Laryngeal (Voice Box) Cancer, from the CureRays guide library.

Laryngeal cancer forms in the voice box; when caught early it is highly curable with radiation that preserves the voice, and even advanced cases can often be cured while keeping the larynx.

What it is.

Laryngeal cancer is a cancer of the larynx, or voice box — the structure in the throat that contains the vocal cords and lets us speak, while also protecting the airway during swallowing. Most laryngeal cancers are squamous cell carcinomas that arise from the cells lining the larynx. Because the voice box is so closely tied to the voice, a common early warning sign is a hoarse voice that does not go away; other signs include a persistent sore throat, a cough, trouble swallowing, ear pain, a lump in the neck, or, in more advanced cases, noisy or difficult breathing. The main risk factors are tobacco use and heavy alcohol, especially together. The encouraging news is that laryngeal cancer is often found early — because hoarseness prompts people to see a doctor — and early-stage disease is highly curable, frequently with radiation alone that preserves the voice. Even more advanced cancers can often be cured while keeping the voice box, using radiation combined with chemotherapy. Care is provided by a head-and-neck team focused on both curing the cancer and protecting voice and swallowing.

How radiation treats it.

Radiation uses focused high-energy beams to damage the DNA inside cancer cells so they can no longer grow and divide. The larynx is well suited to radiation: for early vocal-cord cancer, radiation alone cures the great majority of patients while preserving a strong, natural voice, which is often a better voice result than surgery. Treatment is given as a series of short daily sessions over several weeks. For larger tumors and when lymph nodes in the neck need treatment, modern techniques such as IMRT shape the dose tightly around the cancer while sparing the swallowing muscles, salivary glands, and spinal cord. In advanced disease, adding chemotherapy makes the cancer more sensitive to radiation and improves the chance of curing it while keeping the voice box, sparing many patients from removal of the larynx. Side effects such as sore throat, dry mouth, voice changes, and difficulty swallowing are watched closely and managed by the team, including speech and swallowing therapists. Your radiation oncologist will tailor a plan aimed at curing the cancer while protecting your voice and quality of life.

The ways we can treat it.

Radiation for early glottic cancer. Precisely targeted radiation to a small vocal-cord tumor cures the great majority of patients while keeping a strong, natural voice, which is why it is a preferred option for early disease.

Intensity-modulated radiation therapy (IMRT). For larger tumors and the neck, IMRT shapes the dose around the cancer and lymph nodes while sparing the swallowing muscles, salivary glands, and spinal cord.

Concurrent chemoradiation. Chemotherapy given with radiation makes the cancer more sensitive to the beams, improving the chance of cure and of keeping the voice box in advanced disease.

Questions we hear often.

Will I lose my voice? Usually not, especially with early cancer. Radiation can cure most early voice-box cancers while preserving a strong, natural voice, and even many advanced cancers are cured while keeping the larynx using radiation plus chemotherapy. Total removal of the voice box is reserved for advanced or recurrent cases — and even then, several methods can restore the ability to speak.

Is radiation or surgery better for early laryngeal cancer? Both cure the large majority of early cancers, so the choice often comes down to voice quality, convenience, and your preferences. Radiation frequently gives an excellent voice result, while laser surgery may be done in a single procedure. Your team will help you weigh the options for your specific tumor.

What happens if I need my voice box removed? If a total laryngectomy is necessary, you can still communicate. Options to restore speech include a small valve placed between the windpipe and esophagus (tracheoesophageal puncture), an electronic device held to the neck, or learned esophageal speech. A speech-language therapist will guide you through whichever method suits you best.

This guide is informational only. It is not medical advice — please confirm anything here with your care team.