The larynx, or voice box, is a part of the throat between the very back of the tongue and the windpipe. The larynx contains a number of sub-structures, including the vocal cords, which vibrate and make sound when air is directed through them. The hypopharynx is an area of the throat that surrounds the larynx and forms a funnel that leads into the esophagus. The most common type of cancer that develops in these regions is called squamous cell carcinoma.
Studies have shown that head and neck cancer treatment by a multidisciplinary team of experts at a high volume medical center leads to significantly improved outcomes.
- Tobacco use of any kind, including cigarettes, chewing tobacco, cigars, pipes and snuff
- Heavy alcohol use
- Gastroesophageal reflux disease (GERD)
- Diet low in fruits and vegetables
- Human papilloma virus infection
- Certain environmental or workplace exposures
Laryngeal Cancer Symptoms
- Voice changes/hoarseness
- Trouble or pain with swallowing
- Difficulty breathing
- Noisy breathing
- Sore throat
- Spitting or coughing up blood
- Ear pain
- Weight loss
If you have any of these symptoms for more than two weeks, be sure to make an appointment with your doctor or dentist. Early detection of laryngeal and hypopharyngeal cancers is critical for your best possible outcome.
As part of the initial visit, the following tests may be used to detect, diagnose and/or stage a laryngeal or hypopharygeal cancer:
- Discussion of current laryngeal cancer symptoms, past medical history and health habits
- Physical examination: an exam to check the throat and neck for abnormal areas
- Endoscopy: a flexible scope placed through the nose to visualize the voice box and throat
- Imaging: May include ultrasound, CT scan, MRI and/or a PET scan
- Biopsy: Sampling of the suspicious lesion/mass to definitively diagnose the type of tumor. This often needs to be done in the operating room with an outpatient procedure.
Larynx Cancer Treatment
Our team of experts always strives for a cure, but we also aim to preserve a patient’s function. The larynx and hypopharynx serve vital roles in breathing, speech and swallowing. We offer treatments that are tailored to each individual patient’s needs and preferences.
Various treatment options can often provide equivalent curative results, allowing patients to work closely with their doctor to choose the option that is best for them. These treatments may include radiation therapy with or without chemotherapy, as well as surgery. Directed and focused nonsurgical treatments are used to preserve function without causing damage to the voice box. Minimally invasive surgical options are offered whenever possible and include the use of lasers and/or robots to remove the tumor, while preserving remaining tissues.
We work closely with all laryngeal cancer patients to provide complete information about their treatment options so they can make the most informed decision possible. This often includes pretreatment consultations with speech and swallowing experts to ensure that functional outcomes can be maximized after treatment.
Not only do patients receive pre-treatment counseling and education from our speech pathology experts, but following treatment, the Clinical Cancer Center’s team of speech-language pathologists also provides patients with individualized, best-practice therapy and rehabilitation. A variety of techniques and rehabilitation options help patients recover with excellent outcomes, including breathing, speech, and swallowing. Additionally, patients have access to the complete menu of patient support resources available through the Clinical Cancer Center.
Laryngeal Cancer - Video FAQ
Jennifer Bruening, MD, surgical oncologist, talks about laryngeal cancer, also known as larynx cancer.
Laryngeal cancer (larynx cancer) is a form of throat cancer that affects the voice box. The most common type of cancer that occurs within the larynx, or voice box, is squamous cell carcinoma.
The leading cause of this is tobacco and alcohol use. Patients who have a history of tobacco and alcohol use (back when they were teenagers and young adults) are still at increased risk of developing this type of cancer. When you quit tobacco or cut back on your alcohol use, you start to reduce your risk.
Jennifer Bruening, MD, surgical oncologist, explains the leading causes of laryngeal cancers.
The most common type of cancer that occurs within the larynx (voice box), is squamous cell carcinoma. The leading cause of this is tobacco and alcohol use.
Patients who have a history of tobacco and alcohol use (back when they were teenagers and young adults) are still at increased risk of developing this type of cancer. When you quit tobacco or cut back on your alcohol use, you start to reduce your risk.
Jennifer Bruening, MD, surgical oncologist, describes laryngeal cancer early warning signs and symptoms.
The symptoms of early stage laryngeal cancer can be very vague in general, but typically include voice changes such as hoarseness or breathiness. Patients can have difficulty swallowing and some ear or throat pain.
Jennifer Bruening, MD, surgical oncologist, describes laryngeal cancer late-stage signs and symptoms.
Symptoms of late-stage laryngeal cancer often include the following.
- Throat pain
- Severe voice changes
- Swallowing difficulties — even swallowing liquids and their own saliva
- Difficulty breathing or noisy breathing called stridor
- Ear pain
- Throat pain
- Feeling of a foreign body or a "frog" in their throat
- Increased phlegm
- Chronic cough
- Coughing up blood
- Significant weight loss (10 or more pounds)
Jennifer Bruening, MD, surgical oncologist, explains laryngeal cancer treatment options for early-stage and advanced laryngeal cancer.
Laryngeal cancer treatment can include surgery, radiation, chemotherapy or even immunotherapy. Early-stage laryngeal cancers can be treated with just surgery or radiation alone, depending on the size and location and the symptoms of the tumor.
More advanced laryngeal cancers often require a combination of these therapies — either surgery plus radiation or radiation plus chemotherapy. In very advanced laryngeal tumors, patients require all three therapies.
Surgery can include minimally invasive techniques for early stage cancers — using endoscopes or microscopes or lasers. Sometimes we need to approach the tumor through the neck. In advanced tumors, we often have to remove the lymph nodes in the neck — the first place that the cancer can spread. And sometimes we have to remove the entire voice box (called a total laryngectomy).
