Diagnosis & staging
Diagnosis
These are tests that may be used to diagnose this type of cancer.
- Physical examination
- In-depth examination by a head and neck specialist (an otolaryngologist) using a mirror (indirect laryngoscopy) or an endoscope.
- Biopsy (usually done under general anaesthetic)
- Imaging of the tumour site by one or more of the following methods:
- X-rays
- Computed tomography (CT)
- Magnetic Resonance Imaging (MRI)
- Positron Emission Tomography (PET)
- Ultrasound
For more information on tests used to diagnose cancer, see our Recommended Websites, Diagnostic Tests section.
Types and Stages
- Nearly all larynx cancers are carcinomas arising from cells that line the larynx (squamous cells), but they differ widely in their behavior depending on their site of origin.
- Cancers of the vocal cords (glottis) are the most common type of larynx cancer. They usually grow slowly; early spread to other sites (metastasis) is uncommon.
- Hyperkeratosis (thickened lesions) on the vocal cords can progress to cancer and should be monitored carefully.
- Cancers of the subglottis are rare (only 1-8% of all larynx cancers), and are more likely to spread to other sites early.
- Supraglottic carcinomas are also rare, and also likely to spread, especially to lymph nodes of the neck.
Staging describes the extent of a cancer. The TNM classification system is used as the standard around the world. In general a lower number in each category means a better prognosis. The stage of the cancer is used to plan the treatment.
T describes the site and size of the main tumour (primary)
N describes involvement of lymph nodes
M relates to whether the cancer has spread (presence or absence of distant metastases)
-
T1
The tumour is limited to just one part of the larynx; all the parts have normal mobility. -
T2
The tumour extends to more than one part of the larynx and the mobility of the vocal cords may be impaired. -
T3
The tumour is limited to the larynx but vocal cords have lost mobility; supraglottic tumours may have invaded adjacent structures like the postcricoid area. -
T4
The tumour has spread into the soft tissues of the neck, thyroid, pharynx, or esophagus. -
T4a
Surgical removal is possible -
T4b
Surgical removal is not possible