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Vocal Cord Cancer

What is vocal cord cancer?

Most cancer experts agree that vocal cord cancer likely starts as small areas of abnormal cells (dysplasia) undergo sequential changes that ultimately lead to the development of cancer. Precancerous lesions may appear as a white or red plaque (called leukoplakia or erythroplakia) on the vocal cord, while cancers themselves are often larger and thicker than the precancerous lesions. Any of these findings on exam indicate that a biopsy or removal of the lesion needs to be done to rule out the presence of cancer. Research suggests that removing precancerous lesions may reduce the risk of developing cancer.

An estimated 10,000 cases of vocal cord cancer are diagnosed nationally each year. Vocal cord cancer is very closely linked with a history of smoking, though nonsmokers may get vocal cord cancer as well. Fortunately, many vocal cord cancers present early because the lesion creates hoarseness that often prompts early evaluation.

What are the symptoms of vocal cord cancer?

Symptoms of vocal cord cancer include:

  • Voice change

  • Chronic sore throat, sometimes with ear pain

  • Trouble swallowing with associated weight loss

  • Trouble breathing

  • Sensation of something stuck in the throat

  • The appearance of one or more lumps that can be felt in the neck

  • Coughing up of blood

Vocal Cord Cancer Treatment

If a suspicious lesion is seen during an office exam, a biopsy is most often performed in the operating room. Based on the size, appearance and location of the lesion, either some or all of it may be removed. If the results indicate a precancerous lesion only, your treatment team will discuss the best follow-up plan for you, which may include a series of follow-up examinations and possibly repeated treatments over time to keep it from progressing. If the results of a biopsy indicate cancer, more aggressive treatment is often needed.

The goal of vocal cord cancer treatment is to completely remove or kill the cancerous growth while preserving as much normal tissue and function as possible. The treatment recommendation will often vary depending on the location and size of the tumor. Treatment options include:

Surgery: This seeks to completely remove the cancerous growth while preserving as much normal tissue as possible. Removing portions or all of a vocal cord can have profound effects on voice and swallowing, and specialists in this type of surgery will try to completely remove the tumor while sparing as much normal tissue as possible. Surgery can often be performed through the mouth but occasionally an open surgery through the neck is needed.

Radiation therapy: This treatment is designed to kill the cancerous cells. The entire voice box is treated at the same time. While radiation treatment technology has dramatically improved over the years, doses of radiation needed for definitive treatment of a vocal cord cancer can still sometimes lead to long-term voice and swallowing problems.

In general, the chance of a cure with early vocal cord cancer is roughly equivalent whether surgery or radiation is used. Your treatment team, working with a radiation oncologist, will help you decide which treatment option is best for you.

Reviewed by Lee Akst, M.D., from the Department of Otolaryngology-Head and Neck Surgery.

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