Jennifer Bruening, MD, surgical oncologist, explains that laryngeal cancer is curable.
Laryngeal cancer is curable if treated adequately. Early-stage tumors that haven't spread beyond the voice box have a survival rate of approximately 60 to 80%. Very advanced laryngeal cancers that have spread to other parts of the body tend to have a lower survival rate from 30 to 40%.
Becky Massey, MD, head and neck surgical oncologist, describes voice box removal surgery (laryngectomy).
A laryngectomy from head and neck cancer is removal of the whole voice box. When we do a laryngectomy procedure, patients have their voice box removed, and we reconstruct their neck to separate the functions of breathing and eating.
After a laryngectomy, patients are reconstructed in such a way that they breathe through a hole or a stoma in their neck. They eat through their mouth which is connected directly to their esophagus.
After a laryngectomy, patients most often return to taking a normal diet by mouth. Many patients think that they may not be able to speak after having a laryngectomy. In most cases, people can speak with a laryngectomy by use of a prosthesis that we surgically implant into their neck during their cancer surgery.
Before a laryngectomy, our lungs send air to our larynx which sends air to our mouth which makes words. After laryngectomy surgery, our speech is powered by our lungs in a prosthesis, and our mouth makes the air into words. Many patients have speech after laryngectomy that can be near normal. Many patients can make telephone calls, and the person on the other end may not even know that they're speaking without the use of a larynx.
Becky Massey, MD, head and neck surgical oncologist, explains the reasons for removing the larynx (laryngectomy).
People might need a laryngectomy if they've had chemotherapy and radiation for their cancer. People who have had that treatment who still have a larynx cancer, or have a recurrent larynx cancer, can have laryngectomy surgery and have excellent chance of survival afterward.
Another reason why people may need a laryngectomy is if the cancer destroys the cartilage walls that hold up the larynx. In those cases, people have better function of speech and swallow after removing the voice box.
Becky Massey, MD, head and neck surgical oncologist, explains the survival rates after a total laryngectomy (voice box removal).
Survival rates after a total laryngectomy can be quite good. For many patients, a laryngectomy is the last part of their cancer treatment — if they have not had a cure of their cancer from chemotherapy and radiation. In general, the survival rate for people who have larynx cancer that requires a laryngectomy exceeds 70%.
Hypopharyngeal Cancer - Video FAQ
Jennifer Bruening, MD, surgical oncologist, talk about hypopharyngeal cancer.
Hypopharyngeal cancer is a type of throat cancer that occurs in the tissues surrounding the voice box. A hypopharyngeal cancer is actually a very rare cancer. It occurs in approximately 2,500 patients per year in the United States.
The most common type of cancer that occurs in the hypopharynx is squamous cell carcinoma, and the leading cause of this type of cancer is tobacco and alcohol use.
Jennifer Bruening, MD, surgical oncologist, describes the leading causes of hypopharyngeal cancer.
The most common type of cancer that occurs in the hypopharynx is squamous cell carcinoma. The leading cause of this type of cancer is tobacco and alcohol use.
Jennifer Bruening, MD, surgical oncologist, explains that hypopharyngeal cancer is rare and affects about 2,500 patients per year in the United States.
Jennifer Bruening, MD, surgical oncologist, explains hypopharyngeal cancer lacks early symptoms, which makes it hard to catch and treat early.
The symptoms of early-stage hypopharyngeal cancer are actually minimal or may have no symptoms at all. Hypopharyngeal cancers are actually very difficult to treat because they often present at a late stage.
With early-stage tumors, you might have a sore throat or maybe some coughing or difficulty swallowing. It's usually not until the tumors get larger that patients actually start feeling something different.
This includes swallowing difficulties, breathing difficulties, changes in voice, coughing up blood and significant weight loss (approximately 10 pounds or more).
Jennifer Bruening, MD, surgical oncologist, explains hypopharyngeal cancer is treated with a combination of therapies. Due to its rarity, having a team of doctors experienced in head and neck cancer care helps improve survival.
Hypopharyngeal cancer treatment often includes a combination of surgery, radiation and chemotherapy. These tumors tend to present late or at an advanced stage, so we often require using multiple modalities — meaning a combination of surgery, radiation and chemotherapy.
Even though these tumors are quite rare, our team has very good expertise on treating this. We work together through the surgeons, the radiation oncologists and the medical oncologist to develop a good treatment plan for each patient.
Because hypopharyngeal cancers are quite rare and often present in an advanced stage, it's very important that your treatment team includes experts within the field of head and neck cancers. Having a team that is experienced in head and neck cancers can improve your overall survival.
Jennifer Bruening, MD, surgical oncologist, explains the survival rates for early versus advanced-stage hypopharyngeal cancer.
While early-staged hypopharyngeal cancers can be cured, most patients often present in an advanced stage and, therefore, have a poor survival. Survival rates can range from 25% to approximately 55% at five years.
Very advanced hypopharyngeal cancers have a poor prognosis. Individual outcomes, however, vary from patient to patient. Having an expert team manager cancer can make an impact on your survival.
Virtual Visits Are Available
Safe and convenient virtual visits by video let you get the care you need via a mobile device, tablet or computer wherever you are. We’ll gather your medical records for you and get our experts’ input so we can offer treatment options without an in-person visit. To schedule a virtual visit, call 1-866-680-0505.
Cancer and the COVID-19 Vaccine
There is currently no data that suggests current or former cancer patients should avoid getting the COVID-19 vaccine. Cancer can weaken your immune system, so we recommend that most patients get the vaccine as soon as possible.