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Laryngeal Cancer (Detailed)

Comprehensive overview of cancer of the voice box including subsites, staging, and organ-preservation strategies.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Onkoloji department. Book Appointment →

What is Laryngeal Cancer (Detailed)?

Laryngeal cancer is a malignancy arising from the larynx (voice box), most commonly squamous cell carcinoma. The larynx is divided into three subsites: supraglottis (above the vocal cords), glottis (vocal cords themselves), and subglottis (below the vocal cords). Glottic cancers are the most common (60-65%) and present earliest due to voice changes.

Tobacco and alcohol are the dominant risk factors with synergistic effects. The incidence of laryngeal cancer has been declining in many countries due to reduced smoking, but it remains a significant global health problem. HPV is implicated in some cases but to a lesser degree than oropharyngeal cancer.

Treatment is determined by subsite, stage, and patient factors. Early-stage cancers (T1-T2) are highly curable with single-modality treatment (radiation or transoral surgery) preserving voice and swallowing. Advanced cancers traditionally required total laryngectomy, but organ-preservation protocols using induction chemotherapy or concurrent chemoradiation have become standard for many T3-T4a tumors. Salvage surgery remains important for recurrent disease.

Symptoms

Persistent hoarseness or voice changes (over 2-3 weeks)
Sore throat or persistent throat pain
Dysphagia (difficulty swallowing) or odynophagia
Otalgia (referred ear pain)
Stridor or dyspnea (airway compromise, advanced disease)
Hemoptysis (coughing up blood)
Neck mass (cervical lymph node metastasis)
Globus sensation (lump in throat)
Chronic cough
Weight loss and cachexia
Halitosis with advanced tumors

Risk Factors

Tobacco smoking (cigarettes, cigars, pipes) — primary risk factor
Alcohol consumption (synergistic with smoking)
Combined heavy smoking and drinking (highest risk)
HPV infection (subset of cases)
GERD/laryngopharyngeal reflux
Occupational exposures: asbestos, wood dust, paint fumes, nickel
Prior radiation to head/neck
Male sex (4-5 fold higher than female, narrowing gap)
Age over 55
Previous head and neck cancer (field cancerization)
Plummer-Vinson syndrome
Fanconi anemia
Poor diet (low fruit and vegetable intake)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Hoarseness lasting more than 2-3 weeks
  • Persistent sore throat or unilateral ear pain
  • Difficulty or painful swallowing
  • Painless neck lump
  • Coughing up blood
  • Stridor or progressive shortness of breath
  • Unexplained weight loss
  • Persistent throat foreign body sensation
  • Smoker with any voice changes

Treatment Methods

01
Smoking and alcohol cessation (essential for treatment outcome)
02
Multidisciplinary head and neck tumor board evaluation
03
Direct laryngoscopy with biopsy for tissue diagnosis
04
Imaging: CT/MRI neck with contrast, PET-CT for staging
05
Early glottic cancer (T1-T2): radiation OR transoral laser microsurgery (TLM)
06
Early supraglottic cancer: partial laryngectomy or radiation
07
Advanced laryngeal cancer (T3-T4a): organ preservation with concurrent chemoradiation (cisplatin)
08
Induction chemotherapy (TPF: docetaxel, cisplatin, 5-FU): selected cases
09
Total laryngectomy with neck dissection: T4b, salvage, dysfunctional larynx
10
Voice rehabilitation: tracheoesophageal puncture, electrolarynx, esophageal speech
11
Neck dissection: clinically N+ disease or elective for high-risk tumors
12
Adjuvant radiotherapy: positive margins, extracapsular spread
13
Cetuximab with radiation: alternative to cisplatin in selected patients
14
Immunotherapy (pembrolizumab, nivolumab): recurrent/metastatic disease
15
Long-term surveillance: q3 months year 1, decreasing frequency
16
Speech, swallowing, and nutrition rehabilitation

Which Department to Visit?

You can visit our Onkoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.