Laryngeal cancer is often diagnosed with a test called “direct laryngoscopy.” This procedure involves placing a tube with a camera into your throat to examine your larynx and take a biopsy.

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Laryngeal cancer is relatively rare and may cause many general symptoms, such as a hoarse voice that persists with no obvious cause. The diagnostic process for laryngeal cancer often starts with visiting a primary care doctor who can:

  • perform a physical exam
  • review your symptoms
  • review your personal and family medical history

If the doctor thinks additional tests are needed, they’ll likely refer you to a specialist called an “otolaryngologist” or “ear, nose, and throat doctor.”

Read on to learn about which tests doctors use to diagnose laryngeal cancer.

Language matters

You’ll notice that the language used in this section to share risk factors is pretty binary, specifically with the use of the term “male.”

Although we typically avoid language like this, specificity is key when reporting on research participants and clinical findings.

Unfortunately, the studies and surveys referenced in this article didn’t report data on, or include, participants who were transgender, nonbinary, gender nonconforming, genderqueer, agender, or genderless.

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The diagnosis process for laryngeal cancer and many other conditions starts by visiting a primary care doctor. They can review your personal and family medical history to see if you have risk factors for laryngeal cancer, such as:

  • family history of cancer
  • age of more than 65 years
  • male sex
  • history of smoking and possible exposure to secondhand smoke
  • moderate or heavy alcohol consumption, defined as more than a drink per day
  • excess body weight
  • exposure to certain occupational chemicals such as:
    • asbestos
    • sulfuric acid
    • wood dust
    • paint fumes
    • some metalworking, petroleum, or construction industry chemicals

A doctor will consider your symptoms when deciding whether you may need further testing. The most common symptoms of laryngeal cancer include:

During a physical exam, a doctor will examine your throat for signs of lumps or swelling. They may:

  • feel the base of your tongue and the bottom of your mouth
  • examine your nose and ear
  • examine the back of your throat and the roof of your mouth
  • check for swelling inside your mouth, cheeks, or lips

A nasendoscopy is a test that allows doctors to get a better view of your larynx. The test involves inserting a small tube with a light and a video camera into one of your nostrils and down into your throat. The doctor will be able to see images of your throat on a computer monitor.

You may receive an anesthetic spray to numb your nose and throat before the procedure so that you don’t have any discomfort.

A laryngoscopy is a similar procedure to a nasendoscopy, except the tube goes into your mouth instead of your nose. Doctors can perform one of two techniques:

Indirect laryngoscopy

During an indirect laryngoscopy, the doctor may numb the back of your throat with an anesthetic spray. They’ll aim a light at your throat and use a small, tilted mirror at the back of your throat to see your vocal cords.

Direct laryngoscopy

A direct laryngoscopy is usually performed under general anesthesia to put you to sleep during the procedure. A doctor will look closely at your larynx using a long, thin tube with a camera.

A laryngoscopy with a tissue biopsy is the gold standard diagnostic test for laryngeal cancer.

A laryngostroboscopy is used to examine your vocal cords while you’re speaking. The procedure may be performed to help diagnose laryngeal cancer or to assess your speech before or after treatment.

During the procedure, a long tube with a camera will be placed down your throat, and flashing lights will be used to create images of your vocal cord movement.

A panendoscopy is a combination of:

  • laryngoscopy
  • esophagoscopy to visualize your esophagus
  • bronchoscopy to examine your lungs

Doctors can use a panendoscopy to assess whether your cancer has spread to your lungs or your esophagus. All panendoscopies are performed under general anesthesia.

A biopsy is a small tissue sample that can be taken during the nasendoscopy or laryngoscopy. Doctors can examine this tissue sample under a microscope to see if a tumor is cancerous. Doctors can also use this tissue sample to identify which subtype of cancer you may have.

A procedure called “fine needle aspiration” may be used to take a sample of a lymph node. This procedure involves injecting your lymph node with a long, thin needle.

Imaging tests may be performed after a biopsy to see how far your cancer has spread. The types of imaging you may receive include:

Blood tests can help doctors assess how well vital organs, such as your liver and kidney, function so that they can assess your overall health before administering treatment.

A doctor may want to measure your:

It’s often recommended to meet with a speech therapist before treatment to assess how well you can speak and swallow. One test you may receive is called a “videofluoroscopy.”

A videofluoroscopy is an X-ray that creates an image of your throat while you’re swallowing.

The diagnostic process for laryngeal cancer often starts by visiting a primary care doctor or healthcare professional who can perform a physical exam and review your personal and family medical history. If they think there’s a chance you may have cancer, they’ll likely refer you to a specialist.

Doctors can use a long, thin tube with a camera to look at your larynx and take a small tissue sample. This tissue sample can be analyzed in a laboratory for cancer cells.

It’s important to see a doctor if you develop a persistent change to your voice or other concerning symptoms that can be early indications of laryngeal cancer.