Laryngeal Cancer Stage II

Stage II laryngeal cancer is an early form of cancer affecting the voice box that has grown beyond the initial area where it started but remains within the larynx and has not spread to lymph nodes or other organs.

Table of contents

• What is Stage II Laryngeal Cancer?
• How Stage II Varies by Location in the Larynx
• How is Stage II Laryngeal Cancer Diagnosed?
• Treatment Options
• Survival and Outlook

What is Stage II Laryngeal Cancer?

Stage II laryngeal cancer means the cancer has grown within the larynx (the voice box in your throat) but has not spread to nearby lymph nodes (small glands that are part of your body’s defense system) or to other parts of your body.^[1] The larynx is the part of your throat that helps you speak, breathe, and swallow, and it contains your vocal cords.^[3]

At this stage, the cancer is larger or has spread to nearby areas within the larynx compared to stage I, but it is still considered an early stage of the disease.^[1] Stage II is often referred to as early stage laryngeal cancer, along with stage I.^[1]

The larynx has three main parts: the upper part above the vocal cords called the supraglottis, the middle part where the vocal cords are located called the glottis, and the lower part below the vocal cords called the subglottis.^[5] The exact definition of stage II depends on which of these three areas the cancer started in.^[1]

How Stage II Varies by Location in the Larynx

The definition of stage II laryngeal cancer changes depending on where in the larynx the cancer began. This is because each part of the larynx is surrounded by different structures and tissues.^[1]

Cancer Starting Above the Vocal Cords (Supraglottis)

When cancer begins in the supraglottis, stage II means the tumor has grown into more than one part of the supraglottis, or it has grown into the vocal cords. The vocal cords may still move normally, or they may not move normally. The cancer has not spread to lymph nodes or other parts of the body.^[1][8]

Cancer Starting in the Vocal Cords (Glottis)

When cancer starts in the glottis where the vocal cords are, stage II means the tumor has spread to the upper part of the larynx above the vocal cords, the lower part below the vocal cords, or both. The vocal cords may not move normally. The cancer has not spread to lymph nodes or other parts of the body.^[1][8]

Cancer Starting Below the Vocal Cords (Subglottis)

When cancer begins in the subglottis, stage II means the tumor has grown into the vocal cords. The vocal cords may or may not be able to move normally. The cancer has not spread to lymph nodes or other parts of the body.^[1][8]

How is Stage II Laryngeal Cancer Diagnosed?

Doctors use several tests to diagnose laryngeal cancer and determine its stage. Your healthcare provider will start by asking about your symptoms and medical history, then perform a physical exam of your throat and neck.^[3]

Several tests may be used to confirm the diagnosis. A laryngoscopy is a procedure where the doctor examines your larynx with a mirror or a thin tube-like instrument with a light and lens. This instrument may also have a tool to remove tissue samples for testing.^[5] An endoscopy is a similar procedure that looks at organs and tissues inside the body, such as the throat, to check for abnormal areas.^[5]

A biopsy involves removing cells or tissues so they can be viewed under a microscope to check for signs of cancer.^[5] Imaging tests such as CT scans (computed tomography) or MRI scans (magnetic resonance imaging) provide detailed images of the inside of your body and help doctors see the size of the tumor and whether it has spread.^[3]

The stage of cancer describes how much cancer is in the body and where it is when first diagnosed. Doctors use the information from tests and scans to find out the size of the tumor, which parts of the organ have cancer, and whether the cancer has spread.^[1]

Treatment Options

Treatment for stage II laryngeal cancer depends on where the cancer is located in the larynx and other individual factors. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.^[13]

Surgery

Surgery is a common treatment for stage II laryngeal cancer.^[13] You may have surgery through the mouth to reach the cancer, called transoral surgery, if this is possible for your cancer.^[13] Some patients may need open surgery, which means having a cut in the neck or jaw to remove part or all of the larynx.^[13]

Surgery may involve removing part of the larynx or vocal cords, or using a laser to remove the cancer. Some people may need to have lymph nodes removed from the neck.^[15] After surgery to remove part or all of your larynx, you may need support to help you speak or communicate.^[13]

Radiation Therapy

Radiation therapy uses high-energy rays to kill cancer cells.^[12] It may be offered as the main treatment for stage II laryngeal cancer, directing external radiation to the tumor and lymph nodes in the neck.^[15] If radiation therapy is used as the main treatment and the cancer comes back, you may need surgery, called salvage surgery.^[15]

Chemotherapy with Radiation (Chemoradiation)

Chemoradiation means receiving chemotherapy at the same time as radiation therapy. The chemotherapy makes the radiation more effective.^[15] This combination treatment may be offered for stage II laryngeal cancer, with the chemotherapy drug cisplatin commonly given along with radiation.^[15]

Additional Considerations

After surgery, you may need additional procedures such as a feeding tube to make sure you get enough nutrients, or a breathing tube (called a tracheostomy) to help you breathe.^[15] Reconstructive surgery may be done to improve the appearance and function of the mouth and neck, usually at the same time as surgery to remove the tumor.^[15]

Your treatment may affect your ability to speak and swallow, as well as your appearance. Support from speech and language therapists, dietitians, and other healthcare professionals will help you manage these changes during and after treatment.^[13]

Survival and Outlook

Survival rates give an idea of how many people with the same type and stage of cancer are still alive a certain amount of time after diagnosis. These numbers are based on large groups of people and cannot predict what will happen in individual cases.^[20]

According to statistics from England for people diagnosed between 2014 and 2016, around 70 out of 100 people (around 70%) with stage II laryngeal cancer survive for 5 years or more after diagnosis.^[20] This means the cancer has spread to another part of the larynx from where it started, and in some types the vocal cords may not be able to move, but the cancer has not spread to lymph nodes or other organs.^[20]

Your own outlook depends on many factors including where exactly the cancer is in the larynx, your general health, how well you respond to treatment, and other individual circumstances. Your doctor can give you more information about your own outlook and what to expect.^[20]

Stage II laryngeal cancer is often treatable, especially when detected and treated early.^[11] Regular follow-up appointments after treatment are important to monitor your recovery and watch for any signs that the cancer has come back.^[19]