A malignant neoplasm is a new and abnormal formation of tissue that forms as a tumor or new growth. It infiltrates, metastasizes, and often recurs after attempts at removal. In this case, it occurs in the larynx.

Usually the cause of this cancer is associated with cigarette smoking and alcohol consumption.

The most common sign of cancer at the glottis is hoarseness. Cancer located in the area above the glottis causes pain and difficulty in swallowing. A swelling in the neck (a metastatic mass) may be a very early sign.

During a direct laryngoscopy, a biopsy is performed, and the tissue is examined under a microscope to determine malignancy. In addition, CT scan and MRI may also be utilized.

Radiation therapy for early glottic carcinoma results in a survival rate of 85 to 95% after 5 years. Cancer of the cord responds well to radiation. Radiation is preferred because a normal voice is retained. In advanced cancer, surgery is necessary. If the lesion is limited to one vocal cord, then half of the larynx is removed; this preserves the ability to speak. A total laryngectomy is performed in more advanced cases. If there is metastasis to the cervical lymph nodes, then radical neck surgery is performed along with the laryngeal surgery.

Rehabilitation will be needed after a total laryngectomy. The loss of speech requires the learning of one of the following: esophageal speech, using an electrolarynx, or speaking with a tracheoesophageal fistula. Complications associated with total laryngectomy may include: pneumonia, collapsed lung, pharyngeal fistula, or wound infection or hemorrhage or both. In addition, counseling for a loss of a body part will be needed.

• May be entitled to special monthly compensation where the Veteran has a single service-connected disability rated as 100% with additional service-connected disability or disabilities independently ratable at 60% or more, which are separate and distinct from the 100% service-connected disability and involves different anatomical segments or bodily systems. See  38 CFR 3.350(i)(1) – Special Monthly Compensation (SMC).

• This disease, (condition), only in its active form , has a 3 year presumptive period and shall be granted service connection although not otherwise established as incurred in or aggravated by service if manifested to a compensable degree within the applicable time limits under 38 CFR 3.307 following service in a period of war or following peacetime service on or after January 1, 1947, provided the rebuttable presumption provisions of 38 CFR 3.307 are also satisfied. [38 CFR 3.309 [Disease subject to presumptive service connection], 38 CFR 3.309(a). [chronic disease].

• Malignant neoplasms of the pharynx, esophagus and lung and bronchiolo-alveolar carcinoma shall be service connected if the veteran was in a radiation risk activity as defined by CFR 38 CFR 3.309 [Disease subject to presumptive service connection, 38 CFR 3.309(d), Diseases specific to radiation-exposed veterans] provided the rebuttable presumption provisions of 38 CFR 3.307 of the part are also satisfied; or for any malignant neoplasm of the respiratory system under 38 CFR 3.311 [Claims based on exposure to ionizing radiation], and 38 CFR 3.311(b) [Initial review of claims] provided the provisions of 38 CFR 3.311(b)(5)(iv) have been met. A claim under 38 CFR 3.311 that involves radiation exposure requires an opinion by the C&P Service before any decision may be made by a Regional Office to grant or deny benefits.

• If the veteran was exposed to an herbicide agent during active military, naval, or air service, malignant neoplasms of the lung, bronchus, larynx and trachea shall be service-connected if the requirements of 38 CFR 3.307(a)(6) are met even though there is no record of such disease during service, provided further that the rebuttable presumption provisions of  38 CFR 3.307(d) are also satisfied. 38 CFR 3.309(e)

•  A rating of 100 percent shall continue beyond the cessation of any surgical, X-ray, antineoplastic chemotherapy or other therapeutic procedure. Six months after discontinuance of such treatment, the appropriate disability rating shall be determined by mandatory VA examination. Any change in evaluation based upon that or any subsequent examination shall be subject to the provisions of 38 CFR 3.105(e) of this chapter. If there has been no local recurrence or metastasis, rate on residuals.