Laryngeal Cancer: Recognizing the Symptoms of Laryngeal Carcinoma (Hoarseness) and Laryngeal Cancer Early—How to Detect the Disease at a Very Early Stage

The larynx is located in the neck and connects the pharynx to the esophagus and the trachea. It enables speech and breathing.

Malignant laryngeal tumors occur in three forms:

• Glottic laryngeal carcinoma: Affects the vocal cords (glottis) and is the most common type of laryngeal cancer.
• Supraglottic laryngeal cancer: Grows above the vocal cords.
• Subglottic laryngeal carcinoma: Grows below the vocal cords.

In advanced stages, laryngeal cancer forms metastases. These first appear in the neighboring lymph nodes and later in more distant regions of the body.

Statistically, 6 out of 10 people diagnosed with laryngeal cancer are still alive 5 years after diagnosis (five-year prognosis).

The location and anatomy of the larynx © bilderzwerg | AdobeStock

Smoking is considered the primary risk factor for the development of this malignant tumor. In addition, excessive alcohol consumption contributes to the development of laryngeal cancer. Smoking and alcohol have a direct influence on the formation of abnormal cells.

In addition, infection with human papillomavirus (HPV) can increase the risk of laryngeal tumors.

Toxic chemical substances such as

• chromium,
• arsenic,
• asbestos,
• nickel, and
• polycyclic aromatic hydrocarbons (PAHs)

increase the risk of developing laryngeal cancer later in life. Certain occupational groups come into contact with these toxic substances. Older buildings may also contain asbestos-cement panels, which can increase the cancer risk for residents. Laryngeal cancer can also be genetically determined.

The symptoms of laryngeal cancer depend on the specific part of the larynx where the tumor forms.

In cases of vocal cord cancer, patients often experience hoarseness and the need to clear their throats in the early stages. This makes it easier to diagnose this form of cancer early.

Other signs of laryngeal cancer include a persistent scratchy throat and a chronic cough. Later on, these are joined by clearly audible breathing sounds and shortness of breath.

Supraglottic tumors are usually not detected until a late stage. Patients

• often have swollen neck lymph nodes
• experience difficulty swallowing
• and experience a sensation of a foreign object (“lump”) in the throat

Laryngeal tumors located below the glottis (voice box) manifest as

• hoarseness,
• a coughing sensation, and
• later, difficulty breathing

.

Hoarseness lasting longer than 3 weeks with no other apparent cause (such as a sore throat) may indicate laryngeal cancer. If you have these symptoms, please contact an ear, nose, and throat specialist as soon as possible.

Advanced laryngeal cancer presents with less specific signs such as

• bloody sputum
• severe bad breath
• weight loss

If a laryngeal tumor is suspected, the doctor first performs a laryngoscopy. This is usually done using a flexible endoscope and a 90° angled scope. The patient is under general anesthesia during the procedure. During the laryngoscopy, the doctor takes a tissue sample, which is sent to the lab for analysis. There, it is examined for cancer cells. 

Swollen lymph nodes can sometimes also be detected during a physical examination of the neck or an ultrasound exam.

Microlaryngoscopy provides the doctor with additional information. For example, the doctor can determine whether the tumor is growing inward, outward, or beneath the mucous membrane, and whether the vocal cords are still mobile.

Imaging technologies such as

• ultrasound,
• computed tomography (CT), and
• magnetic resonance imaging (MRI)

reveal the exact location and extent of the tumor.

In addition, the ENT specialist must determine whether there is another malignant tumor, for example in the esophagus or the lung. To do this, the specialist performs an esophagoscopy and a bronchoscopy. A chest X-ray shows the size and location of the metastasis.

Treatment for laryngeal cancer depends on

• the tumor’s location,
• how large it is, and
• which stage of cancer has been diagnosed.

The patient’s overall health and age also play a role in the decision. Based on these factors, the specialist will recommend surgery and/or radiation therapy or chemotherapy. Sometimes, these treatments are used in combination.

