Laryngeal (Voice Box) Cancer

Laryngeal cancer starts in the voice box, most often on the vocal cords themselves (glottic), less often above them (supraglottic) or below (subglottic). Almost all are squamous cell carcinomas.

Cancers on the vocal cords cause hoarseness early, so many are found at a small, highly treatable stage. Treatment decisions balance cure against the three functions of the larynx: voice, swallowing and breathing.

Symptoms

• Hoarseness or voice change lasting more than three weeks
• A persistent sore throat or feeling of a lump in the throat
• Pain or difficulty swallowing
• Ear pain on one side with a normal ear
• A lump in the neck
• Persistent cough or coughing blood
• Noisy breathing or shortness of breath in advanced disease

Causes and risk factors

Tobacco smoking is the dominant cause and alcohol multiplies its effect. Other contributors are occupational exposure to asbestos, wood dust, paint fumes and strong acids, long-standing reflux, and human papillomavirus in a small proportion. It is several times more common in men and is usually diagnosed after the age of 55. Continuing to smoke during and after treatment reduces the chance of control and raises the risk of a second cancer.

How it is diagnosed

• Flexible nasendoscopy: A thin camera through the nose in the clinic shows the cords and their movement. Stroboscopy adds detail for small lesions.
• Microlaryngoscopy and biopsy under general anaesthetic: Provides the tissue diagnosis and maps the tumour.
• CT or MRI of the neck: Shows depth of invasion, cartilage involvement and lymph nodes.
• CT chest or PET-CT: Checks for spread and for a second tumour in the lungs.
• Voice and swallowing assessment: By a speech and language therapist before treatment.

Treatment options

• Transoral laser microsurgery: Removal of early cord tumours through the mouth, usually as a day case or single night.
• Radiotherapy: An equally effective alternative for early disease, given daily over three to six weeks, often with a better voice outcome for larger early tumours.
• Chemoradiotherapy: Larynx-preserving treatment for many locally advanced cancers.
• Partial laryngectomy: Open or robotic removal of part of the larynx in selected cases.
• Total laryngectomy: Removal of the whole larynx for advanced tumours that have destroyed cartilage, or for recurrence after radiotherapy. Breathing is then through a permanent opening in the neck, and speech is restored most often with a valve placed between windpipe and gullet.
• Rehabilitation: Speech and swallowing therapy, stoma care training, dental care and stop-smoking support.

When it is urgent

Noisy, laboured breathing, inability to swallow saliva, or coughing up significant blood are emergencies needing immediate care at the nearest hospital. Hoarseness for more than three weeks, especially in a smoker, needs a local ENT examination promptly.

Travelling to Türkiye for treatment

A second opinion on whether the larynx can be preserved is a legitimate reason to consult abroad, and it can often begin remotely with your endoscopy video, scans and pathology. Laser surgery for early cancer fits a visit of about a week. Radiotherapy takes up to seven weeks plus recovery, and a total laryngectomy needs three to four weeks and a good deal of training afterwards, so both demand a realistic plan for support. Follow-up examinations every few months for five years must be available at home.

Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.

Frequently Asked Questions