If you have symptoms such as pain when swallowing and persistent coughing, your GP will ask you about your symptoms and your recent medical history.
They may also examine the inside and outside of your throat for any abnormalities, such as lumps and swellings.
If laryngeal cancer is suspected, you'll probably be referred to the ear, nose and throat (ENT) department of your local hospital for further testing.
Nasoendoscope
A nasoendoscope is a medical instrument that consists of a small tube with a light at one end. The tube can be inserted into one of your nostrils and passed into the back of your throat to enable hospital staff to get a clearer view of your larynx.
The procedure isn't painful but can sometimes feel a little uncomfortable, so an anaesthetic spray is often used to numb your nose and throat.
Panendoscope
A panendoscope is similar to a nasoendoscope but it is longer and has a camera at one end as well as a light. It's often used when the results of earlier tests have been inconclusive or have detected a possible problem. A panendoscope can be used to show more of the larynx in greater detail.
The procedure can be painful so it's usually carried out under general anaesthetic (where you will be asleep). You should be able to leave hospital as soon as you've recovered from the effects of anaesthetic, which is usually the same day as the procedure or the day after.
Biopsy
During a biopsy, a small sample of tissue is removed and sent to a laboratory so that it can be examined for cancerous cells. A biopsy can usually be done at the same time as using the nasoendoscope or panendoscope. Small instruments are passed down the tube and used to remove a tissue sample.
Alternatively, if you have a lump in your neck, a needle can be used to draw out a tissue sample. This is known as fine needle aspiration (FNA).
Further testing
If the results of the biopsy show that you have cancer and there's a risk that it may have spread, you'll probably be referred for further testing to assess how widespread the cancer is. The tests may include:
Staging
After the tests described above have been completed, the doctor in charge of your care should be able to tell you how far the cancer has spread from your larynx to other parts of your body. Healthcare professionals use a four-stage system to describe how far laryngeal cancer has advanced. The four stages are described below.
- Stage 1 – the cancer is present in the top layers of tissue that cover the larynx. The vocal cords are usually unaffected.
- Stage 2 – the cancer has spread deeper into the larynx, affecting the functioning of the vocal cords and making the voice hoarse. Nearby lymph nodes are unaffected.
- Stage 3 – the cancer has spread throughout the larynx and one of the vocal cords is no longer able to move, resulting in a loss of voice. Small lymph nodes near the larynx may also contain cancerous cells.
- Stage 4 – the cancer has spread beyond the larynx and into the larger lymph nodes. In very advanced cases, the cancer can also spread to other parts of the body, usually the lungs.