Surgery for Early-Stage Laryngeal Cancer

Early-stage laryngeal cancer has a favorable prognosis, as it can often be completely removed surgically.

If the tumor is located in an area easily accessible through the mouth, it can be removed endoscopically and microscopically using a laser. This minimally invasive procedure leaves only a small incision and spares healthy tissue. If this is not possible, the larynx is opened with a scalpel.

After surgery, patients usually experience breathing difficulties. To ensure they get enough air, a temporary artificial breathing opening (tracheostomy) is usually created on the front of the neck.

Surgery for Advanced-Stage Laryngeal Cancer

Surgery for advanced-stage laryngeal tumors is more difficult. These tumors can only be treated by completely removing the larynx (laryngectomy). If the lymph nodes in the neck are already affected, they must also be removed.

After surgery, patients require a tracheostomy and speak through an artificial speech valve. Tumor cells may still be present in the body after surgery. To destroy these, radiation therapy and/or medication (conservative treatment) are used in advanced stages of the tumor.

If the surgical risk is too high for the patient, conservative therapy is the only treatment option available. This is also the case in earlier stages of the tumor. The patient should undergo regular follow-up examinations for 5 years following the surgery.

Laryngeal cancer is a malignant disease of the larynx and should be detected as early as possible to significantly improve the chances of recovery. The causes and risk factors primarily include tobacco and alcohol use, which can increase an individual’s risk. Men are affected by laryngeal cancer significantly more often, although women can also develop the disease. The disease often originates in the vocal cords, where it grows early on and can quickly cause symptoms.

Typical symptoms of laryngeal cancer include hoarseness, difficulty swallowing, or other signs of the disease; therefore, individuals experiencing persistent symptoms should consult a doctor. Diagnosis is made through specialized examinations, though a definitive diagnosis can often only be confirmed after tissue samples are analyzed. If laryngeal cancer is diagnosed, various specialists are available for treatment, depending on the stage of the disease. Treatment options for laryngeal cancer include surgery, radiation therapy, and chemotherapy. 

Since laryngeal cancer causes malignant changes in the mucous membrane and is more likely to spread in advanced stages, early diagnosis is particularly important. If you suspect you may have laryngeal cancer or have questions about it, you should always consult a doctor to determine whether laryngeal cancer is present.

What are the symptoms of laryngeal cancer?

Typical symptoms of laryngeal cancer include persistent hoarseness, difficulty swallowing, throat pain, or swollen lymph nodes in the neck. Laryngeal cancer affecting the vocal cords, in particular, often grows slowly and is often first noticed due to changes in the voice. Other signs of laryngeal cancer may include coughing, breathing difficulties, or discomfort when swallowing.

What risk factors increase the risk of laryngeal cancer?

The most important risk factors for laryngeal cancer are tobacco and alcohol use. Exposure to pollutants, chronic irritation of the mucous membrane, and genetic factors can also increase an individual’s risk of laryngeal cancer. Men are affected by laryngeal cancer significantly more often than women.

How is laryngeal cancer diagnosed?

If laryngeal cancer is suspected, the doctor will thoroughly examine the larynx and the vocal cords. Diagnosis of laryngeal cancer involves endoscopic examinations, CT scans, MRI scans, and tissue samples from the tumor. Further tests help determine whether metastases or cervical lymph nodes are involved.

How is laryngeal cancer treated?

Treatment for laryngeal cancer depends on the stage, location, and extent of the tumor. In the early stages, surgery or radiation therapy is often sufficient. For advanced laryngeal cancer, chemotherapy, laryngectomy, or combination therapies may be considered to completely remove the malignant tumor.

What are the chances of recovery from laryngeal cancer?

The chances of recovery from laryngeal cancer depend on whether the tumor is detected early and how far it has already spread. Early diagnosis of laryngeal cancer significantly improves life expectancy and the chances of a successful recovery. After treatment and follow-up care, patients should undergo regular checkups to detect relapses or new changes in a timely manner.