Laryngeal cancer

What is laryngeal cancer?

The larynx is also called the voicebox. It is in the neck, above the windpipe (trachea) and in front of the gullet (oesophagus).

The larynx allows air you breathe to reach your lungs. It also contains the 2 vocal cords which vibrate together when air passes between them. This makes the sound of your voice.

Laryngeal cancer is also called cancer of the larynx. Around 2,360 people in the UK are diagnosed with cancer of the larynx each year.

Booklets and resources

Types of laryngeal cancer

Most cancers of the larynx are squamous cell carcinoma. This means the cancer starts in the thin, flat cells that line the larynx.

Some rarer types of cancer of the larynx include the following:

Sarcoma – cancer of the connective tissues in the larynx.
Lymphoma – cancer of the lymphatic tissue in the larynx.
Adenocarcinoma – cancer that starts in the glandular (adeno) cells of the larynx.
Neuroendocrine carcinoma – cancer that develops from cells similar to nerve (neuro) cells that make hormones (endocrine). Hormones control how different organs in the body work.

This information is about treatment for squamous cell cancer of the larynx. For information about rarer types of cancer of the larynx, contact our cancer information nurses on 0808 808 00 00.

Symptoms of laryngeal cancer

The most common symptom of laryngeal cancer is changes to your voice, such as hoarseness.

If you are worried about laryngeal cancer, we have more information about the signs and symptoms.

Risk factors and causes of laryngeal cancer

Doctors do not know the exact cause of laryngeal cancer. But certain risk factors can increase your chance of developing it.

Having one or more risk factors does not mean you will definitely get laryngeal cancer. Some people with risk factors never get cancer. Other people can still develop cancer of the larynx without any known risk factors, although this is not common.

This type of cancer is rare in people under the age of 40. It is more common in people over 60. It is 4 times more common in men than women.

The main risk factors are smoking tobacco and drinking alcohol.

Smoking

The risk of developing cancer of the larynx increases the longer you smoke for and the more you smoke.

We have more information about giving up smoking.

Alcohol

Drinking lots of alcohol (especially spirits) over a long time increases your risk of developing cancer of the larynx. The risk is higher for people who smoke and also drink lots of alcohol.

You can find information about alcohol guidelines and how alcohol can affect your health at drinkaware.co.uk.

As with other cancers, laryngeal cancer is not infectious. This means you cannot pass it onto other people.

Diagnosis of laryngeal cancer

If you have symptoms, you usually start by seeing your GP. They will examine you and may arrange some tests.

They might refer you to an ear, nose and throat (ENT) doctor or a specialist clinic.

The specialist will:

ask about your symptoms
check your general health
ask whether you take any medicines
feel for lumps in your neck.

Swollen lymph nodes may be causing these lumps. But other medical conditions, such as a swollen salivary gland, can also cause lumps.

After carefully examining you, they will explain what tests you need.

These may include a:

Nasendoscopy

A nasendoscopy is used to look at the back of your mouth and throat.
Laryngoscopy and biopsy

A laryngoscopy is used to look at the larynx closely. During the laryngoscopy the doctor collects a sample (biopsy) of cells if tissues from the area look abnormal.
Fine needle aspiration (FNA)

An FNA is a simple test used to check lumps in your neck.

Further tests for laryngeal cancer

If there are cancer cells in your larynx, your doctor will ask you to have some more tests. These will help you and your doctor make decisions about treatment.

Possible tests include:

Blood tests

You may have blood tests to check your general health and what treatments may be suitable for you.
CT scan

A CT scan makes a detailed picture of the inside of the body. The picture is built up using x-rays taken by the CT scanner.
MRI scan

An MRI scan uses magnetism to build up a detailed picture of areas of your body.
PET or PET-CT scan

A PET scan uses a low dose of radiation to check the activity of cells in different parts of the body. It can give more detailed information about cancer or abnormal areas seen on x-rays, CT scans or MRI scans. You may have a PET scan and a CT scan together. This is called a PET-CT scan.

Waiting for test results can be a difficult time. We have more information that can help.

Staging and grading of laryngeal cancer

The results of your tests help your doctors find out more about the size and position of the cancer and whether it has spread. This is called staging.

A doctor decides the grade of the cancer by how the cancer cells look under the microscope. This gives an idea of how quickly the cancer might grow or spread.

Knowing the stage and grade of laryngeal cancer helps doctors decide the best treatment for you.

Treatment for laryngeal cancer

A team of specialists will meet to discuss the best possible treatment for you. This is called a multidisciplinary team (MDT).

Your cancer doctor or specialist nurse will explain the different treatments and their side effects. It can help to write down any questions before you see them. They will also talk to you about the things you should consider when making treatment decisions.

Treatment for laryngeal cancer depends on:

where the cancer is in the larynx
the size of the cancer and whether it has spread (its stage)
how fast-growing the cancer is (its grade)
your general health.

We have more detailed information about laryngeal cancer treatment.

The main treatments for early stage laryngeal cancer are radiotherapy and surgery. Other treatments may be used for locally advanced and advanced laryngeal cancer.

Radiotherapy

Radiotherapy uses high-energy rays to destroy the cancer cells. It can be given on its own, with chemotherapy (chemoradiation) or with a targeted therapy drug.
Surgery

You may have surgery through your mouth if you have early stage laryngeal cancer. If the tumour is large you may need surgery to remove part or all of the larynx (laryngectomy).

