immune system may not attack your cancer because cancer cells make proteins that help them hide from immune system cells. Immunotherapy works by interfering with this process.

Immunotherapy treatments are generally reserved for people with advanced throat cancer who don't respond to standard treatments.

rehabilitation after treatment

Treatment for throat cancer often causes complications that may require working with specialists to improve the ability to swallow, eat solid food, and speak. During and after treatment for throat cancer, your doctor may ask you for help with:

  • Repair of a surgical opening in the throat (stoma) if you have had a tracheostomy
  • difficulties eating
  • swallowing difficulties
  • Stiffness and pain in the neck
  • Language problems

Your doctor can talk with you about the possible side effects and complications of your treatments.

Supportive care (palliative)

Palliative care is specialized medical care focused on relieving pain and other symptoms of a serious illness. Palliative care specialists work with you, your family and your other doctors to provide an extra layer of support to complement your ongoing care. Palliative care can be used while other aggressive treatments are being given, such as surgery, chemotherapy, or radiation therapy.

When palliative care is used with all other appropriate treatments, people with cancer can feel better and live longer.

Palliative care is provided by a team of specially trained doctors, nurses, and other professionals. Palliative care teams aim to improve the quality of life for people with cancer and their families. This form of care is offered in conjunction with any healing or other treatments you may receive.

More information

  • Throat cancer treatment at Mayo Clinic
  • brachytherapy
  • chemotherapy
  • Enteral nutrition at home.
  • radiotherapy
  • Transoral Robotic Surgery

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clinical trials

Explore Mayo Clinic studiesExperiment with new treatments, interventions, and tests as a means of preventing, detecting, treating, or managing this condition.

lifestyle and home remedies

stop smoking

Throat cancer is closely related to smoking. Not all people with throat cancer smoke. But if you smoke, now is the time to quit because:

  • Smoking makes treatment less effective
  • Smoking makes it harder for your body to heal after surgery
  • Smoking increases the risk of developing another type of cancer in the future

Quitting smoking can be very difficult. And it's even harder when you're trying to cope with a stressful situation like a cancer diagnosis. Your doctor can discuss all of your options, including medications, nicotine replacement products, and counseling.

stop drinking alcohol

Alcohol, especially when combined with smoking or chewing tobacco, significantly increases the risk of throat cancer. If you drink alcohol, stop now. This can help reduce the risk of developing a second cancer. Quitting drinking can also help you better tolerate throat cancer treatments.

alternative medicine

No alternative treatment has been shown to be helpful in treating throat cancer. However, some complementary and alternative treatments can help you cope with your diagnosis and the side effects of throat cancer treatment. Talk to your doctor about your options.

Alternative treatments that you may find helpful include:

  • Acupuncture
  • message therapy
  • Meditation
  • relaxation techniques

coping and support

A cancer diagnosis can be devastating. Throat cancer affects a part of your body that is essential for everyday activities, such as breathing, eating, and speaking. In addition to worrying about how these basic activities might be affected, you may also be concerned about your treatments and chances of survival.

Even if you feel like your life, your survival, is out of your hands, there are steps you can take to feel more in control and cope with your diagnosis of throat cancer. Try the following to fix it:

  • Learn enough about throat cancer to make treatment decisions.Write a list of questions to ask your doctor at your next appointment. Ask your doctor for other sources of information about your cancer. Knowing more about your specific condition can help you feel more comfortable making treatment decisions.
  • Find someone to talk to.Find sources of support that can help you deal with the emotions you are feeling. Perhaps you have a close friend or family member who is a good listener. Ministers and counselors are other options. Consider joining a support group for people with cancer. Contact your local chapter of the American Cancer Society (ACS) or support people with mouth, head, and neck cancer. HeACSThe Cancer Survivor Network offers online message boards and chat rooms that you can use to connect with other people with throat cancer.
  • Take care of yourself during cancer treatment.Be sure to keep your body healthy during treatment. Avoid additional stress. Get enough sleep each night to wake up refreshed. Go for a walk or take time to exercise if you feel like it. Take some time to relax, such as listening to music or reading a book.
  • Keep all your follow-up appointments.Your doctor will schedule follow-up visits every few months for the first two years after treatment, and less frequently thereafter. These tests allow your doctor to monitor your recovery and check for a recurrence of cancer.

