Laryngeal cancer (cancer of the voice box) produces symptoms earlier than many other cancers, because even a small change in the vocal cords affects the voice immediately. Recognising the symptoms and going for an examination in time allows the diagnosis to be made at an early stage. This page explains which symptoms you should watch for and how the diagnostic process proceeds.
Early symptoms
- Hoarseness that has not gone away for a few weeks or is gradually getting worse
- A rough, cracking or easily tiring voice
- A feeling of something stuck in the throat, of a foreign body, or of dryness
- A frequent need to clear the throat
- Mild pain or discomfort on swallowing
These symptoms also occur for harmless reasons such as a cold, reflux or overuse of the voice. What makes the difference is that the symptoms do not go away on their own.
Advanced symptoms
- Difficulty swallowing and inability to swallow solid food
- Pain radiating to the ear on the same side
- Noisy breathing and shortness of breath
- A swelling or hardness you can feel in the neck
- Coughing up blood-stained phlegm
- Unexplained weight loss and bad breath
When is an examination needed?
If hoarseness lasts longer than a few weeks, and especially if you smoke or drink alcohol, it is advisable to have an ear, nose and throat examination rather than wait and see. The same applies if, even without hoarseness, you have persistent throat pain, difficulty swallowing or a swelling in the neck. The examination is short and painless; finding out the cause before your worry grows is the healthiest way forward.
How is the diagnosis made?
- Examination and endoscopy: The ear, nose and throat doctor first assesses the neck and throat by hand and by eye. Then, with a thin, flexible camera (flexible endoscope) passed through the nose or mouth, the vocal cords and all parts of the larynx are viewed directly. This is done in the consulting room with a local anaesthetic spray and takes a few minutes.
- Biopsy: When a suspicious area is seen, a tissue sample must be taken to make a definite diagnosis. This is usually done under general anaesthesia, in a procedure in which the larynx is examined under a microscope through a tube placed via the mouth (direct laryngoscopy). The sample is examined in the pathology laboratory and the result is reported within a few days.
- Imaging: The depth of the tumour within the larynx, whether it has spread into the cartilage and the state of the lymph nodes in the neck are assessed with computed tomography or magnetic resonance imaging. If considered necessary, advanced imaging methods that also scan other parts of the body are used.
After the diagnosis
The pathology and imaging results are brought together to determine the stage of the disease. This information forms the basis for creating the treatment plan that is most suitable for you. Do not hesitate to ask your doctor every question that comes to mind while the diagnosis is being made; understanding what is happening makes it easier for you to take part in the decisions.
Frequently asked questions
Can laryngeal cancer occur without hoarseness?
Yes. Tumours that start above or below the vocal cords may affect the voice late; in that case the first symptom may be difficulty swallowing, a sore throat or a swelling in the neck.
Is the endoscopic examination painful?
No. The examination with a thin, flexible camera is completed within a few minutes using a local anaesthetic spray and usually causes only mild discomfort.
Does a biopsy spread the cancer?
No. A biopsy is a necessary and safe procedure for diagnosis; there is no scientific evidence that it causes the tumour to spread.
This page is general information. Decisions about diagnosis and treatment are made for you personally, and only after an examination. If you have symptoms, see a doctor.