The larynx, also called voicebox, is a 2 inch long organ in the neck. We use this particular structure when we breathe, talk or swallow. It is located at the top of the windpipe and the walls are made of cartilage. The large cartilage that forms the front of the voicebox sometimes protrudes in men and is called the Adams Apple.
Each time we breathe in and out air goes through the larynx, down the trachea and into our lungs. When we breathe, the vocal cords are relaxed and air moves through the spaces between them. However, when we talk the vocal cords tighten and they move closer together. Air is forced between them making the cords vibrate and produces the sound of our voice.
Symptoms of cancer of the larynx will depend upon the size and location of the tumor in the voice box. Most of these cancers begin in the vocal cords themselves and not in the cartilage that forms the walls of the voice box.
While these tumors are seldom painful, they almost always cause hoarseness or other changes in the quality of the voice. In some individuals it can cause a lump in the throat, a sore throat or an earache. Tumors that develop below the level of the vocal cords are very rare and will cause difficulty with breathing. Some tumors can also cause bad breath that doesn’t go away with mouth wash and diligent teeth brushing because the source of the odor isn’t from the mouth.
Most of these symptoms can be caused by cancer but are also indications of other, less serious, conditions. Swelling in the vocal cords can occur from hours of yelling at a football game, long hours of practicing vocal performance, a sinus infection, nighttime acid reflux, allergies or cigarette smoking.
Treatment for laryngeal cancer will begin with diagnosis and staging of the tumor. Diagnosis will include blood tests, indirect laryngoscope to view the vocal cords, a chest x-ray, MRI, ultrasound, CT scan or other tests to view the airway or larynx. The results of these tests will determine the course of treatment – as well as the individual’s overall health, age, and extent of the disease.
Generally, the treatment for laryngeal cancer will first focus on radiation to destroy the cancer cells. Radiation will stop the spread of cancer and help to shrink the tumor in preparation for surgerical removal. Treatments are usually given 5 days a week for 5-8 weeks. If a person has a small tumor then radiation may be all that is needed.
Chemotherapy is another choice for treatment for laryngeal cancer. Chemotherapy are medicines used to attack cancer cells and can be used in conjunction with radiation. Chemotherapy can also be used to decrease the size of the tumor prior to considering surgery. After surgery, chemotherapy can be used to kill any remaining cells and used to treat metastasis – or cells that have spread from the primary tumor.
Surgical removal of the tumor is the third option for treatment. In this case a surgeon will use either a scalpel or laser to remove the cancer cells. During a total laryngectomy the surgeon will remove the entire larynx. A partial laryngectomy will involve partial removal of either the top of the larynx (supraglottic) or one or both of the cords themselves (cordectomy).
During surgery the doctor can also remove the lymph nodes in the neck, called a lymph node dissection. The thyroid is another organ, close to the larynx, that will be considered for removal. The lymph nodes may be removed if the surgeon believes that cancer may have spread from the larynx to the nodes in the area.
During the surgery, the doctor will need to make a stoma, or hole, from which the patient will be able to breathe. This is called a tracheostomy. For many this may be a temporary necessity and can be reversed at a later time. After surgery some may need a temporary feeding tube to help them receive nutrition.
MedlinePlus: Cancer – Throat or Larynx
National Cancer Institute: Laryngeal and Pharyngeal Cancer
MayoClinic: Throat Cancer
Cancer Research UK: Larynx or laryngeal cancer
MD Anderson Cancer Center: Throat Cancer
University of California San Francisco: Larynx Cancer