Laryngeal Cancer Overview

Laryngeal cancer develops in the larynx, commonly known as the voice box. Located in the throat between the pharynx and trachea, the larynx contains the vocal cords and plays an essential role in speaking, breathing and swallowing. It also helps protect the airway during eating and drinking.

Most laryngeal tumors begin in the thin, flat cells that line the inside of the larynx. Because the cancer can affect the vocal cords, persistent hoarseness and other noticeable changes in the sound of the voice are often among the earliest signs. Although laryngeal cancer can become serious if left untreated, many cases can be successfully managed when diagnosed early.

How does laryngeal cancer start?

Laryngeal cancer begins when abnormal cells form within the tissues of the voice box and start multiplying uncontrollably. Over time, these cells can grow into a tumor and invade nearby tissues.

Cancer can develop in any part of the larynx, which is divided into three main regions:

• Supraglottis – Located above the vocal cords
• Glottis – Contains the vocal cords
• Subglottis – Located below the vocal cords

Although glottic cancer is most common, a tumor can develop in any of these areas. In advanced cases, cancer cells may spread to nearby lymph nodes or metastasize to distant organs.

What are the types of laryngeal cancer?

Several types of cancer can affect the larynx, including:

• Squamous cell carcinoma (SCC) – The most common type of laryngeal cancer, SCC develops in the thin cells lining the larynx.
• Verrucous carcinoma – A rare, slow-growing subtype of SCC, verrucous carcinoma is less likely to spread to distant areas.
• Minor salivary gland cancers – Rare tumors may form in the small salivary glands located within the larynx.
• Sarcoma – This uncommon cancer arises in connective tissues, such as muscle or cartilage, within the larynx.

The specific type of cancer can significantly influence both the recommended treatment approach and the patient’s overall prognosis.

How common is laryngeal cancer?

Laryngeal cancer is one of the more frequently diagnosed head and neck cancers, with thousands of new cases identified in the United States each year. The risk is significantly higher among individuals with a history of tobacco use, heavy alcohol consumption or both.

Because the larynx plays a central role in voice production, even a small tumor can cause noticeable vocal changes, such as persistent hoarseness. As a result, many cases are identified at an early stage, which can improve the treatment outcome and increase the likelihood of preserving vocal function.

How does laryngeal cancer impact the body?

Because the larynx plays a critical role in speaking, breathing and swallowing, cancer in this area can affect several essential functions. The most common symptoms are persistent hoarseness and other voice changes, which can occur even if the tumor is relatively small. As the cancer grows, it may begin to interfere with normal airflow through the throat, potentially causing breathing difficulties, noisy breathing or a persistent cough.

Laryngeal cancer may also affect swallowing by causing pain, irritation or a sensation that something is lodged in the throat. In more advanced cases, the tumor may extend into nearby muscles, cartilage or nerves, which can further impair speech, swallowing and airway protection. These changes can have a significant impact on daily activities and overall quality of life, making an early diagnosis and specialized treatment especially important.

What is the prognosis for laryngeal cancer?

The prognosis for laryngeal cancer can vary depending on several factors, including the size, location and stage of the tumor and whether the cancer has spread beyond the larynx. Cancers detected at an early stage—particularly those confined to the vocal cords—are often highly treatable and may be managed while preserving the voice and other important functions.

A more advanced tumor may require a combination of treatments, such as surgery, radiation therapy and chemotherapy, to achieve effective cancer control. Additional factors, including the patient’s smoking status, overall health and response to treatment, can also influence the outcome. Ongoing advances in treatment techniques and supportive care continue to improve both outcomes and quality of life for many people diagnosed with laryngeal cancer.

What are the causes and risk factors for laryngeal cancer?

Laryngeal cancer develops when cells in the tissues of the larynx acquire genetic mutations that cause them to grow uncontrollably and form a tumor. Although the exact cause is not always known, researchers have identified several factors that may increase the risk. These include:

• Advanced age – Laryngeal cancer is diagnosed most often in adults 55 and older, with the risk increasing over time.
• Exposure to industrial toxins or chemicals – Long-term contact with certain harmful substances, including asbestos, paint fumes and chemical vapors, may increase the likelihood of developing laryngeal cancer.
• Gastroesophageal reflux disease (GERD) – Chronic acid reflux can repeatedly irritate the tissues of the throat and larynx, potentially increasing the risk of abnormal cellular changes over time.
• Heavy alcohol consumption – Frequent or excessive alcohol use can damage the lining of the throat and voice box, especially when combined with tobacco use.
• Human papillomavirus (HPV) infection – Certain strains of HPV have been linked to some head and neck cancers, including select cases of laryngeal cancer.
• Male gender – Laryngeal cancer occurs more commonly in men than women, though researchers do not fully understand why.
• Poor nutrition – A diet low in fruits and vegetables may deprive the body of nutrients and antioxidants needed to help protect healthy cells from damage.
• Tobacco use – Smoking cigarettes, cigars or pipes or using other tobacco products significantly increases the risk of laryngeal cancer by directly exposing the throat and larynx to harmful carcinogens.

