Laryngeal cancer

The larynx is the organ responsible for voice and for protecting the bronchi and lungs from food particles. Laryngeal cancer is the disordered development of cells in this organ, which can begin in three parts of it: the supraglottis (above the vocal cords), glottis (vocal cord), or subglottis (below the vocal cords).

Symptoms may appear in different ways depending on the stage and location of the disease. In early cases, the most common are:

• hoarseness: unusual changes in the voice are one of the main symptoms
• sore throat: may appear as a pain that lasts for long periods or as a sensation of a lump in the throat
• difficulty or pain when swallowing: tumor growth can cause difficulty eating and drinking liquids
• difficulty breathing: the presence of the tumor in the initial portion of the airway can cause various symptoms such as persistent cough, stridor—a characteristic sound when breathing—or even airway obstruction

Smoking accounts for the majority of laryngeal cancer cases, even among former smokers. Some other factors that may trigger the disease are:

• alcoholism (alcohol-related disorders): the consumption of alcoholic beverages leads to an inflammatory process that can develop into a malignant lesion in the larynx
• advanced age: over time, the cell renewal process may present failures
• gender: most affected patients are male
• exposure to occupational toxic agents: wood dust, paint fumes, and other chemical substances used in metallurgy, petrochemical, construction, and textile industries can increase the chance of developing the disease

Diagnosis usually involves several steps to be accurate and effective. Some examples are:

• physical examination: a head and neck cancer specialist should examine the oral cavity, ears, and nose, as well as carefully assess the neck
• laryngoscopy: an exam performed to examine the larynx in more detail, which can be done in the office, but in some situations, the professional may prefer to perform the exam under anesthesia. The ability of the vocal cords to open and close is evaluated in this exam
• biopsy: performed by direct visualization during laryngoscopy or, if present, by biopsy of neck lymph nodes

Treatment may vary depending on the stage of the disease and the exact location of the tumor. The goal of treatment, in addition to avoiding oncological outcomes, should be to preserve the functions of the larynx whenever possible, which include swallowing, sound production (phonation), and breathing. Some of the most common treatments are:

• partial or total surgical removal of the larynx: in early cases, using minimally invasive surgical techniques, it is possible to remove only part of the larynx without losing its functions. In more advanced cases, especially when there is already significant impairment of the organ’s functions, total removal of the larynx may be necessary
• radiotherapy: used in early or locally advanced stages of the disease, with high chances of preserving the patient’s voice. It can be performed alone or in combination with chemotherapy, or even as a complement after surgery. This high-energy radiation aims to destroy diseased cells
• chemotherapy: generally used as a strategy alongside another treatment. Its main goal is to preserve the larynx. This is a common approach to destroy or control diseased cells using medication

Einstein Oncology and Hematology offers comprehensive care from diagnosis to treatment. Learn more.

To prevent the development of laryngeal cancer, it is necessary to maintain a healthy lifestyle. Here are some practices to avoid:

• avoid alcohol and smoking: smokers are 10 times more likely to get sick, while people who combine smoking with alcohol consumption are 43 times more likely
• balanced diet: it is important to have a diet focused on proteins, vegetables, and fruits rich in vitamins, such as oranges and papayas

National Cancer Institute, 2022.
Healthy Living, 2023.

By Einstein Editorial Board