    Follow-up visits can make you nervous, as they may remind you of your original diagnosis and treatment. You may be concerned that his cancer has come back. Expect some anxiety around the time of each follow-up appointment. Plan ahead by finding relaxing activities that can help take your mind off your fears.

Prepare for your date

Make an appointment with your GP if you have any signs or symptoms that worry you. If your doctor suspects that you have cancer or another condition that affects the throat, he or she may refer you to an ear, nose, and throat (ENT) specialist.

Because appointments can be short and there is often a lot of information to discuss, it's a good idea to prepare. Here is information to help you prepare and what to expect from your doctor.

What you can do

  • Observe all restrictions prior to appointment.When you make an appointment, be sure to ask if there is anything you need to do in advance, such as B. Restrict your diet.
  • Write down any symptoms you haveincluding any that appear unrelated to the reason you made the appointment.
  • Write down important personal information,including major stress or recent life changes.
  • Make a list of all medicationsVitamins or supplements you are taking.
  • Consider taking a family member or friend with you.Sometimes it can be difficult to remember all the information provided during an appointment. Someone accompanying you may remember something you missed or forgot.
  • Write down the questions you want to askyou doctor

Your time with your doctor is limited, so making a list of questions can help you make the most of your time together. In case time runs out, please number your questions from most important to least important. If you have throat cancer, there are some basic questions to ask your doctor:

  • What is likely causing my symptoms or condition?
  • Are there other possible causes of my symptoms or condition?
  • What types of tests do I need?
  • What is the best course of action?
  • What alternatives are there to the approach you propose?
  • I have these other health conditions. How can I better manage them together?
  • Are there any restrictions that I must follow?
  • Should I see a specialist? How much does it cost and will my insurance cover it?
  • Is there a generic alternative to the medication you are prescribing?
  • Are there brochures or other printed material that I can take with me? What websites do you recommend?
  • What determines if I should schedule a follow-up visit?

In addition to the questions you want to ask your doctor, don't hesitate to ask any other questions that come to mind.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. If you are ready to answer them, you may have time later to bring up the points you want to raise. Your doctor may ask:

  • When did you first experience symptoms?
  • Have your symptoms been continuous or intermittent?
  • How severe are your symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, seems to be making your symptoms worse?

What you can do in the meantime

If you use tobacco, stop. Avoid things that make your symptoms worse. If you have a sore throat, avoid foods and drinks that cause further irritation. If you're having trouble eating because of a sore throat, consider supplemental drinks. These can be less irritating to your throat while still providing the calories and nutrients you need.

By Mayo Clinic staff

15. September 2022

FAQs

How is laryngeal cancer diagnosed? ›

The tests may include: a CT scan – a series of X-rays are taken to build up a more detailed three-dimensional picture of your larynx and the surrounding tissue. a MRI scan – a strong magnetic field and radio waves are used to produce a more detailed image of your larynx and the surrounding tissue.

What is the treatment for laryngeal cancer? ›

The treatment for laryngeal cancer largely depends on the size of the cancer. The main treatments are radiotherapy, surgery, chemotherapy and targeted cancer medicines. Most hospitals use multidisciplinary teams (MDTs) of specialists that work together to decide the best way to proceed with your treatment.

How curable is laryngeal cancer? ›

If the cancer has not spread (metastasized) to surrounding tissues or lymph nodes in the neck, about one half of patients can be cured. If the cancer has spread to the lymph nodes and parts of the body outside the head and neck, the cancer is not curable. Treatment is aimed at prolonging and improving quality of life.

How is Stage 1 laryngeal cancer treated? ›

Most stage I and II laryngeal cancers can be treated successfully without removing the whole larynx. Either radiation alone or surgery with a partial laryngectomy can be used in most people. Many doctors use radiation therapy for smaller cancers.

What are the first signs of laryngeal cancer? ›

Signs and symptoms of laryngeal cancer include a sore throat and ear pain.
  • A sore throat or cough that does not go away.
  • Trouble or pain when swallowing.
  • Ear pain.
  • A lump in the neck or throat.
  • A change or hoarseness in the voice.
Aug 24, 2021

Is laryngeal cancer fatal? ›

The 5-year survival rate for this cancer is 76%. If the cancer is only located in the larynx (localized cancer), the 5-year survival rate is 83%. If the cancer has spread to surrounding tissues or organs and/or the regional lymph nodes (regional cancer), the 5-year survival rate is 49%.

