What Does Laryngeal Cancer Feel Like?

Laryngeal cancer is a type of throat cancer that begins in the larynx, or voice box, which is part of the body that helps us breathe, swallow and speak. Each year, approximately 13,000 people in the U.S. are diagnosed with laryngeal cancer.

Cancer may start in one of three parts of the larynx:

• Supraglottis, or the upper part: Almost 35% of laryngeal cancers start here.
• Glottis, or the middle part: More than 60% of laryngeal cancers start here.
• Subglottis, or the lower part: About 5% of laryngeal cancers start here.

Risk factors for laryngeal cancer include:

• Smoking or using other tobacco products: If you smoke more than 25 cigarettes in a day, or if you have smoked for more than 40 years, you are 40 times more likely to develop laryngeal cancer.
• Heavy consumption of alcohol: Drinking more than 60 ml a day over several years also raises your risk of laryngeal cancer. Using both alcohol and tobacco together increases the risk further.
• Age: Laryngeal cancer occurs more frequently in people over the age of 55.
• Gender: Men are more likely to develop this type of cancer, possibly because smoking and heavy alcohol consumption are more common among men.
• History of head and neck cancer: Approximately 25% of people who have had head and neck cancer in the past will get it again.
• Occupational exposure: People who are exposed to sulfuric acid mist, wood dust, nickel, asbestos, or mustard gas at work are at an increased risk of developing laryngeal cancer.

The Surveillance, Epidemiology and End Results (SEER) database, maintained by the National Cancer Institute, classifies laryngeal cancer in the following stages:

• Localized laryngeal cancer: Cancer is limited to the larynx.
• Regional laryngeal cancer: Cancer has spread outside the larynx to the nearby structures or lymph nodes.
• Distant laryngeal cancer: Cancer has spread to distant parts of the body, such as the lungs.

Another classification often used by oncologists to stage laryngeal cancer is the TNM classification. However, this classification is not used by the National Cancer Institute to predict survival rates due to its complex subcategories. This system is more useful to guide the treatment plan.

• The extent of the main tumor (T): The site, growth, and invasion are considered.
• The spread to nearby lymph nodes (N): The lymph node involvement is evaluated.
• The spread (metastasis) to distant sites (M): The distant spread of the tumor is evaluated.

Based on the TNM involvement, the stages of cancer are calculated as stage I to stage IV.

• Stage 0: The tumor is present exclusively in the top layer of cells lining the inside of the larynx.
• Stage I: The tumor has grown deeper, but it is only in the vocal cords, and they move normally.
• Stage II: The tumor is still only in the larynx, but it has caused a vocal cord to stop moving.
• Stage III: The tumor is growing into the paraglottic space, or the tumor is growing into the inner part of the thyroid cartilage (firm tissue that separates the thyroid gland from the front of the larynx). Cancer has not spread to nearby lymph nodes.
• Stage IV: Moderate to relatively advanced cancer, where the tumor has started to spread through the thyroid cartilage to spread to deeper tissues such as the thyroid gland, tongue, trachea, and esophagus. Tumor involving distant sites such as distant seeding in lymph nodes and lungs is also included in this stage.

Cancer survival rates are estimated in terms of how many individuals (expressed as a percentage) are alive after at least five years of a cancer diagnosis. This is commonly called the “five-year survival rate.” For laryngeal cancer, survival rates differ depending on the part of the larynx cancer originated in: Note: The data is based on people diagnosed with cancer of the larynx or hypopharynx between 2011 and 2017.

• Supraglottis (part of the larynx above the vocal cords)
• Glottis (part of the larynx including the vocal cords)
• Subglottis (part of the larynx below the vocal cords

Understanding the numbers

• These numbers apply only to the stage of cancer when it is first diagnosed. They do not apply later on if cancer grows, spreads, or comes back after treatment.
• These numbers don’t take everything into account. Survival rates are grouped based on how far cancer has spread. But other factors, such as your age and overall health, and how well cancer responds to treatment, can also affect your outlook.
• People now being diagnosed with laryngeal or hypopharyngeal cancer may have a better outlook than these numbers show. Treatments improve over time, and these numbers are based on people who were diagnosed and treated at least five years earlier.

SEER = Surveillance, Epidemiology, and End Results

Early-stage cancers that are localized to the throat may be managed by surgery. Advanced cancers may need a combination of treatment approaches:

• Surgery: For early-stage laryngeal cancer, surgery can remove the tumor while preserving the person’s ability to speak and swallow. For advanced cancer, surgeons often need to do a laryngectomy, removing the entire larynx. Surrounding tissues such as lymph nodes, vocal cords, and muscles may also need to be resected.
• Radiation therapy: High-energy radiation beams are targeted to the neck to kill the cancer cells.
• Chemotherapy: Oral or intravenous (IV) medications are used to kill or slow the growth of cancer cells.
• Immunotherapy: This treatment targets specific proteins on the cancer cells. Once these target proteins are uncovered, the body’s immune system can attack and kill the cancer cells.