Laryngeal cancer is caused by an uncontrolled growth of cells in your larynx. About 2,300 people are diagnosed with laryngeal cancer each year in the UK. Most of these people are men over 40.
Your larynx sits at the entrance of your windpipe (trachea). It stops food entering your trachea and allows you to breathe. It also produces the sounds you make when you speak.
Nine out of 10 laryngeal cancers are squamous cell carcinomas. This type of laryngeal cancer starts in the flat, skin-like cells that cover the inside of your larynx. Other, rarer types of laryngeal cancers include the following.
A change in your voice or hoarseness is often the first sign of laryngeal cancer. If you have a hoarse voice for longer than three weeks, see your GP. Other symptoms of laryngeal cancer include:
These symptoms aren't always caused by laryngeal cancer, but if you have them see your GP.
The exact reasons why you may develop laryngeal cancer aren’t fully understood at present. But there are certain factors that make laryngeal cancer more likely, such as:
Your GP will ask about your symptoms and examine you. He or she may also ask about your medical history. You may be referred to a doctor who specialises in ENT (ear, nose and throat) conditions.
At the hospital, you will have tests to confirm a diagnosis. Your doctor will pass a narrow, flexible, tube-like telescopic camera into the back of your throat to see your larynx. The tube may be passed through your mouth (called laryngoscopy) or through your nose (called nasoendoscopy). The procedure may feel a bit uncomfortable, so your doctor may use a local anaesthetic spray.
Your doctor will take a biopsy. This is when a small sample of tissue is removed and sent to a laboratory for testing.
If you have laryngeal cancer, your doctor will recommend further tests to find out the size of your tumour and check whether the cancer has spread to other parts of your body. These tests may include X-ray, ultrasound, a CT scan or MRI scan. You may also have blood tests.
Your treatment will depend on the type of laryngeal cancer you have and how far it has spread. It will also depend on your age and general health. Your doctor will discuss your treatment options with you.
Surgery (including the use of lasers) involves removing just the affected tissue. How much surgery is needed depends on how much tissue is affected. If the cancer is caught early, the cancerous cells may be destroyed using a laser, leaving your larynx intact. If the cancer is advanced, you may need to have part, or all, of your larynx removed. If you have all of your larynx removed, this is called a total laryngectomy.
Surgery is sometimes followed by chemotherapy or radiotherapy treatment to make sure all the cancer cells are destroyed.
A beam of radiation is targeted into the affected area. The aim of the treatment is to destroy cancer cells with minimal damage to the surrounding healthy tissue. Radiotherapy is often the first treatment option if the cancer affects only a small area of your larynx.
If you have a large laryngeal tumour, you may have chemotherapy before, or at the same time as, radiotherapy treatment. The medicines are usually injected into a vein but sometimes may be given as tablets.
Your surgeon may treat you with manufactured monoclonal antibodies (cetuximab), in combination with radiotherapy. Cetuximab is a new treatment and is approved for use only in advanced squamous cell cancer of the head and neck. It blocks areas on the surface of cancer cells that can trigger growth.
Not smoking, eating a healthy, balanced diet, maintaining a healthy weight and drinking sensibly may help to protect against laryngeal cancer.
It depends on the type of treatment you have had, but in general, treatment for laryngeal cancer is more likely to affect the way you breathe and speak than the way you eat and drink. You may find you have difficulty swallowing at first, but this should improve as you recover.
Your larynx is part of your trachea (windpipe), so having treatment for laryngeal cancer is more likely to affect the way you breathe and speak and not the way you eat and drink. It’s possible you may have some problems with swallowing, but this will depend on the type of treatment you have had.
Radiotherapy treatment can give you a dry mouth and a sore throat for about two weeks. Eating softer foods can help. Having surgery will make swallowing difficult. If you have laser surgery, swallowing will become easier within a couple of days as the swelling improves.
If you have any concerns about how your treatment may affect your ability to eat or drink, talk to your doctor.
If your larynx is removed, you won't be able to speak in the normal way. However, most people can learn how to make sounds and speak using a variety of different methods.
If you need to have your larynx removed, your surgeon may fit a valve onto the opening made in your neck. This is called voice prosthesis. Pressing on the prosthesis with your thumb or finger when you breathe out will cause your oesophagus (the pipe that goes from your mouth to your stomach) to vibrate and make a sound. Your lips, tongue and cheeks also help to make sounds.
Other options include:
Having your larynx removed is a major operation and it can be distressing. Specialist doctors, nurses and speech therapists are experts in providing the care and support you need. A speech and language therapist will help you find the best ways to communicate. Ask your doctor about support groups you can join so you can meet people who have had similar experiences to you.
If your larynx is removed, your surgeon will bring your windpipe (trachea) to the surface of your skin through a hole in your neck. You will no longer breathe through your mouth, but instead through the hole.
If your larynx is removed, your trachea will no longer link to your mouth. Your surgeon will create a hole in your neck, called a laryngectomy stoma. This will be the opening for your trachea. Instead of taking air in through your mouth, it will pass directly into your lungs from the stoma in your neck.
You may need to use a stoma cover when you shower and special equipment if you go swimming to prevent water getting into your lungs. You may also need to use a stoma filter to protect against dust and dirt, and a heat and moisture exchanger (HME), which warms and moistens the air to prevent coughing.
Having your larynx removed is a major operation and it can be distressing. Specialist doctors, nurses and speech therapists are experts in providing the care and support you need. Ask your doctor about support groups you can join so you can meet people who have had similar experiences to you.