Many cancers of the larynx and some of the hypopharynx can be found early--when they are small and have not spread. Cancer that forms on the vocal cords are often found early because they cause hoarseness. Cancers that start above or below the vocal cords are often found at later stages.

Talk to your doctor if you have any of these symptoms:

• sore throat that doesn't go away
• constant coughing
• pain when swallowing
• trouble swallowing
• ear pain that doesn't go away
• trouble breathing
• weight loss
• hoarseness or voice changes that last more than 2 weeks
• lump or mass in the neck

Tests to find out if you have laryngeal or hypopharyngeal cancer

History and physical exam

If there is any reason to suspect cancer, the first step is for the doctor to gather facts about your health, symptoms, risk factors, and family history. You will have a physical exam and your doctor will ask you questions about your health. Your doctor will probably refer you to a specialist in diseases of the ear, note, and throat (called an ENT doctor, an otolaryngologist, or a head and neck surgeon). You will also need to have some tests. These might include any of the following:

Blood tests: Blood tests won't tell if you have these cancers, but they will give information about your overall health.

Complete head and neck exam: If there is reason to suspect a cancer, you will need to have a careful exam of your mouth, head, and neck area. The larynx and hypopharynx are deep inside the neck and not easy to check. This doctor will give you an exam with a mirrors and special fiber-optic scope. This thin, flexible, lighted tube will be put through your mouth or nose and moved down to your throat. It helps the doctor to see these areas.

Panendoscopy: If the doctor suspects you have cancer in the head and neck he or she will do a complete exam of this area. This exam is done in the operating room after you are given drugs to make you sleep (general anesthesia). The surgeon looks at the entire area through a scope and may take a sample of tissue (biopsy) to be looked at under a microscope. Biopsy is discussed below.

Imaging tests

Once a tumor has been found, imaging studies may be useful in finding out how far it has spread.

CT (computed tomography) scan: These scans (also call CAT scans) use x-rays to take a series of pictures of the body from many angles. A computer combines the pictures to form a detailed image. This test can help your doctor learn the size of the tumor and whether it has spread to the lymph nodes or nearby tissue. CT scans take longer than regular x-rays. You will need to lie still on a table while they are being done. You may also have an IV (intravenous) line through which a contrast "dye" is injected. You may be asked to drink 1 to 2 pints of a liquid called "oral contrast" before any pictures are taken. This helps outline your organs so that they are not mistaken for tumors.

MRI (magnetic resonance imaging): Like a CT scan, an MRI displays a cross-sectional picture of the body. But the MRI uses radio waves and strong magnets instead of x-rays. MRI scans take longer than CT scans--often up to an hour. Also, you are placed in a narrow tube which can upset some people. Newer, open MRI machines can help with this, if needed. A contrast dye might be injected just as with CT scans. MRI scans are very useful for pictures of the brain and spinal cord. They are sometimes more helpful than CT scans for other places in the body, too.

Barium swallow: This is a series of x-rays taken while you swallow a liquid with barium in it. Barium coats the inside surface of the throat and helps create a good picture. This test helps to see how your throat looks as you swallow.

Chest x-ray: This is routine for people with head and neck cancers. It is done to look for cancer in the lungs.

PET scan: PET scans use a form of sugar that contains a radioactive atom. The sugar is put into a vein and after a certain amount of time cancer cells in the body absorb large amounts of the sugar. A special camera can then find where the sugar has collected. Your doctor can use this test to see whether the cancer has spread to lymph nodes or other places. Newer machines combine CT and PET scans to even better pinpoint the tumor.

Types of biopsies

A biopsy is a test that involves taking a sample of tissue to see if it contains cancer cells. It is the only sure way to know that a growth is cancer. There are many different types of biopsies that might be done to check for cancer cells. Some are done in the operating room with the patient asleep. Others can be done with a thin (fine) needle in the doctor's office.

Endoscopic biopsy: The larynx and hypopharynx are found deep inside the neck, so biopsies of these places are not done in the doctor's office. They are done in the operating room while you are under general anesthesia (asleep). The surgeon uses special instruments through the scope to remove small tissue samples.

Fine needle aspiration (FNA) biopsy: For this type of biopsy, a thin needle is placed into the tumor to remove cells. The cells are looked at under a microscope to see whether the swelling is caused by something like an infection, or if it is cancer. This is often done to find the cause of an enlarged lymph node. FNA is not used to biopsy the larynx or hypopharynx. If FNA is used to look at a lymph node and the results show no cancer, it only means that cancer was not found in that lymph node. Cancer could still be present in other places. If you are having symptoms, you will need other tests to find the cause of the symptoms.

Last Medical Review: 05/27/2009
Last Revised: 05/27/2009