If your healthcare provider believes you may have voice box cancer, you will need certain exams and tests to be sure. You should expect to be asked questions about your health history, your symptoms, risk factors and family history of disease. Understanding your background will help your provider make a diagnosis.

He or she will also give you a physical exam, including an exam of your head and neck and inside your mouth. You may have one or more of the following tests.

Otolaryngologists, or ENT (ear, nose and throat) specialists will perform a physical exam and may perform other tests to visualize the inside of your throat. A laryngoscopy is a procedure in which a small, tube-shaped instrument called a laryngoscope is placed down the throat to see the voice box. Your doctor will usually perform this procedure in an outpatient setting with a numbing spray, but less commonly it could require general anesthesia (to put you to sleep temporarily) in a hospital setting. Biopsies may be taken during laryngoscopy and sent to a pathologist to evaluate for cancer cells. There are several types of laryngoscopies including:

  • Indirect laryngoscopy: The simplest of the laryngoscopy procedures, this test uses a laryngoscope in your throat combined with a light and a tiny mirror at the roof of your mouth to look down your throat. This test is typically be done in an outpatient setting with numbing spray while you are awake. This allows the ENT specialist to see your larynx in the mirror.
  • Direct flexible laryngoscopy: This procedure uses a lighted fiber-optic laryngoscope that is placed in your nose and goes down into your throat to look at your throat and voice box. Your ENT typically performs this test in an outpatient setting with numbing spray while you are awake.
  • Direct rigid laryngoscopy: This procedure is a complete exam of your throat and may be performed to also visualize the nasopharynx (nose and back of the mouth or throat). Specialists usually perform this test while you are under anesthesia in a hospital setting.
  • Panendoscopy: A procedure that is typically done under general anesthesia and allows visualization of the larynx (voice box), esophagus (the feeding tube that connects your mouth to your stomach), and the trachea (windpipe).

We use imaging to get detailed pictures and accurately diagnose voice box cancer. Imaging tests may include MRI (magnetic resonance imaging), PET scans or CT scans.

  • CT scan, also called a computed tomography scan, uses an advanced X-ray and computer to take pictures of the head in cross-sections to visualize the voice box and surrounding tissue.
  • MRI, also called magnetic resonance imaging, is a noninvasive imaging study that does not use radiation but rather relies on magnets and radio waves to take several pictures of the head in cross-sections in order to visualize the voice box and surrounding tissues.
  • PET scan, also called a positron emission tomography scan, is a noninvasive imaging study in which a radioactive tracer is injected through an IV to help evaluate the metabolic activity in your tissues prior to imaging, to help detect cancer. PET scans may be used if biopsy results show a cancerous voice box tumor. PET scans can help identify whether the cancer is localized or if it has spread to other parts of the body.

A biopsy removes tissue or cells from the voice box to be checked by a pathologist under a microscope. Results from a biopsy help determine if cells are cancer.

  • An endoscopic biopsy using laryngoscopy is typically performed under anesthesia by an otolaryngologist.
  • A fine needle aspiration biopsy may be performed on suspicious lymph nodes. In this biopsy, a needle is placed into the lymph node to remove a core sample of cells to be evaluated by a pathologist to see if the cancer has spread to the lymph nodes.
  • Other types of biopsies may be performed if your provider is concerned about other tissues or organs.
  • Ask your provider about your specific type of biopsy to learn more.

Patients will be contacted after a biopsy by a Markey team member to review results. Further management will be recommended at that time.

When you are diagnosed with voice box cancer, it is common to feel a sense of urgency around starting treatment. However, in most cases, there is time to do the needed research to ensure that your diagnosis is correct. That may include getting a second opinion.

Our team of experts works together to diagnose, treat and prevent voice box cancer, with a focus on individualized patient care.

Markey is among the best cancer centers in the nation, according to U.S. News & World Report, when it comes to advanced treatment options, survival rates and experienced providers. As the first and only NCI-designated comprehensive cancer center in Kentucky, Markey is able to serve many patients each year with rare and common cancers, including voice box cancer.

Our specialized team is happy to work with your doctors and communicate to ensure confidence in your diagnosis.

Should I get a second opinion?

A second opinion can help to ensure that you will be getting the latest and most effective therapy for treating voice box cancer. The following are common reasons for seeking a second opinion after your initial diagnosis:

  • You are having difficulty understanding your diagnosis.
  • A dedicated team specialized in your cancer type may not be available in your area.
  • There may be uncertainty around the stage of voice box cancer.
  • You may want to learn more about different treatment options, including clinical trials and advanced technologies only available at an advanced center like Markey.
  • Your health insurance requires a second opinion before continuing toward treatment.

Questions to ask when getting a second opinion

After receiving a cancer diagnosis, you may have a lot on your mind. Here a few questions to keep in mind for your doctor when seeking a second opinion:

  • Is there a chance that my medical problem could have a different diagnosis?
  • Are there additional tests I should take before moving forward with treatment?
  • Do you recommend any treatments at this time?
  • What do you expect to happen if I wait or don’t have the treatment?
  • What are the side effects of treatment?
  • How long are treatment recovery periods?

For more information, visit these trusted national sources for a variety of additional educational tools and resources:

NCI Comprehensive Cancer Center - A Cancer Center Designated by the National Cancer Institute

Markey Cancer Center is designated by the National Cancer Institute as a Comprehensive Cancer Center – a distinction that recognizes our commitment to accelerating precision cancer research and care to patients. We are the first and only NCI-Comprehensive Cancer Center in Kentucky, and one of 57 in the nation.