Is laryngeal cancer preventable?

Although laryngeal cancer cannot always be prevented, certain lifestyle choices and protective measures may help reduce the risk. Because tobacco and alcohol use are among the strongest risk factors, reducing exposure to these substances can play an important role in supporting long-term throat and respiratory health. In addition to avoiding tobacco products and limiting alcohol consumption, potential preventive measures include:

• Maintaining a healthy, balanced diet
• Managing chronic acid reflux when present
• Seeking a medical evaluation for persistent throat or voice symptoms
• Using appropriate protective equipment when working around industrial chemicals or airborne irritants

Early detection is particularly important for laryngeal cancer because symptoms such as chronic hoarseness often develop before the disease becomes advanced. A prompt evaluation of ongoing throat or voice changes may help support an earlier diagnosis, more effective treatment and better preservation of vocal function.

What are the signs and symptoms of laryngeal cancer?

Symptoms of laryngeal cancer often develop gradually and can vary depending on the location of the tumor within the larynx. Persistent throat or voice symptoms that do not improve should be evaluated by a physician.

What are the early warning signs of laryngeal cancer?

Early-stage laryngeal cancer often causes subtle symptoms that may be mistaken for a more common condition, such as laryngitis, acid reflux or allergies. In many cases, the symptoms develop gradually and may persist or worsen over time rather than resolving on their own.

Possible early warning signs of laryngeal cancer include:

• Hoarseness lasting longer than two weeks
• Mild throat discomfort or irritation
• A persistent cough
• A sensation that something is stuck in the throat
• Ongoing voice changes
• Ear pain without a clear cause

Although these symptoms do not always indicate cancer, persistent or worsening throat and voice symptoms should be evaluated by a healthcare professional, especially when they do not improve with routine treatment.

What are the most common symptoms of laryngeal cancer?

As the tumor grows, symptoms may become more apparent and start to interfere with everyday activities involving speaking, breathing and swallowing. Common signs of laryngeal cancer include:

• A chronic or worsening cough
• Difficulty or pain when swallowing
• Mild swelling or a lump in the neck
• Persistent hoarseness or significant voice changes
• Ongoing sore throat or throat irritation
• Shortness of breath or noisy breathing
• Unexplained weight loss

Some people may also cough up blood or experience increasing vocal weakness as the tumor affects the structures responsible for voice production. Because these symptoms can indicate advanced disease or involvement of nearby tissues, a prompt medical evaluation is imperative.

What are the signs of advanced laryngeal cancer?

As laryngeal cancer progresses, it may increasingly interfere with essential functions involving the airway, voice and swallowing. Symptoms often become more severe as the tumor grows into nearby tissues or obstructs portions of the throat.

Signs of advanced laryngeal cancer may include:

• Airway obstruction
• Complete or near-complete voice loss
• Difficulty breathing
• Enlarged lymph nodes in the neck
• Persistent throat pain
• Severe difficulty swallowing
• Unexplained weight loss

In more advanced cases, the tumor may extend into nearby cartilage, muscles or soft tissues, potentially affecting airway protection, speech and overall quality of life. Laryngeal cancer may also spread to nearby lymph nodes or distant areas of the body, requiring more extensive treatment.

What are the signs that laryngeal cancer has spread?

If laryngeal cancer spreads beyond the larynx to nearby lymph nodes or distant parts of the body, additional symptoms may develop depending on the areas affected. Metastatic disease can interfere with normal organ function and may cause more generalized symptoms throughout the body.

Possible signs that laryngeal cancer has spread include:

• Bone pain
• Chest pain
• Persistent or overwhelming fatigue
• Swollen lymph nodes, particularly in the neck
• Significant weight loss

When head and neck cancers spread to distant areas of the body, the lungs are among the most commonly affected sites. In some cases, metastasis may also involve the bones or liver. Because these symptoms can indicate advanced disease, a prompt medical evaluation is essential to determine the cause and guide treatment planning.

How is laryngeal cancer diagnosed?

Diagnosing laryngeal cancer typically involves a combination of physical examination, imaging studies and specialized procedures that allow the physician to closely evaluate the larynx and surrounding structures. Because persistent hoarseness is often one of the earliest warning signs, evaluation by a head and neck specialist is especially important when voice changes last longer than expected or do not improve with routine treatment.

