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Larynx Cancer Symptoms and Diagnosis

Symptoms of Larynx Cancer
The symptoms of cancer of the larynx depend mainly on the size and location of the tumor. Most cancers of the larynx begin on the vocal cords. These tumors are seldom painful, but they almost always cause hoarseness or other changes in the voice. Tumors in the area above the vocal cords may cause a lump on the neck, a sore throat, or an earache. Tumors that begin in the area below the vocal cords are rare. They can make it hard to breathe, and breathing may be noisy.

A cough that doesn’t go away or the feeling of a lump in the throat may also be warning signs of cancer of the larynx. As the tumor grows, it may cause pain, weight loss, bad breath, and frequent choking on food. In some cases, a tumor in the larynx can make it hard to swallow.

Any of these symptoms may be caused by cancer or by other, less serious problems. Only a doctor can tell for sure. People with symptoms like these usually see an ear, nose, and throat specialist (otolaryngologist).

Diagnosis of Larynx Cancer
To find the cause of any of these symptoms, the doctor asks about the patient’s medical history and does a complete physical examination. In addition to checking the general signs of health, the doctor carefully feels the neck to check for lumps, swelling, tenderness or other changes. The doctor can also look inside the larynx in two ways:

Indirect laryngoscopy
The doctor looks down the throat with a small, long–handled mirror (laryngeal mirror) to check for abnormal areas and to see whether the vocal cords move as they should. This test is painless, but a local anesthetic may be sprayed in the throat to prevent gagging. This exam is done in the doctor’s office.

Direct laryngoscopy
The doctor inserts a lighted tube (laryngoscope) through the patient’s nose or mouth. As the tube goes down the throat, the doctor can look at areas that cannot be seen with a simple mirror. A local anesthetic eases discomfort and prevents gagging. Patients may also be given a mild sedative to help them relax. Sometimes, the doctor uses a general anesthetic to put the person to sleep. This exam may be done in a doctor’s office, an outpatient clinic, or a hospital.

If the doctor sees abnormal areas, the patient will need to have a biopsy. A biopsy is the only sure way to know whether cancer is present. For a biopsy, the patient is given a local or general anesthesia, and the doctor removes tissue samples through a laryngoscope. A pathologist then examines the tissue under a microscope to check for cancer cells. If cancer is found, the pathologist can tell what type it is. Almost all cancers of the larynx are squamous cell carcinomas. This type of cancer begins in the flat, scale–like cells that line the epiglottis, vocal cords, and other parts of the larynx.

If the pathologist finds cancer, the patient’s doctor needs to know the stage (extent) of the disease to plan the best treatment. To find out the size of the tumor and whether the cancer has spread, the doctor usually orders more tests, such as X–rays, a CT (or CAT) scan, and/or an MRI. During a CT scan, many X–rays are taken. A computer puts them together to create detailed pictures of areas inside the body. An MRI scan produces pictures using a huge magnet linked to a computer.

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