By Dr. Laureano Giraldez-Rodriguez, MD, FACS
There are diagnoses that change your life. Laryngeal cancer is one of them. However, when detected early, laryngeal cancer has very high cure rates. The problem is that many people ignore the early warning signs or attribute them to trivial causes. The goal of this article is for you to recognize those signs and act in time.
What Is Laryngeal Cancer?
The larynx is the organ that contains the vocal cords and allows us to speak, breathe, and swallow safely. Laryngeal cancer occurs when cells in this structure begin to multiply uncontrollably. It is the most common type of head and neck cancer, excluding skin cancers, and predominantly affects men, although its incidence in women has been increasing.
Cancer can originate in different areas of the larynx. The most frequent type affects the vocal cords directly, known as glottic cancer. It can also originate above the vocal cords, in the supraglottic region, or below them, in the subglottic region.
Risk Factors You Should Know
Tobacco is, without a doubt, the most important risk factor for laryngeal cancer. Smokers have a risk up to 30 times higher than non-smokers. Excessive alcohol consumption is another significant factor, and when combined with tobacco, the risk multiplies synergistically — meaning the combination is more dangerous than the sum of both factors separately.
Other risk factors include occupational exposure to substances such as asbestos, paint fumes, and certain industrial chemicals; chronic untreated gastroesophageal reflux; and a diet low in fruits and vegetables. Age is also a factor: most cases are diagnosed after age 55.
Early Warning Signs You Should Not Ignore
The most important and earliest sign of laryngeal cancer is persistent hoarseness. When cancer originates in the vocal cords, even a very small tumor disrupts their vibration and produces a change in the voice. This is a diagnostic advantage: hoarseness appears when the tumor is still small and curable.
The rule I repeat constantly to my patients and colleagues is this: any hoarseness lasting more than two weeks without improvement requires an evaluation of the vocal cords. It doesn’t matter if you think it’s from a cold, from talking too much, or from allergies. Two weeks of hoarseness warrants an examination.
Other warning signs include persistent sore throat that does not respond to standard treatments, a sensation of a foreign body in the throat, difficulty or pain when swallowing, referred ear pain, persistent cough, difficulty breathing or noisy breathing, and unexplained weight loss.
Early Diagnosis Makes a Difference
The difference between detecting laryngeal cancer at an early stage versus an advanced stage is dramatic. A stage one glottic cancer has a cure rate above 90%. In contrast, cancer diagnosed at advanced stages may require far more aggressive treatments and carries a considerably less favorable prognosis.
Diagnosis begins with a direct visualization of the larynx through laryngoscopy, from which the best course of action is determined if cancer requires treatment.
Treatment Options
Treatment of laryngeal cancer depends on the stage and location of the tumor. In early stages, options include endoscopic laser surgery — where the tumor is removed through the mouth without external incisions, preserving the larynx and voice — and radiation therapy, which can also cure small tumors while preserving laryngeal structure.
In more advanced stages, a combination of more extensive surgery, radiation therapy, and chemotherapy may be necessary. In some cases, total laryngectomy — the complete removal of the larynx — may be required. Although this involves the loss of the natural voice, alternatives for communication exist, such as esophageal voice, the electrolarynx, and voice prostheses.
The Importance of Taking Action
Laryngeal cancer, like many other cancers, is a battle more easily won when fought early. Do not wait for symptoms to become unbearable, nor justify them indefinitely with everyday explanations. Hoarseness that persists for more than two weeks, discomfort when swallowing that won’t go away, a cough that settles in for no apparent reason — your body is speaking to you. Listen to it.
A timely consultation can be the difference between a simple treatment and one that changes your life forever.