All about laryngeal cancer and throat cancer

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Laryngeal cancer is a type of throat cancer that occurs in the voice box or “larynx.” It is one of two types of cancer that occur in the lower part of the throat. The other is hypopharyngeal cancer.

A third type of throat cancer called “oropharyngeal cancer” occurs in the middle part of the throat, just behind the oral cavity. This is the part of the throat a person can see when they open their mouth wide.

The upper throat in this system is called the nasopharynx, and nasopharyngeal cancer can occur there.

Further details of the different types of throat cancer are outlined below.

Laryngeal cancer

Laryngeal cancer affects the larynx in the lower part of the throat. The larynx consists of three sections. From top to bottom, these are:

The supraglottis

The supraglottis sits just above the vocal cords. It contains a flap of tissue called the epiglottis, which closes off the larynx during swallowing to prevent food and fluids from entering the lungs.

Around 35% of laryngeal cancers start in this part of the larynx.

The glottis

The glottis contains the vocal cords, which move together to change the sound and pitch of the voice.

Around 60% of laryngeal cancers start in this part of the larynx.

The subglottis

The subglottis sits below the vocal cords. Only around 5% of laryngeal cancers start here.

Hypopharyngeal cancer

The hypopharynx sits below the larynx, in the lower part of the throat. It serves as the entrance to the esophagus, the tube connecting the mouth and stomach.

The hypopharynx ensures food and fluids go into the esophagus and not the larynx.

In the United States, hypopharyngeal cancers are very rare.

Oropharyngeal cancer

The oropharynx is the middle part of the throat. It consists of the following:

• the back one-third of the tongue
• the soft palate, which sits behind the roof of the mouth
• the tonsils
• the side and back walls of the throat

Nasopharyngeal cancer

Nasopharyngeal cancer forms in the tissues of the nasopharynx, which is the upper area of the throat, connecting the back of the nose to the back of the mouth.

Signs of nasopharyngeal cancer include difficulty breathing, hearing, or speaking.

This section looks at subtypes of throat cancer.

Squamous cell carcinomas

According to the American Cancer Society (ACS), almost all laryngeal, hypopharyngeal, and oropharyngeal cancers are squamous cell carcinomas (SCCs), meaning they develop from squamous cells.

These are thin, flat cells that line the larynx and hypopharynx.

An example is HPV-related SCCs. These can occur following infection with certain types of the human papillomavirus (HPV).

They tend to carry a better prognosis compared to HPV-negative SCCs, as they typically respond better to treatment.

Lymphomas

Other types of oral cavity and oropharyngeal cancers include lymphomas, which are cancers that develop in the lymphatic tissues.

Lymphatic tissues are present in the tonsils and the base of the tongue. Types of lymphomas include non-Hodgkin’s lymphoma.

Minor salivary gland cancers

Rarer forms of laryngeal, oropharyngeal, and hypopharyngeal cancers include minor salivary gland cancers.

These cancers develop in tiny glands called minor salivary glands, which line the mouth and throat. The glands produce mucus and saliva.

Sarcomas

Rarely, cancers can develop in the connective tissues of the larynx and hypopharynx.

Examples of such cancers include chondrosarcomas and synovial sarcomas.

A person should contact a doctor if they develop signs or symptoms of throat cancer that persist for more than 2 weeks, such as:

• persistent sore throat
• ear pain
• voice changes
• hoarseness
• pain when swallowing
• difficulty swallowing
• a lump in the back of the mouth, throat, or neck
• coughing or spitting up blood

Below are some answers to frequently asked questions about throat cancer.

Is laryngeal cancer considered throat cancer?

As the ACS explains, laryngeal cancer is a type of throat cancer. This type affects the voice box, known as the “larynx.”

What are the first signs of laryngeal cancer?

According to the ACS, a common, early sign of laryngeal cancer is vocal changes, such as hoarseness.

A person should see a doctor if they experience vocal changes that persist for more than 2 weeks.

What are the main types of throat cancer?

The four main types of throat cancer are:

• laryngeal cancer, which starts in the larynx of the lower throat
• hypopharyngeal cancer, which starts in the hypopharynx of the lower throat
• oropharyngeal cancer, which starts in the oropharynx in the middle section of the throat
• nasopharyngeal cancer, which starts in the nasopharynx, the upper section of the throat

What can be mistaken for laryngeal cancer?

Laryngeal cancer shares certain features and symptoms with other conditions.

Doctors may need to rule out the following conditions when diagnosing laryngeal cancer:

• Benign tumors: These are noncancerous lesions.
• Sialadenitis: This is inflammation of the salivary glands.
• Bacterial lymphadenopathy: This is when the lymph nodes swell due to a bacterial infection.
• Branchial cleft cyst: A cyst develops in the neck or below the collarbone with this condition.
• Chronic laryngitis: Inflammation of the larynx due to overuse, irritation, or infection.
• Contact granuloma: A benign area of inflammation on the larynx.
• Hemangioma: A red birthmark made up of extra blood vessels in the skin.
• HPV papillomas: Warts that can develop following infection with certain types of HPV.
• Vocal cord polyps: These are small, benign growths on the vocal folds.
• Reinke’s edema: Swelling of the vocal cords due to a buildup of fluid in the area.
• Thyroglossal duct cyst: A rare type of cyst in the throat that is present from birth.

Laryngeal cancer is one of the four main types of throat cancers. This type affects the voice box, or “larynx,” in the lower part of the throat.

Hypopharyngeal cancer is another type of cancer that affects the lower throat, whereas oropharyngeal cancer affects the middle of the throat and nasopharyngeal cancer begins in the upper part of the throat.

These throat cancers share symptoms with many other conditions, most of which are relatively benign. However, a person who experiences symptoms should see a doctor to rule out cancer and any other serious underlying causes.