Introducing: Ask a Doctor
At UTHSC ENT, we understand that patients need clear, helpful answers to their questions. We also know that a flood of new information can be overwhelming.
That’s why our department’s introducing Ask a Doctor: an ongoing series of posts that tackle Frequently Asked Questions about common issues. We hope these articles give you a better understanding of your situation and an easy path to treatment.
Today, we highlight vocal cord cancer.
Prepared by: Philip Morgan
Reviewed by: Dr. Sandra Stinnett
What is vocal cord cancer?
The vocal cords are folds found in a part of the throat called the larynx or voice box. The vocal cords open and close to regulate the air flow to and from the lungs. When air passes through this narrowed opening the vocal cords can vibrate and produce a sound that the upper airway, tongue, and mouth can form into speech.
Vocal cord (glottic) cancer is the result of malignant (cancerous) cell growth on these folds. In the early stage of disease these cancerous cells may be viewed by your physician as red or white lesions on the tissue that covers the cords.
As the cancer cells continue to divide, the tumor can prevent the vocal cords from working properly and spread to other parts of the larynx. Cancer can affect one or both vocal cords and may be detected early because of changes in the voice such as hoarseness.
What causes vocal cord cancer?
Many people who are diagnosed with laryngeal cancers including vocal cord cancer have a history of smoking and tobacco use. Research shows that smoking can also reduce the effectiveness of treatment for vocal cord cancer and increase the chances that the cancer comes back.
If you are a smoker and you are concerned about cancer or have been diagnosed, you may wish to talk to your doctor about methods to quit smoking. Excessive alcohol consumption has also been linked to higher risk for vocal cord cancer.
Although smoking and alcohol consumption are major risk factors, sometimes individuals who do not smoke or drink will develop vocal cord cancer. A common virus called human papillomavirus (HPV) may also increase the chances of getting laryngeal cancer. Some research shows that acid reflux could be involved as well.
What are its symptoms?
Symptoms include (but are not limited to):
- Hoarseness or “breathy” voice lasting longer than 3 weeks
- Chronic sore throat (may also experience ear pain)
- Difficulty swallowing
- Chronic cough (blood may be brought up)
- Sensation that something is stuck in the throat
- Difficulty catching your breath while talking
- Lumps that can be felt in the neck
- Unexplained weight loss
This drawing illustrates what the vocal cords look like, their position in the airway, and how they open and close in order to regulate air flow and make sound.
How is vocal cord cancer diagnosed?
You and your physician will discuss your medical history, the results of your physical exam and your symptoms. You may be referred to an ear nose and throat specialist (Otolaryngologist) in order to assess problems with the larynx and vocal cords.
Laryngoscopy is a common technique which involves using a thin camera, inserted through the mouth or nose, to look down into the voice box. If your doctor notices a suspicious lesion or growth a tool on the camera can be used to take a small tissue sample called a biopsy.
If the results of the biopsy show that the cells are cancerous then you may need further diagnostic testing such as a CT, MRI, or PET-CT scan to see the location and spread of the cancer. Fortunately, when vocal cord cancer is diagnosed early there is often no spread from the primary tumor site (where the cancer started). This is because cancer cells have a more difficult time spreading to other parts of the throat from the vocal cords.
If the tumor has spread into other parts of the larynx then cancer cells can invade lymph nodes on one or both sides of the neck. The size of the tumor as well as the spread of the cancer to other locations will allow your doctor to determine the stage that your cancer is in and use this information to help create a treatment plan.
What are the treatments?
You and your healthcare team will work together to create a treatment plan based on the size and stage of the tumor, your medical history, the desired voice result, values or concerns you may have, and cost of treatment.
The two most common treatments for vocal cord cancer are:
1) Laser surgery. This can be done using a small camera and tools that are inserted through the mouth while you are under anesthesia. The surgeon burns away the cancerous growths while aiming to preserve the healthy tissue of the vocal cords.
2) Radiation therapy. Using beams of x-ray radiation, the doctor kills the cancer cells on and around the vocal cords. These treatments are done over the course of several weeks as outpatient visits.
For early vocal cord cancer these treatment options have the same success or cure rate. The goal in both cases is to remove or kill all the cancer cells and to preserve as much of the voice function as possible.
Chemotherapy is not as common for early vocal cord cancer because the side-effects are thought to outweigh the benefits. Chemotherapy used along with radiation may become an option in later stage vocal cord cancer if the cancer cells have spread to other parts of the neck.
Removal of the larynx (laryngectomy) and surgery on the neck to remove cancerous lymph nodes or metastases (new tumors) may also be necessary in late-stage vocal cord cancer. You will need to work with your doctor to find out which therapy is right for you.
When the disease is caught early the survival and treatment outcomes for vocal cord cancer are usually good compared to other types of laryngeal cancer. However, if left untreated the cancer can lead to the loss of vocal cord function which means difficulty in speaking or loss of the voice. This can also create severe problems in breathing which may require a tracheostomy.
Cancer can spread out of the voice box and into the lymph nodes and blood vessels of the neck allowing it to invade other parts of the body. The treatment options and techniques that your healthcare team and specialists will use depend on the stage and severity of the cancer.
How can our Dream Team help?
UTHSC ENT’s Dream Team provides world class treatment in your hometown. No one is better suited to address vocal cord cancer than our renowned Voice Box Doctor, Sandra Stinnett M.D.
If you’re having any issue with your voice, Dr. Stinnett should be your first call!