Laryngeal cancer refers to cancer of the larynx or voice box. About 60 percent of laryngeal cancers start in the glottis (vocal cord area), while another 35 percent develop in the supraglottic region (the area above the vocal cords). The rest occur in either the subglottis (the area below the vocal cords) or overlap more than one area. Cancer in each of these three areas is treated differently.
Almost all laryngeal cancers are squamous cell carcinomas, meaning they begin in the thin, flat squamous cells in the epithelium, the inner lining of these structures. Most of these start as dysplasia, a pre-cancerous condition. When dysplasia does progress into carcinoma in situ, the earliest form of cancer, it has not yet spread and can be cured if treated.
Cancers of the larynx are about four times more common in men than in women. More than 50 percent of new cases are in people older than 65. Laryngeal cancer is more common among African Americans and Caucasians than among Asians and Latinos.
Smoking is the biggest risk factor for laryngeal cancer. The risk is compounded when smoking and heavy alcohol use occur together. Poor nutrition is another risk factor. Reflux is also a possible contributor to developing laryngeal cancer. These cancers are more common in people who have a weak immune system. Prolonged exposure to wood dust, paint fumes, and industrial chemicals used in metalworking, petroleum, plastics, and textile manufacturing (and possibly exposure to asbestos) can also increase the risk of laryngeal cancer.
There are no simple screening tests for laryngeal cancer. Still, it can be found early when patients are diligent about seeing an otolaryngologist (ear, nose and throat specialist) to check out certain symptoms. Foremost among the symptoms of cancer that originates in the glottis is hoarseness or a change in the voice that shows no improvement. When cancer doesn't arise from the vocal cords, hoarseness appears later and the first sign may be a growing mass in the neck. Symptoms of cancers that start in the supraglottis or subglottis may also include: an unrelenting sore throat; constant coughing; pain when swallowing; ear pain; trouble breathing; or weight loss.
Surgery, often coupled with radiation and/or chemotherapy (and sometimes reconstructive surgery) is the usual treatment for laryngeal cancer. Radiation therapy with or without chemotherapy is also an option to treat laryngeal cancers. A major consideration in any of these treatments is saving as much of the patient's voice as possible. Discussion of the various treatment options is the role of the treating head and neck oncologic team.