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Larynx (VoiceBox) Cancer

Laryngeal cancer, or voice box cancer, is a type of head and neck cancer characterized by the growth of tumors on the vocal cords (glottis), or the tissues above (supraglottis) or below (subglottis) them. Untreated, the cancer may spread to the thyroid, trachea, esophagus and nearby lymph nodes. It often afflicts smokers. It is also nine times more common in men than women.

Symptoms of Laryngeal Cancer

Unlike some other types of cancer, larynx cancer is relatively easy to detect, making it very treatable when caught early. Symptoms vary depending on the size and location of the cancer.

Persistent hoarseness and voice changes are the main signs of tumours on the vocal cords. For cancers affecting the tissues above or below the vocal cords, common symptoms include:

  • Neck lumps or swelling
  • Painful swallowing
  • Breathing difficulties
  • Earache
  • Sore throat
  • Bloody nasal discharge or coughing up blood
  • Weight loss

Seek medical attention should these symptoms persist or worsen, so as to obtain an accurate diagnosis.

What are the Risk Factors?

  • Older age (45 years and up)
  • Being male: men are more likely to get laryngeal cancer than women
  • Medical or family history of head and neck cancer
  • Heavy alcohol consumption or smoking
  • Occupational exposure to asbestos, formaldehyde and coal dust
  • Poor nutrition
  • Immune system disorders such as HIV

Diagnosing Laryngeal Cancer

Apart from reviewing your medical and family history and checking your symptoms, a head and neck surgeon may recommend the following tests to diagnose larynx cancer:

  • Physical exam – Using a gloved finger, the doctor will manually feel (palpate) the inside of the mouth to look for abnormalities.
  • Imaging tests – Various tests such as an MRI, barium X-ray, and CT, PET and bone scans are done to locate and map out tumors within the throat.
  • Laryngoscopy – A thin, lighted instrument attached with a camera is inserted into the throat to get a closer look at the larynx. This form of endoscopy may also be used for biopsies and tumor removal.
  • Biopsy – A tissue sample is obtained from the larynx and assessed by a pathologist for signs of cancer.

What are the Treatment Options?

Different types of larynx cancer treatments are available, depending on the size, stage and location of the tumor, with surgery, radiation and chemotherapy being the most standard methods.

  • Surgery – The aim of surgery in treating laryngeal cancer is to remove the tumor without affecting the ability to talk. This is usually done by removing one of or both the vocal cords (cordectomy), removing the top part of the larynx above the vocal cords (supraglottic laryngectomy) or removing only the affected part of the larynx (partial laryngectomy).
  • Radiation therapy – High-energy beams are applied to the affected area to kill cancer cells. This may be done to shrink the tumor first before it is removed via surgery.
  • Chemotherapy – Medications, either taken by mouth or IV, are used to kill cancer cells. Similar to radiation therapy, this may be done to first shrink the tumor or stop it from growing before being removed via surgery.

A/Prof Luke Tan is a Singapore head and neck surgeon with more than 15 years of experience in the comprehensive screening and treatment of ENT, mouth and thyroid cancers. To learn more about our services, call 6474 6116 today.

Take Home:

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  • Transoral Laser Surgery
  • Partial Layrngeal Surgery

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