Cancer - throat or larynx

Alternative names
Vocal cord cancer; Throat cancer; Laryngeal cancer; Cancer of the glottis

Definition
Cancer of the throat involves malignant tumors (growths) on the vocal cords, voice box (larynx), or other areas of the throat.

Causes, incidence, and risk factors

People who smoke or otherwise use tobacco are at risk of developing tumors of the throat. Excessive alcohol use also increases risk, and smoking and alcohol use together constitute an extreme risk for the development of throat cancers.

Most cancers of the throat develop in adults older than 50, and men are 10 times more likely than women to develop throat cancers.

Symptoms

     
  • Hoarseness that does not resolve in 1 to 2 weeks  
  • Sore throat that does not resolve in 1 to 2 weeks, even with antibiotics  
  • Neck pain  
  • Difficulty swallowing  
  • Swelling in the neck  
  • Unintentional weight loss  
  • Cough  
  • Coughing up blood  
  • Abnormal (high-pitched) breathing sounds

Signs and tests

An examination of the neck and throat may show cancer of the throat. The sputum may appear bloody. A lump may appear on the outside of the neck. A laryngoscopy, which is examination by use of a tube with a small lighted camera (laryngoscope), allows the physician to look into the mouth and down the throat to see the tumor.

A neck or cranial CT scan or cranial MRI may show throat cancer. These tests will also help determine if the cancer has spread to lymph nodes in the neck.

Biopsy and analysis of tissues that appear abnormal may confirm the presence of a cancerous tumor.

Treatment

Treatment is aimed at destruction of the cancer and prevention of spread of the cancer to other parts of the body.

When the tumor is small, either surgery or radiation therapy alone can be used to eliminate the tumor.

When the tumor is larger or has spread to lymph nodes in the neck, combination radiation and chemotherapy is often used to preserve the voice box and is successful in most cases.

Surgical removal of the tumor, including all or part of the vocal cords (laryngectomy) may be necessary in some cases. If a laryngectomy is required, a surgical prosthesis (artificial vocal cords) may be implanted, voice aids may be used, or speech therapy may be recommended to teach alternative methods of speaking.

Many patients also need swallowing therapy after treatment to help them adjust to the changes in the structure of the throat.

Support Groups
The stress of illness can often be eased by joining a support group of people who share common experiences and problems. See cancer - support group.

Expectations (prognosis)

Throat cancers can be cured in 90% of patients if detected early. If the cancer has spread to surrounding tissues or lymph nodes in the neck 50-60% of patients can be cured. If the cancer has spread (metastasized) to parts of the body outside the head and neck, the cancer is not curable and treatment is aimed at prolonging quality of life.

After treatment patients generally need therapy to help with speech and swallowing. A small percentage of patients (5%) will not be able to swallow and will need to be fed through a feeding tube.

Complications

     
  • Airway obstruction  
  • Loss of voice and speaking ability  
  • Disfigurement of the neck or face  
  • Hardening of the skin of the neck  
  • Difficulty swallowing  
  • Spread of the cancer to other body areas (metastasis)

Calling your health care provider
Call your health care provider if symptoms indicate cancer of the throat, especially hoarseness or change in voice with no obvious cause that lasts longer than 1 week. Also call your health care provider if you find a lump in the neck that does not go away in 2-3 weeks.

Prevention
Minimize or avoid smoking and excess alcohol use.

Johns Hopkins patient information

Last revised: December 8, 2012
by Armen E. Martirosyan, M.D.

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