The diagnostic process for laryngeal cancer is designed to determine whether cancer is present and, if so, assess the tumor’s size, exact location and extent of spread. This information will play an essential role in developing an individualized treatment plan focused on both effective cancer control and preservation of vocal and swallowing function.

What laboratory tests can help detect laryngeal cancer?

Although lab testing cannot directly diagnose laryngeal cancer on its own, it can play an important role in evaluating the patient’s organ function and overall health, which can help the physician determine whether the patient is prepared for treatment. Lab work may also reveal underlying conditions that could influence treatment planning or recovery.

Common lab tests include:

• Blood chemistry tests – Measure certain substances in the blood, such as electrolytes, glucose and proteins, which can help the physician evaluate metabolic function, hydration and organ health
• Complete blood count (CBC) – Measures the levels of red blood cells, white blood cells and platelets, which can help the physician identify anemia, infection and other conditions that could affect laryngeal cancer treatment
• Kidney function tests – Assess how effectively the kidneys are filtering waste from the blood, which is especially important before administering certain chemotherapy medications or imaging contrast agents
• Liver function tests – Evaluate how well the liver is functioning, which can help the physician determine whether certain medications used during cancer treatment could be processed safely

Together, these diagnostic tests can provide valuable information about the patient’s overall condition and help support safe, individualized treatment planning.

What imaging tests are used to evaluate laryngeal cancer?

Imaging studies can help the physician evaluate the size of the tumor and determine whether it has spread beyond the larynx. Frequently used imaging tests include:

• Computed tomography (CT) scan – Creates detailed cross-sectional images that can help the physician assess the larynx, nearby lymph nodes and surrounding tissues for signs of cancer involvement
• Magnetic resonance imaging (MRI) – Uses magnetic fields and radio waves to generate highly detailed images that may reveal cancer spread into nearby soft tissues, nerves or cartilage
• Positron emission tomography (PET) scan – Uses a small amount of radioactive tracer to identify areas of abnormal metabolic activity, which may indicate cancer growth or spread throughout the body
• Chest X-ray – May be performed to check the lungs for signs of cancer spread beyond the head and neck region

These imaging studies can provide detailed information about the larynx, nearby lymph nodes, cartilage involvement and distant cancer spread.

What procedures are used to diagnose laryngeal cancer?

A procedure that allows the physician to closely examine the larynx and collect tissue samples is essential for confirming a diagnosis of laryngeal cancer. This specialized evaluation can help the physician determine whether cancer is present, identify the exact location of the tumor and assess the extent of disease involvement.

Common diagnostic procedures for laryngeal cancer include:

• Biopsy – During a biopsy, the physician will remove a small sample of suspicious tissue from the larynx to be sent to a laboratory for microscopic examination. A pathologist will then analyze the specimen to determine whether cancer cells are present and, if so, identify the specific type of cancer.
• Endoscopic examination – The physician will carefully guide a thin, flexible tube equipped with a light and camera through the nose or mouth to obtain a detailed view of the throat and larynx. This procedure will allow the physician to examine the abnormal area more closely and evaluate how well the vocal cords are functioning.
• Fine needle aspiration (FNA) biopsy of lymph nodes – If enlarged lymph nodes are present in the neck, the physician will insert a thin needle into an affected node to collect cells for laboratory testing. This procedure can help the physician determine whether the cancer has spread beyond the larynx.
• Laryngoscopy – Using a specialized scope inserted through the nose or mouth, the physician can closely examine the larynx, vocal cords and surrounding tissues for tumors, abnormal growths and changes in vocal cord movement.

Together, these procedures provide critical information that the physician can use to confirm the diagnosis and develop an individualized treatment plan.

How is laryngeal cancer treated?

Treatment for laryngeal cancer is highly individualized based on several factors, including the tumor’s location within the larynx, the stage of the cancer and whether any nearby tissues or lymph nodes are involved. Because the larynx plays a critical role in speaking, breathing and swallowing, preserving these functions is often a major consideration during treatment planning whenever possible.

Many patients with laryngeal cancer benefit from a combination of therapies, such as surgery, radiation therapy and chemotherapy, carefully tailored to their specific diagnosis and overall health of the patient. A multispecialty team will work together to develop a treatment approach focused not only on effective cancer control but also on maintaining quality of life and the long-term functional outcome.

Surgery for laryngeal cancer

Surgery may be considered to remove part or all of the larynx, depending on the size and location of the tumor. Surgical treatment options for laryngeal cancer may include:

• Partial laryngectomy – Removes only the portion of the larynx affected by cancer while preserving as much normal voice and swallowing function as possible
• Total laryngectomy – Removes the entire larynx if the cancer is extensive or cannot be treated effectively with more conservative approaches
• Laser surgery – Removes small tumors or abnormal tissue through the mouth without the need for external incisions
• Neck dissection – Removes lymph nodes and surrounding tissues in the neck to determine whether the cancer has spread beyond the larynx
• Reconstructive surgery – May help restore appearance, improve swallowing function or assist with speech rehabilitation after laryngeal cancer surgery

Whenever possible, the surgeon will work to preserve speech, swallowing function and airway protection while removing the cancer completely.

