Cancer can develop in the larynx, vocal cords, tonsils, or pharynx. These cancers can be more common in people exposed to certain carcinogens, including cigarette smoke and asbestos.

Cancer is a class of diseases in which abnormal cells multiply and divide uncontrollably in the body. These cells form malignant, or cancerous, growths called tumors.

When people talk about throat cancer, they often mean cancer of the:

  • gullet (esophagus)
  • windpipe (trachea)
  • voice box (larynx)

Doctors do not usually use the term “throat cancer.” Instead, they refer to the particular area in which the cancer appears.

In this article, we look at cancer that affects the voice box (larynx), the vocal cords, and other parts of the throat, such as the tonsils and pharynx.

The National Cancer Institute (NCI) refers to these cancers as:

  • pharyngeal cancer, often grouped with oral cavity cancer as oropharyngeal cancer
  • laryngeal cancer

Throat cancer is relatively uncommon compared with other cancers.

According to the NCI, oropharyngeal cancer accounts for 2.8% of all cancer cases and 1.9% of all deaths from cancer in the United States. In the larger population, the chance of having one of these cancers is around 1.2%.

According to the NCI, laryngeal cancer accounts for around 0.6% of new cancer cases and 0.6% of cancer deaths in the United States. Around 0.3% of people will develop this type of cancer at some time.

The treatment plan and outlook for someone with cancer depends on the type of cancer. A biopsy can show what type of cancer cell is present.

The most common type of throat cancer is squamous cell carcinoma. It affects the flat cells lining the throat.

Two main categories of throat cancer are:

Pharyngeal cancer

This cancer develops in the pharynx, the hollow tube that runs from behind your nose to the top of your windpipe.

Pharyngeal cancers that develop in the neck and throat include:

  • Nasopharynx cancer: upper part of the throat
  • Oropharynx cancer: middle part of the throat
  • Hypopharynx cancer: bottom part of the throat

Laryngeal cancer

This cancer forms in the larynx, which is your voice box. Cancer can develop in the:

  • Supraglottis: part of the larynx above the vocal cords
  • Glottis: part of the larynx around the vocal cords
  • Subglottis: part of the larynx below the vocal cords
Anatomy of throat and surrounding structuresShare on Pinterest
Illustration by Diego Sabogal

Common signs and symptoms of cancers that occur in the throat include:

Make a doctor’s appointment if any of these symptoms develop and do not go away.

The risk factors for throat cancer depend on the type.

Here are some general factors that may increase the risk of developing oropharyngeal and laryngeal cancer:

People who smoke and drink a lot are around 30 times more likely to develop oropharyngeal cancer than those who do not. They’re also much more likely to develop laryngeal cancer, according to the American Cancer Society.

Oral HPV is a sexually transmitted virus that affects around 10% of males and 3.6% of females, according to the Centers for Disease Control and Prevention (CDC). The CDC adds that HPV may account for around 70% of cases of oropharyngeal cancer in the United States.

Males are more likely to develop oropharyngeal or laryngeal cancers than females. While the overall rate is higher among white people, it’s significantly higher for Black males compared with all females and with males from other races, according to statistics published by the NCI.

A 2014 study notes the difference in survival rates for laryngeal cancer between Black and white American males increased rather than decreased between 1975 and 2002.

Study authors suggest that socioeconomic factors, a later stage at diagnosis, and less access to appropriate treatment could be the reasons.

It’s not always possible to prevent throat cancer, but you can take steps to reduce your risk:

  • avoid or quit smoking and tobacco use
  • monitor your alcohol intake and reduce it to moderate levels if needed
  • consume a nutrient-rich diet that includes plenty of fresh fruits and vegetables and limits the intake of added fats, sugars, and highly processed foods
  • get regular physical activity

According to the NCI, alcohol use and smoking combine to form the biggest risk factor for developing these cancers.

This makes avoiding or limiting alcohol consumption and avoiding smoking two main ways of helping prevent head and neck cancers.

At your doctor’s appointment, your doctor will ask about your symptoms and medical history.