Some people also have surgery to remove cancer that has spread to nearby lymph nodes (a neck dissection).
Chemoradiation

Having chemotherapy at the same time as radiotherapy is called chemoradiation. It may be given as your main treatment, if the cancer is locally advanced. Or it may be used if the cancer cannot be removed with surgery. It is also sometimes used to reduce the risk of the cancer coming back after surgery (adjuvant treatment).
Chemotherapy

Chemotherapy can be given before and after surgery. It can be given on its own or with radiotherapy. It an also be given to slow the growth of the cancer and control symptoms (palliative chemotherapy).
Targeted therapy

Targeted therapy uses drugs to find and attack cancer cells. There are many different types of targeted therapy. Each type of therapy targets something in or around the cancer cell that is helping it grow and survive. The most commonly used targeted therapy to treat laryngeal cancer is cetuximab (Erbitux®).
Immunotherapy

The immune system protects the body against illness and infection. Immunotherapy treatments use the immune system to find and attack cancer cells. The immunotherapy drugs used to treat laryngeal cancer are nivolumab and pembrolizumab.

The treatments can be used alone or in combination with each other. We have information to help you understand more about treatments. Learn more about:

Related pages

After laryngeal cancer treatment

Once your treatment has finished, you will have regular follow-up appointments with your healthcare team. These may continue for several years.

It is important to tell your doctor about any new symptoms you have, or any symptoms that are not improving. Do not wait until your next appointment to tell them.

You may get anxious between appointments. This is natural. It may help to get support from family and friends or a support organisation.

We are also here to support you. If you would like to talk, we will listen. You can:

Call the Macmillan Support Line on 0808 808 00 00.
Chat to our specialists online.
Visit our laryngeal (larynx) cancer forum to share your experience, talk with people who have been affected by laryngeal cancer, and ask an expert your questions.

Wellbeing and recovery

It can take time to recover after treatment. There might be physical changes in the way you look. Or you may have to cope with changes to your daily life, such as speaking and eating.

Even if you already have a healthy lifestyle, you may choose to make some positive lifestyle changes after treatment. There are things you can do to help your body recover and improve your sense of wellbeing. You may choose to:

Stop smoking

Giving up smoking can be difficult, but there is lots of support available. Speak to your doctor or specialist nurse, or call a stop smoking helpline for further advice.
Drink less alcohol

Drinking alcohol will greatly increase your risk of developing another head and neck cancer. You can reduce this risk if you stop or reduce the amount of alcohol you drink. Drinkaware.co.uk has more information about alcohol and drinking guidelines.
Eat well and keep active

It can be difficult to eat well after treatment for laryngeal cancer, but your dietician can help you. Eating well and keeping active will help keep up your strength, increase energy levels and improve your sense of wellbeing.
Complementary therapies

Complementary therapies such as yoga or meditation and can help you feel better and reduce stress and anxiety. It is important to talk with your cancer doctor or specialist nurse first as some therapies may not be suitable to use alongside certain cancer treatments.

Sex life

The physical and emotional effects of cancer and its treatment may affect your sexual confidence. After treatment, some people have problems with their body image.

Laryngeal cancer and its treatments can change how you feel about kissing and having sex. This usually improves over time.

Late effects

Some side effects of treatment can take time to get better. Sometimes side effects may become permanent. Other side effects may develop some time after treatment has finished. These are called late effects.

Learn more about the late effects of laryngeal cancer treatment.

Your feelings after laryngeal cancer treatment

For some people, it may take several months to recover from treatment. It can be difficult to cope if treatment has changed your appearance, voice or how you eat and drink. It is common to feel overwhelmed by different feelings.

There are national support groups that you may find helpful:

Changing Faces
Changing Faces offers advice and information to anyone who is affected by a change in their appearance.
Cancer Laryngectomee Trust
The Cancer Laryngectomee Trust provides support to people who are about to have, or have had a laryngectomy.
National Association of Laryngectomee Clubs
The National Association of Laryngectomee Clubs aims to promote the welfare of people who have had a laryngectomy, and their families
The Swallows Head and Neck Cancer Support Group
The Swallows offers face-to-face support groups across the UK and online support groups for people with head and neck cancers, and those that care for them.

About our information

References

Below is a sample of the sources used in our laryngeal cancer information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk

ESMO Annals of Oncology. Squamous cell carcinoma of the oral cavity, larynx, oropharynx and hypopharynx. EHNS-ESMO-ESTRO Clinical Practice Guidelines for diagnosis, treatment and follow up. 2020. Available from www.esmo.org/guidelines/head-and-neck-cancers/squamous-cell-carcinoma-of-the-head-and-neck (accessed Jan 2022).

NICE Guideline NG36. Cancer of the upper aerodigestive tract: assessment and management in people aged 16 and over. 2018. Available from www.nice.org.uk/guidance/ng36 (accessed Jan 2022).

NICE Technology Appraisal TA736. Nivolumab for treating recurrent of metastatic squamous cell carcinoma of the head and neck after platinum-based chemotherapy. 2021. Available from www.nice.org.uk/guidance/ta736 (accessed Jan 2022).

Reviewers

This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Claire Paterson, Consultant Clinical Oncologist.

Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.