There are four stages of laryngeal cancer. They are slightly different depending on where in your larynx the cancer starts.

Laryngeal cancer happens when abnormal (cancerous) cells start to grow in your larynx (also known as your voice box). Your larynx is the section of your airway that connects your throat to your trachea. Your trachea is the pathway that air travels through to get to your lungs.

Your larynx contains your vocal cords, which vibrate as air passes through them to allow you to speak. Your larynx also helps coordinate breathing and swallowing.

Your larynx has three sections:

  • the supraglottis, at the top, where your larynx connects to your throat
  • the glottis, in the middle, where your vocal cords are
  • the subglottis, at the bottom, where your larynx joins your trachea

Laryngeal cancer can start in any of these sections.

When a doctor diagnoses cancer, they will identify the cancer’s stage based on the size of the tumor and whether the cancer has spread to another part of your body. This information helps them choose the best treatment options for your cancer.

Here’s what to know about the stages of laryngeal cancer.

The staging of laryngeal cancer differs depending on exactly where in your larynx the cancer starts. Laryngeal cancer is staged from 0–4.

Stage 0 is the same for all types of laryngeal cancer. In stage 0, cancer cells are present in your larynx but are on only the very top layer of tissue. They have not yet started to grow deeper into healthy tissue.

Laryngeal cancer in the supraglottis, above your vocal cords

  • Stage 1: Cancer is only in the supraglottis.
  • Stage 2: Cancer has spread to your vocal cords and may or may not affect your voice.
  • Stage 3: Cancer has spread within your larynx and may have spread to a nearby lymph node.
  • Stage 4: Cancer has spread beyond your larynx to some other area of your body.

Laryngeal cancer in the glottis, where your vocal cords are located

  • Stage 1: Cancer is only in the glottis. Since your vocal cords are located here, cancer in the glottis may affect your voice.
  • Stage 2: Cancer has spread above or below your vocal cords.
  • Stage 3: Cancer has spread within your larynx and may have spread to a nearby lymph node.
  • Stage 4: Cancer has spread beyond your larynx to some other part of your body.

Laryngeal cancer in the subglottis, below your vocal cords

  • Stage 1: Cancer is present only in the subglottis.
  • Stage 2: Cancer has spread to your vocal cords and may affect your voice.
  • Stage 3: Cancer has spread within your larynx and may have spread to a nearby lymph node.
  • Stage 4: Cancer has spread beyond your larynx to another part of your body.

Cancer that starts in the glottis is most likely to be diagnosed at an early stage. It causes changes in your voice or makes your voice hoarse since the cancer is growing around your vocal cords.

Cancer in the supraglottis or subglottis doesn’t cause voice changes until it reaches a more advanced stage. At that point, it may have already spread to your vocal cords.

Supraglottis or subglottis cancer does not cause symptoms until a more advanced stage. These symptoms may also be related to more advanced glottis cancer.

Symptoms include:

  • a sore throat
  • a lump on your throat
  • difficulty swallowing or pain with swallowing
  • ear pain
  • trouble breathing

Doctors typically use the term “remission” rather than saying that cancer is cured. “Remission” means that the cancer is not active or that there is no sign of cancer cells. The term “cure” suggests that the cancer is not expected to come back, and it’s very difficult to know that for sure.

Laryngeal cancer that is diagnosed at an early stage is more likely to be completely removed with surgery. If no cancer cells remain after surgery, a doctor may consider the cancer cured.

Treatment for later stages of laryngeal cancer typically involves surgery, which may be followed by chemotherapy or radiation if needed. A surgeon can remove the tumor, and then chemotherapy or radiation can help destroy any remaining cancer cells. The exact treatment plan will depend on the size of the tumor and whether it has spread.

Smoking and drinking alcohol are both risk factors for developing laryngeal cancer. According to the National Cancer Institute, this cancer is more likely to come back in people who continue to smoke and drink after treatment.

Cancer survival statistics are often discussed in terms of a 5-year relative survival rate. This rate describes the odds that a person will be alive 5 years after their diagnosis, as compared to someone without cancer.

It’s important to remember that many variables affect a person’s survival after a diagnosis of laryngeal cancer. It’s not possible to predict exactly how long someone will live.

For laryngeal cancer that starts in the supraglottis, the 5-year relative survival rate is:

  • 61% if the cancer is only in the supraglottis
  • 46% if it has spread within your larynx or to a lymph node or tissue beside your larynx
  • 30% if the cancer has spread to a more distant part of your body

For laryngeal cancer that starts in the glottis, the 5-year relative survival rate is:

  • 84% if the cancer is only in the glottis
  • 52% if it has spread within your larynx or to a lymph node or tissue beside your larynx
  • 45% if the cancer has spread to a more distant part of your body

For laryngeal cancer that starts in the subglottis, the 5-year relative survival rate is:

  • 59% if the cancer is only in the subglottis
  • 38% if it has spread within your larynx or to a lymph node or tissue beside your larynx
  • 44% if the cancer has spread to a more distant part of your body

Research suggests that treating any stage of laryngeal cancer with surgery has better outcomes than treating it with radiation therapy alone.

Quality of life means different things to different people. It’s important to consider what is most important to you and make sure that your family and your healthcare team understand.

Advances in surgery techniques mean that, when possible, doctors will preserve your vocal cord function. But in some cases, surgeons may need to remove your entire larynx, or treatment may damage your vocal cords.

In those cases, rehabilitation programs and special equipment can help you learn to speak again.

Studies have found that people who have had their larynx removed tend to report lower quality of life than other people being treated for head and neck cancers. This is a major life adjustment that affects many aspects of physical and emotional well-being.

Yes. For early stage laryngeal cancer, surgery is usually the main treatment. If the cancer has not spread, a surgeon may be able to remove the whole tumor.

For later stages, surgery might still be an option to remove as much of the cancer as possible. After surgery, doctors may recommend radiation or chemotherapy to destroy or shrink remaining cancer cells.

Laryngeal cancer is any cancer that starts in your larynx (voice box). Your larynx has three sections — the supraglottis, glottis, and subglottis — and cancer can begin in any section.

If you receive a diagnosis of laryngeal cancer, your doctor will give you more details about your cancer, including the stage.

The stage of cancer is based on the extent of the cancer and whether it has spread. The stage of cancer provides information to guide treatment decisions.