If symptoms such as a sore throat, hoarseness, and persistent cough are not improving and don’t have an explanation, your doctor may suspect cancer in some part of the throat.

To check for throat cancer, your doctor can perform a laryngoscopy. They may refer you to a specialist for a panendoscopy.

A laryngoscopy gives your doctor a closer view of the larynx. They may use special mirrors to see these areas or insert an endoscope into your throat for a clearer view. An endoscope is a thin tube with a camera at the end.

A panendoscopy allows the specialist to see the larynx, esophagus, mouth, nasal cavity, and possibly the lungs at one time.

If cancer is present in one location, it can also occur in other areas prone to the same risk factors, such as smoking. The specialist can then order a tissue sample, called a biopsy, for testing.

They can also order imaging tests, such as an X-ray, CT scan, MRI scan, or ultrasound, to help get a correct diagnosis.

Blood tests cannot show if cancer is present in the mouth or throat, but they can help assess your overall health.

If your doctor needs more detail about your esophagus, you may need to have an X-ray after drinking a chalky liquid called a barium swallow. The barium swallow helps show any problems with the esophagus on an X-ray.

A bone scan can show whether cancer has spread to the bones.

If your doctor finds cancerous cells in your throat, they will order additional tests to identify the stage, or the extent, of your cancer.

The most basic way of staging cancers in the throat involves a number system, ranging from 0–4:

  • Stage 0: The tumor is only on the top layer of cells of the affected part of the throat.
  • Stage 1: The tumor is limited to the part of the throat where it started.
  • Stage 2: The tumor has grown into a nearby area.
  • Stage 3: The tumor has grown into other structures in the throat or spread to one lymph node.
  • Stage 4: The tumor has spread to the lymph nodes or distant organs.

To work out the stage, your doctor considers:

  • the tumor size (T)
  • lymph node involvement (N)
  • whether any cells have spread to other parts of the body, known as metastasis (M)

Together, these are known as the TNM staging system. The diagnosis depends on how these factors combine.

Cancer staging is a complex process. If you receive a diagnosis, your doctor considers the stage, grade, and individual factors to prepare your treatment plan.

Learn more about what cancer stages mean.

A number of specialists will be involved in your diagnosis and treatment, such as:

  • a medical oncologist, who uses chemotherapy to treat tumors
  • a surgical oncologist or an otolaryngologist, who performs surgical procedures like the removal of tumors
  • a radiation oncologist or a radiologist, who treats your cancer using radiation therapy
  • a pathologist, who examines tissue samples from your biopsy
  • an anesthesiologist, who administers anesthesia and monitors your condition during a biopsy or surgery
  • a psychologist, if needed

Treatment options for throat cancer include:

  • surgery
  • radiation therapy
  • chemotherapy

The treatment method your doctor recommends depends on the cancer stage and other factors.

Surgery

If the tumor in your throat is small, your doctor may surgically remove the tumor. This surgery is done in the hospital while you’re under sedation.

Your doctor may recommend one of the following surgical procedures:

  • Endoscopic surgery: A surgeon uses an endoscope to pass surgical instruments or lasers to treat early stage cancers. An endoscope is a long, thin tube with a light and camera at the end.
  • Cordectomy: This procedure removes all or part of your vocal cords.
  • Laryngectomy: This procedure removes all or a portion of your voice box, depending on the severity of the cancer. Some people can speak after surgery, but others need to learn how to speak without a voice box.
  • Pharyngectomy: This procedure removes a part of your throat.
  • Neck dissection: If throat cancer spreads within the neck, your doctor may remove some of your lymph nodes.

Radiation therapy

Following the removal of the tumor, your doctor may recommend radiation therapy. Radiation therapy uses high energy rays to destroy cancer cells. It targets any cancerous cells the tumor has left behind.

Types of radiation therapy include:

  • Intensity-modulated radiotherapy and 3D-conformal radiation therapy: In both types of treatment, radiation beams are tailored to the tumor’s shape. This is the most common way of giving radiation for laryngeal and hypopharyngeal cancer.
  • Brachytherapy: A specialist places radioactive seeds directly inside the tumor or close to the tumor. Although this type of radiation could be used for laryngeal and hypopharyngeal cancer, it rarely is.