Where does laryngeal cancer spread first? ›

Laryngeal cancer metastases are most typically noted locoregionally to the cervical lymph nodes. Distant metastasis is seen much less frequently. The most commonly affected sites for distant metastases are the lungs (66%), bone (22%), liver (10%), mediastinum, and bone marrow.

What is the prognosis for laryngeal cancer? ›

For laryngeal cancers, survival rates differ based on which part of the larynx the cancer started in (supraglottis, glottis, or subglottis).
...
Glottis (part of the larynx including the vocal cords)
SEER stage5-year relative survival rate
Localized83%
Regional50%
Distant44%
All SEER stages combined77%
Mar 1, 2022

What age is laryngeal cancer common? ›

Most people diagnosed with laryngeal cancer are 55 or older; a very small number of people diagnosed are younger than 55. The average age of people diagnosed with laryngeal cancer is about 66. Black men are more likely to develop laryngeal cancer than White men and are more likely to die from it.

What is the major cause of laryngeal cancer? ›

Alcohol and tobacco are the 2 main things that can increase your risk of developing laryngeal cancer. They're thought to contain chemicals that can damage the cells of the larynx. The more you drink or smoke, the higher your risk of developing laryngeal cancer.

What is the most common symptom of laryngeal cancer? ›

Having a hoarse voice for more than 3 weeks is one of the most common symptoms of laryngeal cancer. Other symptoms include: pain or difficulty swallowing. shortness of breath.

What is the prognosis for Stage 1 laryngeal cancer? ›

Stage 1. Around 90 out of 100 adults (around 90%) will survive their cancer for 5 years or more after diagnosis. Stage 1 laryngeal cancer is only in one part of the larynx and the vocal cords are still able to move. The cancer has not spread to nearby tissues, lymph nodes or other organs.

What happens if you don't treat laryngeal cancer? ›

The survival of patients with stage T4a larynx cancer who are untreated is typically less than one year. The symptoms associated with untreated disease include severe pain and inability to eat, drink, and swallow.

Is laryngeal cancer fast growing? ›

Throat cancer is a rare form of cancer that develops in the throat, larynx or tonsils. Some of its most common symptoms include a persistent sore throat and/or cough, difficulty swallowing, hoarseness, ear pain and a neck mass. It can develop quickly, which is why early diagnosis is key to successful treatment.

Can an ENT see laryngeal cancer? ›

24, 2020. Your ENT doctor sees, diagnoses, and treats many conditions related to the ear, nose, and throat. One of the most worrisome is throat cancer, along with malignancies of the pharynx, tonsils, and larynx.

Does laryngeal cancer show up in blood work? ›

Although there is no specific blood test that detects laryngeal or hypopharyngeal cancer, several laboratory tests, including blood and urine tests, may be done to help determine the diagnosis and learn more about the disease. Laryngoscopy. A laryngoscopy can be performed in 3 ways: Indirect laryngoscopy.

Who is at high risk for laryngeal cancer? ›

Tobacco and alcohol use

Tobacco use is the most important risk factor for head and neck cancers (including cancers of the larynx and hypopharynx). People who smoke have a much higher risk for these cancers than people who don't smoke.

What are the red flags for throat cancer? ›

Persistent unexplained head and neck lumps for >3 weeks. Unexplained ulceration or unexplained swelling/induration of the oral mucosa persisting for >3 weeks. All unexplained red or mixed red and white patches of the oral mucosa persisting for >3 weeks. Persistent (not intermittent) hoarseness lasting for >3 weeks.

What does laryngeal cancer feel like? ›

Early cancer of the supraglottis (above the vocal cords) may cause pain, perhaps made worse with swallowing, and the pain may feel like it involves the ear, a phenomenon known as referred ear pain. Moderate to advanced laryngeal cancer may cause: Difficulty or painful swallowing. Difficulty breathing.

What are late signs of throat cancer? ›

Advanced throat cancer symptoms
  • Persistent cough.
  • Difficulty swallowing.
  • A lump in the mouth, throat or neck.
  • Hoarseness or other voice changes.
  • Ear or jaw pain.
  • White patches or sores in the mouth or throat.
  • Difficulty breathing.
  • Headaches.
Jun 3, 2022

Can you speak if you have laryngeal cancer? ›

If you have had all of your larynx removed (total laryngectomy), you will not be able to speak normally, because you'll no longer have vocal cords. There are a number of different ways you can learn to communicate again, although they can take weeks or months to learn.

