[Sportschosun Reporter Jang Jong-ho] Speaking, breathing and swallowing food are actions we repeat unconsciously every day. All of them involve the larynx. Located at the front of the neck, the larynx is responsible for voice production and breathing, and it also keeps food from entering the airway. If a malignant tumor, known as laryngeal cancer, develops there, these everyday functions can be disrupted and quality of life can be seriously affected.
Laryngeal cancer occurs more often in men, and many patients are in their 60s and 70s. According to data released in 2026 by the National Cancer Registry, the number of male patients in Korea in 2023 was about 15 times higher than the number of female patients. By age group, people in their 60s accounted for the largest share at 40.3 percent, followed by those in their 70s at 29.8 percent. In particular, if middle-aged or older men develop persistent voice changes or other suspicious symptoms, it is important not to dismiss them lightly.
The earlier laryngeal cancer is found, the more treatment can be limited. However, once the cancer progresses, part or all of the larynx may need to be removed, making timely treatment essential. With help from Professor Cho Jae-gu of the Department of Otolaryngology-Head and Neck Surgery at Korea University Guro Hospital, we summarize the causes, symptoms and treatments of laryngeal cancer.
◇Mostly develops in the laryngeal mucosa... smoking is the biggest risk factor
Laryngeal cancer is a malignant tumor that develops when cells that make up the larynx grow abnormally. It usually arises in the mucosa of the larynx and is classified as squamous cell carcinoma. Depending on where it starts, it is divided into supraglottic cancer, glottic cancer and subglottic cancer.
Several factors influence the development of laryngeal cancer, but the most representative risk factor is smoking. When the laryngeal mucosa is continuously exposed to carcinogens in cigarette smoke, the likelihood of cancer increases, and the longer and heavier the smoking history, the greater the risk. The risk can rise even further when smoking is combined with excessive alcohol consumption. Long-term exposure to certain occupational or environmental hazardous substances can also affect the risk of developing laryngeal cancer.
◇The most common sign is hoarseness... symptoms vary by location
Laryngeal cancer is divided into glottic, supraglottic and subglottic cancer depending on where it develops, and the symptoms differ as well. Glottic cancer, which develops on the vocal cords that produce the voice, often causes hoarseness or voice changes relatively early, even when the tumor is not large. Supraglottic cancer, which develops above the vocal cords, often causes a foreign-body sensation in the throat or pain when swallowing. Subglottic cancer, which develops below the vocal cords, may not cause clear early symptoms and is sometimes discovered only after the tumor has progressed and voice changes or breathing difficulty appear. As the cancer advances, a hard lump may be felt in the neck, breathing difficulty may occur, and blood may appear in phlegm, regardless of where it started. In particular, if voice changes persist for more than two to three weeks without a clear cause, it is important to see an otolaryngology specialist.
If laryngeal cancer is suspected during an examination, a laryngoscopy is performed to observe the vocal cords and surrounding tissue. If an abnormal lesion is found, a biopsy is used to confirm the diagnosis, and tests such as computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET) are performed to assess the extent of invasion and whether the cancer has spread. Because laryngeal cancer is closely linked to smoking, it is also essential to check for lung cancer, which is also strongly associated with smoking.
◇In early laryngeal cancer, the tumor can be removed with a laser without opening the neck
Treatment for laryngeal cancer is determined by considering the tumor’s location and size, stage, lymph node metastasis and the patient’s overall condition. The main treatment options are surgery, radiation therapy and chemotherapy. Early-stage laryngeal cancer is usually treated with surgery or radiation therapy, while advanced cancer may require all three approaches together.
Surgery aims to remove the cancer completely while preserving as much normal laryngeal tissue and function as possible. The most commonly used surgical treatment for early laryngeal cancer is transoral laser microsurgery, which reaches the lesion through the mouth without making an incision in the neck. Instruments are inserted through the mouth, and the lesion is examined under a microscope while the cancer tissue is precisely removed with a laser.
Professor Cho explained, "Transoral laser microsurgery can remove cancer tissue while minimizing damage to normal tissue," and added, "Compared with open surgery, it has the advantage of causing less postoperative pain and recovery burden, and it can shorten the hospital stay."
◇If laser surgery is difficult, partial laryngectomy may be considered... total removal is considered when the cancer is extensive
If the tumor’s location or extent makes transoral laser surgery insufficient for complete removal, a conservative partial laryngectomy may be considered. This surgery removes the cancerous area while preserving as much normal laryngeal tissue as possible, and it has the advantage of maintaining laryngeal functions such as voice production. However, after surgery, voice therapy and swallowing rehabilitation and training may be needed to restore vocal and swallowing function.
If the cancer has extensively invaded the laryngeal cartilage or surrounding tissue, making it difficult to preserve laryngeal function, a total laryngectomy may be performed. In this case, it becomes difficult to use the vocal cords for speech, but communication is still possible through voice rehabilitation methods such as esophageal speech, an electrolarynx, or tracheoesophageal speech, which creates a passage between the trachea and esophagus to produce speech using air from the lungs. Recently, after total laryngectomy, many patients have also used artificial larynx devices such as Provox to help with speech.
◇The key to prevention is quitting smoking... high-risk groups should watch for voice changes
The most important step in preventing laryngeal cancer is to quit smoking. Since smoking is the leading risk factor, current smokers should stop, and people who have smoked for many years should pay close attention to changes in their voice. If hoarseness persists or gradually worsens without a specific cause such as a cold, it is advisable to have the larynx checked by an otolaryngologist. It is also necessary to avoid excessive drinking and to wear proper protective equipment in workplaces where exposure to harmful substances such as dust or asbestos is common.
Professor Cho emphasized, "The earlier laryngeal cancer is detected, the more likely it is that treatment can be limited and laryngeal function preserved," adding, "If you have a smoking history or if unusual changes such as hoarseness persist for more than two to three weeks, do not ignore the symptoms and make sure to get an accurate examination."
Reporter Jang Jong-ho bellho@sportschosun.com
This article has been translated by GripLabs Mingo AI.
