Laryngeal and Hypopharyngeal Cancer

The following are the most common symptoms of laryngeal cancer. However, each individual may experience symptoms differently. Symptoms may include:

• Swollen lymph nodes in the neck
• A cough that does not go away
• A sore throat that does not go away
• Feeling of a lump in the throat
• Hoarseness or voice change
• Difficult or painful swallowing
• Frequent choking on food
• Pain when swallowing
• Trouble breathing
• Noisy breathing
• Ear pain that does not go away
• A lump in the neck
• Unplanned weight loss
• Bad breath

The symptoms of laryngeal or hypopharyngeal cancer may resemble other conditions or medical problems. Always consult your health care provider for a diagnosis.

Read more about laryngeal cancer.

The exact cause of laryngeal cancer is not known. However, there are certain risk factors that may increase a person's chance of developing this cancer.

• Tobacco use including chewing tobacco
• Alcohol abuse
• Poor nutrition
• More common in men than in women
• Older than 65
• More common in African-Americans
• Workplace exposures. People exposed to wood dust, paint fumes, asbestos, and some other chemicals appear to be at increased risk for laryngeal cancer.
• Gastroesophageal reflux disease (GERD) is a risk factor for esophageal cancer and is being studied as a possible risk factor for laryngeal cancer.

In addition to a complete medical history and physical examination, your health care provider may carefully examine your neck to check for lumps, swelling, tenderness, and other changes.

Other diagnostic exams may be performed:

• Indirect laryngoscopy. A small, long-handled mirror is inserted into the throat so parts of the larynx can be examined.
• Direct laryngoscopy. An instrument called a laryngoscope is inserted through the nose or mouth. The scope is a narrow, lighted tube, which provides a better view of the area than the indirect laryngoscopy.
• Endoscopy, Esophagoscopy, or Bronchoscopy. A thin, lighted tube inserted into the nose or mouth allows the doctor to see further down into the throat into the esophagus or trachea.
• Biopsy. This is a small tissue sample that can be acquired during an endoscopy, esophagoscopy, or bronchoscopy. The tissue is analyzed for the presences of cancer cells.
• CT-scan or MRI. These tests will give doctors a detailed picture of any abnormalities in the body. For a CT scan, the patient often swallows a dye that coats the throat and provides a better image. An MRI is a better tool if the patient is pregnant because the test uses no radiation.
• PET scan (positron emission tomography scan). A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.
• Bone scan. A procedure to check if there are rapidly dividing cells, such as cancer cells, in the bone. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones and is detected by a scanner.
• Barium swallow. A series of x-rays of the esophagus and stomach. The patient drinks a liquid that contains barium (a silver-white metallic compound). The liquid coats the esophagus and stomach, and x-rays are taken. This procedure is also called an upper GI series.

Specific treatment for laryngeal and hypopharyngeal cancers will be determined by your doctor based on:

• Your age, overall health, and medical history
• Extent of the disease
• Your tolerance for specific medications, procedures, or therapies
• Expectations for the course of the disease
• Your opinion or preference

Treatment may include one, or a combination of, the following:

• Surgery to remove the cancerous cells or tumor
• Radiation therapy to kill cancerous cells or keep them from growing in the treated area
• Chemotherapy to shrink tumors or kill cancerous cells that may have spread to other parts of the body
• Targeted therapy to kill cancerous cells

Careful monitoring and the involvement of an experienced otolaryngologist are important to the successful outcome for patients with ear, nose and throat disorders and conditions.

If you are having surgery or a procedure, you will likely be scheduled for a visit to the Weiner Center for Preoperative Evaluation for pre-operative information and tests.

If surgery is needed, you will be cared for in the operating room by an experienced otolaryngology surgeon. After surgery, you will recover in the post-surgical care unit where you will receive comprehensive care by an experienced medical and nursing staff.

Brigham and Women’s Faulkner Hospital provides a multidisciplinary approach to patient care by collaborating with colleagues who have extensive experience in diagnosing and treating ear, nose and throat disorders and conditions. In addition, patients have full access to Brigham and Women's Hospital's world-renowned academic medical community, with its diverse specialists, and state-of-the-art facilities.

When surgery is necessary, our board-certified surgeons offer extensive surgical experience, performing thousands of operations per year. Our otolaryngologists are faculty members at Harvard Medical School and active researchers who continually seek causes and investigate treatments for conditions and diseases affecting the ear, nose and throat.