Laryngeal cancer symptoms can be similar to those of other conditions. They may include:

• Coughing up blood or bloody sputum
• Ear pain
• Hoarseness
• Lump in the neck or throat
• Sore throat or cough that does not go away
• Trouble or pain when swallowing

Certain factors can increase your risk of developing larynx cancer. Having one or more risk factors does not mean you will develop cancer, and some people with no risk factors develop the disease.

Laryngeal cancer more often affects males, older adults, and African Americans. Your risk for laryngeal cancer also increases with:

• Heavy alcohol use
• Human papillomavirus (HPV) infection
• Poor nutrition
• Tobacco use
• Weakened immune system

The most common type of laryngeal cancer is squamous cell carcinoma (squamous cell cancer), which starts in the thin, flat squamous cells lining the inside of the larynx.  

Other types of cancers that can start in the larynx include:

• Salivary gland cancer: Starts in the larynx’s minor salivary glands
• Sarcoma: Develops within the tissue connecting the larynx with other structures

Rare forms of laryngeal cancer include:

• Lymphoma: Starts in the lymph system, part of the body’s immune system
• Neuroendocrine tumor: A mass of abnormal cells in the systems that control hormones, nerves, and other processes
• Plasmacytoma: A type of blood cancer 

After diagnosing laryngeal cancer, your doctor runs tests to understand if the cancer affects your vocal cords and has spread elsewhere in the body. This process is called staging, with Stage 0 describing the early signs of disease and Stage 4 indicating an advanced case.

Learning your laryngeal cancer’s stage helps you and your doctor make decisions about your treatment plan. This information is also helpful in determining your prognosis (probable outcome based on the experience of others).

Laryngeal cancer stages can be complicated, so talk with your doctor to understand your situation. Stages also differ based on the part of the larynx where cancer started (supraglottis, glottis, or subglottis). In general terms, laryngeal cancer stages are:

Your doctor first feels your neck. If they detect swollen lymph nodes, the doctor will perform a laryngoscopy. This exam allows your doctor to check your larynx, vocal cords, and other parts of the throat. Laryngoscopy types include:

• Indirect laryngoscopy: Your doctor holds a mirror at the back of the throat and shines a light on it to see the larynx’s reflection in the mirror.
• Flexible fiberoptic laryngoscopy: Your doctor sends a flexible laryngoscope (thin tube with a lens or camera on the end) through your nose and into your throat. They may take some tissue samples for a biopsy. Doctors usually administer this examination in their offices.    
• Direct rigid laryngoscopy: This comprehensive examination allows your doctor to look for tumors in the larynx and any issues throughout the throat using a rigid (stiff) laryngoscope. Your doctor may also collect tissues samples for a biopsy. You may need to go to the hospital and receive anesthesia for this procedure.  

Your doctor inserts an endoscope (thin tube with specialized tools) through the mouth to examine the digestive tract. During an endoscopy, we may take some tissue samples for a biopsy.

Imaging tests provide detailed pictures of the inside of your body and can help doctors see a tumor’s size and location. These tests can also show whether cancer has spread to lymph nodes or other areas of the body. Your doctor may order one or more imaging tests that use various technologies, such as:

• Computed tomography scan (CT scan): Special X-ray and computer equipment create images of bones, tissues, and organs.
• Magnetic resonance imaging scan (MRI): Powerful magnets, radio waves, and a computer create clear, detailed pictures.
• Barium swallow/upper gastrointestinal (GI) series: A drinkable fluid called barium coats your digestive system’s organs, helping the organs show up when we perform an X-ray. 
• Positron emission tomography (PET scan): A PET scan is a type of nuclear medicine imaging that measures cell activity in the body. You receive a small amount of a radioactive substance called a tracer that travels through your body. The tracer collects in areas of increased cell activity (hot spots), which show up brighter on the scan. These hot spots typically indicate cancerous cells.
• PET/CT scan: A combination of PET and CT technology shows areas of increased cell activity, along with highly detailed images of surrounding organs and tissues.
• PET/MRI scan: This PET and MRI combination highlights cell abnormalities while providing detailed images of the brain, internal organs, and soft tissues, with less radiation exposure than a CT scan.  

If imaging tests suggest you have laryngeal cancer, your doctor may order a biopsy of the tumor. A biopsy takes a tiny sample of cells from abnormal areas to check for cancer.

Our doctors use several types of biopsies, including:

• Needle biopsy: Your doctor inserts a very thin needle (fine needle aspiration) or a wider needle (core biopsy) into a tumor.
• Image-guided biopsy: A radiologist uses an imaging technique such as ultrasound or MRI to guide the needle for the biopsy.
• Endoscopy: Your doctor inserts a thin, flexible fiber optic tube down the nose or throat to collect a sample.
• Surgical (or excisional) biopsy: Your surgeon may remove all or part of a tumor to be tested.

Before and during treatment, we take small samples of your blood to test in the lab. Blood tests provide information about your health and help us monitor any potential side effects of treatment for laryngeal cancer.