Cancer of the Larynx (Voice Box)

Cancer of the larynx (voice box) is a growth of abnormal cells in the voice box. The cells create a malignant (life-threatening) tumor in your larynx. If not treated, it can spread throughout the throat and block your air passage. It may spread to the lymph nodes in your neck and then to other parts of your body.

Laryngeal cancer can usually be cured if found in its early stages. Most cases of laryngeal cancer happen in people who have been smokers.

How does it occur?

The exact cause of laryngeal cancer is not known, but it is most common among people who smoke heavily and drink large amounts of alcohol.

What are the symptoms?

Often the only early symptom of laryngeal cancer is hoarseness that does not go away and gets worse over time. Usually there are no cold or flulike symptoms and no pain with the hoarseness.

You may have the following symptoms in later stages:

• chronic cough
• trouble breathing and swallowing
• coughing up blood
• pain
• an obvious lump in the neck

How is it diagnosed?

Your healthcare provider will ask about your symptoms and will examine your throat. To gain more information, your provider may do the following:

• Look at your larynx in the office with mirrors or a special viewing tube (a flexible fiber-optic laryngoscope). A numbing spray may be used to prevent gagging.
• Do a direct laryngoscopic exam in an operating room if a growth was seen during the office exam. For this exam, you will be put to sleep with a general anesthetic.
• Remove a sample (biopsy) of the affected area of your larynx or vocal cords for examination and tests. A biopsy can be done at the time of a laryngoscopic exam. The biopsy may is to see if a growth is cancer.

What is the treatment?

Your healthcare provider will treat cancer of the larynx based on the spread of the cancer when it is diagnosed. The cancer may be completely cured if treatment begins in the early stages of the disease. Your provider may recommend that you have a combination of the following treatments:

• radiation therapy
• chemotherapy (anticancer drugs) to destroy cancer cells, reduce the size of the tumor, and possibly let you keep your voice box
• surgery to remove the tumor and all or part of your larynx

Your exact treatment plan will depend on the stage of your cancer. Ask your healthcare provider to write down for you the stage of your cancer and the planned treatment.

Radiation alone cures 85% of laryngeal cancers in the early stages.

If your larynx is removed, you will need speech therapy to learn new ways to speak. A laryngectomee is a person who has had the larynx surgically removed and so has permanently lost the ability to speak normally. You can expect to live a healthy, productive life and will learn to speak in new ways, such as the following:

• having a one-way valve implanted between your esophagus and airway to allow air for speech to enter your mouth
• using an electromechanical device to cause a vibration that produces sound that you can shape into words with your tongue, cheeks, lips, and teeth
• learning to use your esophagus instead of your larynx by swallowing air and bringing the air back into your mouth for speech

How long will the effects last?

The effects of cancer of the larynx depend on the spread of the tumor when it is detected and the treatment. Your age and physical condition are also important. Some treatments are not recommended for people in poor health or who do not stop heavy use of cigarettes or alcohol.

How can I take care of myself?

Ask about side effects you may have from surgery, radiation, or chemotherapy. Talk to your healthcare provider about any concerns you have about your illness and treatments. You may want to make a list of questions at home and take it with you when you visit your provider. Ask a family member or friend to go with you who can listen, too. If you don't understand a word or concept, ask your provider to explain it. Take notes if you need to.

In addition, follow these guidelines:

• Eat frequent, healthy meals that are low in fat and high in fiber. Drink liquid food supplements. This will help you avoid losing weight if your throat becomes sore during treatment.
• Do not use any type of tobacco.
• Do not drink alcohol.
• Complete the full course of surgery, radiation, or chemotherapy treatments your healthcare provider orders.
• Keep all follow-up appointments with your provider.
• If possible, join a cancer support group during your illness and recovery.
• Maintain a hopeful and positive outlook throughout your treatment and recovery.
• Exercise regularly and follow good health practices.

For more information on cancer and laryngectomees, contact:

• American Cancer Society, Inc.
  Phone: 800-ACS-2345 (800-227-2345)
  Web site: http://www.cancer.org
• AMC Cancer Research Center and Foundation
  Phone: 800-525-3777
  Web site: http://www.amc.org
• Cancer Information Service
  Phone: 800-4-CANCER (800-422-6237)
  Web site: http://cis.nci.nih.gov
• The International Association of Laryngectomees
  Phone: 866-425-3678
  Web site: http://www.larynxlink.com

What can be done to help prevent cancer of the larynx from spreading or recurring?

You may be able to reduce the risk of spread or recurrence of cancer of the larynx by:

• completing the full course of surgery, radiation, or chemotherapy treatments ordered by your healthcare provider
• not using any tobacco products
• avoiding heavy use of alcohol
• seeing your healthcare provider right away if your voice changes, you notice a return of any previous symptoms, or you develop new symptoms