Laryngeal and Hypopharyngeal Cancer

Laryngeal cancer is a disease in which malignant (cancer) cells form in the tissue of the larynx. According to the American Cancer Society (ACS), approximately 12,000 people are diagnosed with laryngeal cancer in the United States every year and approximately 3,600 deaths will occur.

Hypopharyngeal cancer is very rare. Only about 2,500 cases are seen in the United States each year. Because of this, hypopharyngeal cancer is difficult to diagnose in its earliest stages and has one of the highest mortality rates of any head and neck cancer.

Laryngeal cancer includes cancerous cells found in any part of the larynx, which consists of the glottis, the supraglottis, subglottis and the epiglottis.

  • The larynx, often referred to as the voice box, is a two-inch long tube-shaped organ located in the neck at the top of the trachea (windpipe). The cartilage in front of the larynx is sometimes called the Adam's apple.
  • The vocal cords (or vocal folds) are two bands of muscle that form a V shape inside the larynx.
  • The area of the larynx where the vocal cords are located is called the glottis. The area above the cords is called the supraglottis, and the area below the cords is called the subglottis.
  • The epiglottis is a flap at the top of the trachea that closes over the larynx to protect it from food that is swallowed into the esophagus.

Hypopharyngeal cancer is a disease in which malignant cells grow in the hypopharynx (the area where the larynx and esophagus meet).

It first forms in the outer layer (epithelium) of the hypopharynx (last part of the pharynx), which is split into three areas. Progression of the disease is defined by the spread of cancer into one or more areas and into deeper tissues.

Otolaryngology surgeons at Brigham and Women’s Hospital (BWH) specialize in surgical techniques for laryngeal and hypopharyngeal cancer. We offer the most current diagnostic methods and proven treatments, including minimally invasive surgical approaches aided by video technology. We are the surgical team for Dana-Farber Brigham Cancer Center, an exceptional collaboration between two world-class medical centers.

Laryngeal and Hypopharyngeal Cancer Topics

Symptoms of 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.

Causes and Risk Factors for Laryngeal and Hypopharyngeal 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.

Read how Brigham and Women Hospital otolaryngologists treat GERD.

Diagnosis of Laryngeal and Hypopharyngeal 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.
Treatment of Laryngeal and Hypopharyngeal Cancer

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
What You Should Expect

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.

Learn more about your hospital stay and returning home.

Multidisciplinary Care

Brigham and Women's 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 BWH’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.

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Resources

Go to our health library to learn more about laryngeal cancer.

Learn more about laryngeal cancer from information provided by the National Cancer Institute.

Watch a video on Transoral Robotic Surgery (TORS), a minimally invasive procedure which improves outcomes and avoids complications in patients with oral cancers.

Visit the Kessler Health Education Library in the Bretholtz Center for Patients and Families to access computers and knowledgeable staff.

Learn about the Weiner Center for Preoperative Evaluation.

Access a complete directory of patient and family services.

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