It is unclear exactly what happened over this past month, but media reports state that he was diagnosed with vocal cord cancer in 1998 and underwent 28 sessions of radiation treatment at the Memorial Sloan Kettering Cancer Center. His cancer was almost certainly due to his 3 packs per day smoking and though he quit with his initial cancer diagnosis, cancer being what it is, it can always come back.
No mention of surgery or chemotherapy since than.
Given this little bit of information and the fact that he did have an albeit raspy voice to the point that he was still able to sing 1 month prior to his death on March 19, 2012, I suspect he had an aggressive recurrence of his vocal cord cancer.
Shown below is what a normal vocal cord looks like along with one that has cancer.
Typically with vocal cord cancer, radiation therapy alone is curative and allows for voice preservation. In fact, if no cancer is seen 5 years after treatment which in Mr. Helm's case would have been in 2003, one could state "cured" from this type of cancer.
So it is strange indeed that his vocal cord cancer would come back with a vengeance to the point it killed him 14 years later, though not impossible, especially if he started smoking again as well as drinking alcohol which exacerbates smoking's cancer-causing potential.
Furthermore, it is rare that vocal cord cancer alone would kill a person as there are salvage treatments in event the cancer does comes back as apparently it did for Mr. Helm.
If the vocal cord cancer comes back, it could grow in size to the point it would cut off the ability to breath. The growth could be quite dramatic taking a breathing/talking person to being unable to breath or talk in a matter of weeks.
This complete voice-box removal is known as total laryngectomy. It would leave the person completely unable to talk in a natural manner. It would also leave the person with a permanent hole in the neck as the only way to breath.
It just may be that Mr. Helm was offered this option, but given his life as a professional singer, it was perhaps too draconian an option for him to conceive of. As any singer can tell you, their voice is their life. Without their voice, their life might as well be over.
Of course, he may have developed a "new" cancer somewhere else in his throat... the supraglottis located immediately above the vocal cords or the pharynx which surrounds the vocal cords.
Unfortunately, the treatment options would have been still pretty much the same.
Source:
Levon Helm's Life After Cancer. CBS 2/11/09
Levon Helm Throat Cancer: Legendary 'The Band' Musician Dies At 71. HuffingtonPost 4/18/12
Levon Helm, Drummer and Singer of the Band, Dead at 71. RollingStone 4/19/12
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