Radiation therapy for laryngeal cancer

Radiation therapy is frequently used to treat early-stage laryngeal cancer and may help preserve the voice without requiring extensive surgery. It may also be recommended after surgery to destroy any remaining microscopic cancer cells and reduce the risk of recurrence.

Because the larynx contains delicate structures involved in speaking, swallowing and breathing, precision is especially important during radiation treatment. Advanced radiation delivery techniques can target the tumor while sparing nearby healthy tissues from unnecessary radiation exposure.

Types of radiation therapy for laryngeal cancer include:

• Image-guided radiation therapy (IGRT) – Uses detailed imaging before and during treatment sessions to improve accuracy and ensure radiation is delivered precisely to the intended area
• Intensity-modulated radiation therapy (IMRT) – Uses carefully shaped radiation beams and adjustable dose intensities to conform the treatment closely to the tumor while limiting exposure to surrounding tissues
• Proton therapy – Uses proton beams rather than traditional X-rays to deliver radiation directly to the tumor with exceptional precision

Proton therapy can be especially beneficial for patients with laryngeal cancer, which often develops near structures that are critical for speech, swallowing and airway function. Unlike conventional radiation therapy, proton therapy can reduce the amount of radiation that passes through healthy tissues beyond the tumor site, such as the vocal cords, salivary glands, esophagus and spinal cord. As a result, proton therapy may help reduce both short-term side effects and long-term complications of laryngeal cancer treatment. In some cases, this advanced technology may also improve the patient’s ability to maintain natural speech and swallowing function after treatment.

Chemotherapy for laryngeal cancer

Chemotherapy may be used alongside radiation therapy, before surgery or as the primary treatment for recurrent or metastatic laryngeal cancer. Commonly used chemotherapy drugs include:

• Cisplatin – Damages the DNA inside cancer cells, helping to stop them from growing and spreading
• Carboplatin – An alternative to cisplatin with a different side effect profile, which may be better-suited for certain patients
• Fluorouracil (5-FU) – Interferes with the ability of cancer cells to produce and repair the genetic material needed for continued growth
• Paclitaxel – Disrupts the processes used by cancer cells to divide and reproduce

The specific chemotherapy regimen will be selected based on the tumor’s characteristics and the patient’s overall health and treatment goals.

Targeted therapy and immunotherapy for laryngeal cancer

Targeted therapy and immunotherapy are emerging treatment options that may benefit some patients with advanced, persistent or recurrent laryngeal cancer. Targeted therapy works by interfering with the specific molecular pathways that cancer cells rely on to survive and multiply. Immunotherapy helps strengthen the body’s natural immune system defenses so it can better identify and attack cancer cells.

These treatments may be considered for a patient whose cancer has returned after initial treatment, continues to grow despite standard therapy or has spread to other areas of the body. In some cases, biomarker testing may be used to help the physician determine whether the patient is a candidate for these therapies.

Frequently asked questions (FAQs) about laryngeal cancer

Patients diagnosed with laryngeal cancer often have questions about treatment options, the recovery process and potential changes involving speech or swallowing. Learning more about surgical treatment and how to prepare can help the patient feel more confident about their care:

• How to prepare for laryngeal cancer surgery

Benefit from world-class care at Moffitt Cancer Center

Patients with laryngeal cancer can receive highly specialized care through the Head and Neck Oncology Program at Moffitt. We understand the unique challenges associated with cancers that affect speech, swallowing and breathing, and we work closely with our patients to preserve these critical functions whenever possible.

As a National Cancer Institute (NCI)-designated Comprehensive Cancer Center, Moffitt offers access to advanced diagnostic tools, innovative treatment technologies and clinical trials exploring new approaches for head and neck cancers. Our patients can benefit from sophisticated options, such as proton therapy, minimally invasive surgical techniques and individualized treatment planning.

Moffitt also offers supportive services designed to help our patients manage the physical and emotional effects of cancer treatment, including speech therapy, nutritional counseling, rehabilitation and survivorship resources. Our comprehensive approach allows our patients to receive coordinated care focused on both cancer control and long-term quality of life.

If you would like to learn more about laryngeal cancer, you can request an appointment with a specialist in the Head and Neck Oncology Program at Moffitt by calling 1-888-663-3488 or submitting a new patient registration form online. We do not require referrals.