Oral exam

In an oral exam, a doctor or dentist checks the mouth for abnormal areas. This exam may be done while under anesthesia. The doctor or dentist will feel the entire inside of the mouth with a gloved finger and examine the area with a small long-handled mirror and lights or a fiberoptic device.

Neck and chest x-ray

An x-ray is a type of radiation that can go through the body and make pictures of the inside of the body. A neck and chest x-ray makes pictures of the organs and bones inside the neck and chest.

Magnetic resonance imaging (MRI)

MRI uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas of the body, such as the head and neck. This procedure is also called nuclear magnetic resonance imaging (NMRI).

CT scan (CAT scan)

A CT scan uses a computer linked to an x-ray machine to make a series of detailed pictures of areas inside the body. The pictures are taken from different angles and are used to create 3-D views of tissues and organs. A dye may be injected into a vein or swallowed to help the tissues or organs show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. Learn more about Computed Tomography (CT) Scans and Cancer.

Computed tomography (CT) scan of the head and neck. The child lies on a table that slides through the CT scanner, which takes a series of detailed x-ray pictures of the inside of the head and neck.

PET scan (positron emission tomography scan)

A PET scan uses a small amount of radioactive sugar (also called radioactive glucose) that is injected into the vein. Then a scanner is used to make detailed, computerized pictures of areas inside the body where the glucose is taken up. Because cancer calls often take up more glucose than normal cells, the pictures can be used to find cancer cells in the body.

Positron emission tomography (PET) scan. The child lies on a table that slides through the PET scanner. The head rest and white strap help the child lie still. A small amount of radioactive glucose (sugar) is injected into the child's vein, and a scanner makes a picture of where the glucose is being used in the body. Cancer cells show up brighter in the picture because they take up more glucose than normal cells do.

Ultrasound

Ultrasound exam uses high-energy sound waves (ultrasound) that bounce off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram.

Barium swallow

Barium swallow is a series of x-rays of the esophagus and stomach. For this procedure, the patient drinks a liquid that contains barium (a silver-white metallic compound). The barium coats the esophagus and stomach which helps them show up more clearly in x-rays. This procedure is also called an upper GI series.

Biopsy

A biopsy is a procedure in which a sample of tissue is removed from the tumor so that a pathologist can view it under a microscope to check for signs of disease, such as cancer or laryngeal papillomatosis.

The sample of tissue may be removed during a procedure such as:

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Laryngoscopy is a procedure in which the doctor checks the larynx (voice box) with a mirror or a laryngoscope to check for abnormal areas. A laryngoscope is a thin, tube-like instrument with a light and a lens for viewing the inside of the throat and voice box. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of disease.

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Endoscopy is a procedure to look at organs and tissues inside the body, such as the throat, esophagus, and trachea to check for abnormal areas. An endoscope is a thin, lighted tube with a light and a lens for viewing that is inserted through an opening in the body, such as the mouth. A special tool on the endoscope may be used to remove samples of tissue.

Human papillomavirus (HPV) test

An HPV test checks tissue samples from the biopsy for certain types of HPV infection that may be linked to laryngeal papillomatosis.

Immunohistochemistry

An immunohistochemistry test measures antibodies to check for certain antigens (markers) in a sample of a patient's tissue. The antibodies are usually linked to an enzyme or a fluorescent dye. After the antibodies bind to a specific antigen in the tissue sample, the enzyme or dye is activated, and the antigen can then be seen under a microscope. This type of test is used to help diagnose cancer and to help tell one type of cancer from another type of cancer.

Who treats children with laryngeal tumors?

A pediatric oncologist, a doctor who specializes in treating children with cancer, oversees treatment of laryngeal tumors. The pediatric oncologist works with other health care providers who are experts in treating children with cancer and who specialize in certain areas of medicine. Other specialists may include:

• pediatrician
• pediatric surgeon
• radiation oncologist
• pathologist
• ear, nose, and throat specialist
• social worker
• rehabilitation specialist
• psychologist
• child-life specialist

There are different types of treatment for children with laryngeal tumors. You and your child's care team will work together to decide on treatment. Many factors will be considered, such as your child's overall health and whether the tumor is newly diagnosed or has come back.

Your child's treatment plan will include information about the tumor, the goals of treatment, treatment options, and the possible side effects. It will be helpful to talk with your child's care team before treatment begins about what to expect. For help every step of the way, see our booklet, Children with Cancer: A Guide for Parents.

Treatment of childhood laryngeal cancer

Laser surgery uses a laser beam (a narrow beam of intense light) to destroy the cancer cells.

For laryngeal cancer that is likely to spread, external radiation therapy is also used. This treatment uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. Learn more about External Beam Radiation Therapy for Cancer and Radiation Therapy Side Effects.

If the cancer comes back after treatment, your child's doctor will talk with you about what to expect and possible next steps. There might be treatment options that may shrink the cancer or control its growth. If there are no treatments, your child can receive care to control symptoms from cancer so they can be as comfortable as possible.

Treatment of childhood laryngeal papillomatosis

Laser surgery, which uses a laser beam (a narrow beam of intense light) to destroy cancer cells, may be used to treat newly diagnosed papillomatosis or other benign tumors.

For laryngeal papillomatosis that comes back after being removed by laser surgery four times in one year, treatment may include:

• Immunotherapy. Immunotherapy uses the patient's immune system to fight disease.
• Laser surgery combined with targeted therapy. Targeted therapy uses drugs or other substances to block the action of specific enzymes, proteins, or other molecules involved in the growth and spread of cancer cells.

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This PDQ cancer information summary has current information about the treatment of childhood laryngeal cancer and papillomatosis. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.

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