How fast does throat cancer progress? ›

Professor Christopher Nutting explains that throat cancers will develop steadily in an individual patient once the tumour has developed. Cancers will double in size about every two to three months, which is quite quick compared to other tumour types.

What is Stage 1 laryngeal cancer? ›

Stage I cancer of the larynx is limited to one area and has not spread to lymph nodes in the area or to distant sites. Supraglottis: The cancer is only in one area of the supraglottis and the vocal cords are normal. Glottis: The cancer is in the vocal cords and the vocal cords can move normally.

Is laryngeal cancer the same as throat cancer? ›

Throat cancer is a general term that applies to cancer that develops in the throat (pharyngeal cancer) or in the voice box (laryngeal cancer).

How long do laryngectomy patients live? ›

The median 5-year survival was 58 months (range, 34-82 months) for T3 lesions, 21 months (range, 8-34 months) for T4 lesions, and 23 months (range, 12-35 months) for recurrent lesions.

Can you have throat cancer for years and not know it? ›

Throat cancers are usually quite small, too, and they can be very difficult to see, even by trained experts. So, only about 20% to 30% of patients will notice something visible.”

Can a CT scan detect laryngeal cancer? ›

You might have a CT scan of your head and neck to show the size of your laryngeal cancer and any enlarged lymph nodes in your neck. You might also have a CT scan of your chest or abdomen. This can show whether the cancer has spread.

Can Stage 3 laryngeal cancer be cured? ›

In some cases, larynx cancer (laryngeal cancer) can be cured with treatment. The 5-year survival rate for stage 3 larynx cancer is about 60%, meaning 60% of people with larynx cancer will survive for 5 years or more after diagnosis.

Would throat cancer show up in bloodwork? ›

No blood test can diagnose cancer in the oral cavity or oropharynx. Still, your doctor may order routine blood tests to get an idea of your overall health, especially before treatment. Such tests can help diagnose poor nutrition and low blood cell counts.

What is the best test to detect throat cancer? ›

In order to diagnose throat cancer, your doctor may recommend:
  • Using a scope to get a closer look at your throat. Your doctor may use a special lighted scope (endoscope) to get a close look at your throat during a procedure called endoscopy. ...
  • Removing a tissue sample for testing. ...
  • Imaging tests.

What does cancer of the larynx feel like? ›

Early cancer of the supraglottis (above the vocal cords) may cause pain, perhaps made worse with swallowing, and the pain may feel like it involves the ear, a phenomenon known as referred ear pain. Moderate to advanced laryngeal cancer may cause: Difficulty or painful swallowing. Difficulty breathing.

Do you need a biopsy to diagnose throat cancer? ›

A sample of throat tissues or cells is required for a biopsy, which must be conducted before treatment begins. The types of biopsies typically used for diagnosing throat and other head and neck cancers are: Endoscopic biopsy: An instrument called an endoscope is inserted into one of the nostrils or the mouth.

Does throat cancer show up suddenly? ›

Some of its most common symptoms include a persistent sore throat and/or cough, difficulty swallowing, hoarseness, ear pain and a neck mass. It can develop quickly, which is why early diagnosis is key to successful treatment.

What is Stage 1 throat cancer? ›

Stage 1 laryngeal cancer is only in one part of the larynx and the vocal cords are still able to move. The cancer has not spread to nearby tissues, lymph nodes or other organs.

Can a throat Xray detect cancer? ›

Diagnostic Imaging for Throat Cancer

(A Panorex is an x-ray that shows the full upper and lower jaw, plus the sinuses.) These imaging tests provide more details about the tissue. If cancer is found, the scans can show how deep the cancer is and if it has spread.

What age is a risk factor for laryngeal cancer? ›

Age. Cancers of the larynx and hypopharynx usually develop over many years, so they are not common in young people. Over half of patients with these cancers are 65 or older when the cancers are first found.

What imaging is best for laryngeal cancer? ›

MRI. A high field MRI scanner using a dedicated neck coil is preferred. A combination of multiplanar noncontrast T1-weighted, T2-weighted and T2-weighted fat saturation images with postcontrast T1 fat-suppressed images are routinely used. It is important to take the T1 and T2 sections at the same levels.

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