There are two main tests your doctor may perform if he or she suspects you have laryngeal cancer:
Indirect laryngoscopy. Using a small mirror with a long handle, the doctor looks down your throat. This lets him or her check to see whether your vocal cords move normally. The exam is painless. Still, your doctor may spray a local anesthetic on your throat to keep you from gagging. You may have this test in the doctor’s office.
Direct laryngoscopy. This test is done by an ear, nose, and throat specialist (otolaryngologist) or a head and neck surgeon. The doctor inserts a lighted tube called a laryngoscope through your nose or mouth. This lets the doctor see areas that cannot be seen with a simple mirror. You get a local anesthetic to ease discomfort or a mild sedative to help you relax. You may have this test in the doctor’s office, an outpatient clinic, or a hospital. Sometimes, the doctor decides to perform this test in the operating room, using a general anesthetic to put you to sleep during the test.
If the doctor finds abnormal areas of tissue, you’ll need a biopsy. The biopsy shows if there is cancer in your larynx. During a biopsy, the doctor removes a piece of tissue while you are under local or general anesthetic. A pathologist then looks at the tissue under a microscope to check for cancer.
If cancer exists, the pathologist can usually tell what type it is. Almost all cancer cells of the larynx are squamous cell carcinomas. Squamous cell cancer begins in the cells that line the epiglottis, vocal cords, and other parts of the larynx.