Chemotherapy

In the case of large tumors and tumors that have spread to the lymph nodes and other organs or tissue, your doctor may recommend chemotherapy as well as radiation.

Chemotherapy is a drug that kills and slows the growth of cancer cells.

Targeted therapy

Targeted therapies are drugs that stop the spread and growth of cancer cells by interfering with specific molecules responsible for tumor growth. One type of targeted therapy used to treat throat cancer is cetuximab (Erbitux).

Experts are researching other types of targeted therapy. Your doctor may recommend this therapy along with standard chemotherapy and radiation, possibly as part of a clinical trial.

Immunotherapy

This treatment involves drugs that enable your own immune system to fight cancer. The drugs are called checkpoint inhibitors.

Usually, the immune system uses cells called checkpoints to turn on an immune response when the body needs it. Cancers, however, sometimes use these checkpoints to stop the immune system from attacking them. Some drugs stop these checkpoints from working. When this happens, the immune system can attack the cancer cells.

If you have laryngeal cancer, two checkpoint inhibitors that may help shrink a tumor are pembrolizumab (Keytruda) and nivolumab (Opdivo).

If these drugs are suitable for you, a doctor may prescribe them alone or alongside chemotherapy. They are given through a vein, usually every 3, 4, or 6 weeks.

People with throat cancer may require therapy after treatment to relearn how to speak. A speech therapist and a physical therapist can help with this.

Other people in recovery may learn a whole new type of speech, such as:

  • esophageal speech
  • electrolarynx speech
  • tracheoesophageal prosthesis

This is different than simply “relearning.” It doesn’t exactly sound like traditional speech.

In addition, some people with throat cancer experience complications. These may include:

  • difficulty swallowing
  • changes in the appearance of the neck or face
  • difficulty speaking
  • difficulty breathing
  • skin hardening around the neck

Occupational therapists can help with swallowing difficulty. If you need reconstructive surgery to help with this or other issues, your doctor can advise you on the next best steps.

The outlook for people with cancer in the throat depends on various factors. These include where it started, the type, and individual factors, such as whether the person smokes cigarettes and continues to smoke.

Per the American Cancer Society, if you receive an early diagnosis, before cancer has spread, the 5-year relative survival rate is 59%. This means you have a 59% chance of living another 5 years compared with a person who does not have cancer.

The overall 5-year relative survival rate for people with oropharyngeal cancer is 52%, according to the American Cancer Society.

For laryngeal cancer, the NCI states the 5-year relative survival rate is 61.6%, but rates vary according to where cancer starts.

For example, if you have cancer in the glottis, the area that includes the vocal cords, and it has not spread beyond the original site, your chance of living at least another 5 years is around 84%, according to the American Cancer Society.

These figures are based on statistics for people who received a diagnosis between 2013 and 2019. They cannot predict the outcome for people with these cancers as they do not consider a person’s unique situation. They also don’t account for any recent medical advancements.

Is throat cancer very curable?

Early stage laryngeal cancer is highly curable with radiation or surgery. When diagnosed early enough, the larynx may be saved.

How do I check myself for throat cancer?

If you have symptoms such as a hoarse voice or sore throat that does not go away, seek medical advice. Symptoms like these could be due to many conditions. A doctor can provide a correct diagnosis.

Can you have throat cancer for years and not know it?

Symptoms for some types of throat cancer may present earlier than in others, but it’s highly unlikely to have any form of throat cancer for years without having any symptoms.

How is throat cancer removed?

Surgery or radiation therapy is required to remove oropharyngeal or laryngeal carcinomas, depending on various other factors.

Various types of cancer can affect the throat, including oropharyngeal and laryngeal cancer. Smoking and high alcohol consumption increase the risk. However, not everyone who develops these cancers will have these risk factors.

Getting an early diagnosis can help improve the outcome of these and other types of cancer.