Laryngeal cancer is a disease, which appears mainly in man in their fifties, who are usually heavy smokers. Statistics show that throat cancers are more common in people who live in big cities, while others rarely suffer from this form of oncological disease. Only 70% of patients recover fully from cancer of the larynx. Complete recovery is possible mainly in the absence of metastases.
The tumor may be formed in any part of the larynx, but it occurs most often in the middle section, where the vocal cords are located. Squamous cell carcinoma is accounted for 98% of laryngeal cancer cases.
There are the several possible triggers for laryngeal cancer:
- The disease occurs in men more frequently, than in women
- Patients, who suffered other head and neck cancer before, are at greater risk.
- Age. This disease mainly affects people over 50 years of age.
- Smoking is a major risk factor.
- Regular exposure to industrial waste
- Alcohol consumption.
- Living in an urban area, with high pollution levels.
It is customary to divide the stages of the larynx cancer development into the following:
- Stage I – cancer located in one of the three areas of the larynx, no proliferation of the mucosa
- Stage II – is characterized by the tumor being located in one of the larynx areas, taking up all its space. Metastases are absent. Mobility of the larynx is not impaired.
- Stage III – cancerous tumor affects surrounding tissues of the larynx, causing immobility of the area of the larynx, where the tumor has spread. However, the lesion is still confined to the specific area, where it has developed.
- Stage III B – cancerous cells affect all areas of the larynx. Metastases might be present.
- Stage IV A– large size tumor is observed, spreading to the entire larynx
- Stage IV B – is characterized by the growth of tumors into adjacent tissues .
- Stage IV C – presence of metastases in neck lymph nodes
- Stage IV D – presence of distant metastases, with the presence of tumor of any size in the larynx
When the tumor is located above the vocal cords or in the epiglottis area, the cancer might not manifest itself for long periods of
In most cases, the first reason for the patient to go and consult with t physician is hoarseness. Often patients complain about regular cough, painful spasms in the throat or larynx, discomfort in swallowing, having a feeling go having a foreign object in the throat (like a lump), swelling in the neck.
With the progression of tumors’ growth symptoms other symptoms may appear, including: general weakness, sudden weight loss, coughing up blood, bad breath.
Diagnosis and tests
Diagnosis of the disease starts with the otolaryngologist consultation and anamnesis. The doctor asks questions in detail regarding the complaints, presence of certain habits and diseases as well as about the patient’s lifestyle. During the examination of the patient doctor examines the thyroid, pharynx, neck and lymph nodes.
- Laryngoscopy allows the specialist to inspect visually the mucous membrane covering the larynx and vocal cords. Using this procedure, the tumor can be detected in the early stages of development.
- Indirect laryngoscopy is performed with a small mirror attached to the special handle.
- Fibrolaryngoscopy is conducted by an elastic laryngoscope, which is applied through the patient’s nose and provides an ability to examine the walls of the larynx and the vocal cords.
- Tracheoscopy can also be used to examine and diagnose laryngeal cancer. To examine the state of the esophagus (located next to the larynx) patients undergo fluoroscopy and oesophagoscopy.
- CT scans of the larynx are also carried out using contrast materials. CT provides the doctor with a clear, layered image of the larynx and gives the ability to determine if there is an increase in size of lymph nodes. MRI, PET and PET-CTs are also used in the diagnostics and evaluation phase .
- Biopsy – using a laryngoscope, physician removes a small sample of larynx tissue for further histological analysis. This procedure is performed with local anesthesia.
Doctors often use laser surgery, if the patient suffers from 1st stage larynx cancer.
Cordectomy – full or partial removal of the vocal fold. Operation is conducted using special tools or laser surgery technique.
Partial laryngectomy is a surgery, during which part of the larynx is removed. This surgery leaves the patient with a possibility to regain his voice.
Upper throat laryngectomy is a surgery aimed at removing the upper area of the larynx.
In total laryngectomy surgery surgeons remove the entire larynx.
This treatment is often used for tumor reduction purposes before surgery. However, radiation therapy is widely used after surgery as well, so the radiation would eliminate the cancer cells, which might remain in the patient’s body after the surgical removal of the main lesion and threaten the positive results of treatment. The choice of therapy depends on the type of tumor and its location – in different cases external radiotherapy or brachytherapy may be used. This method of treatment is also frequently combined with chemotherapy.
Cytotoxic agents – anti-cancer drugs are used during chemotherapy, in order to actively fight the cancer cells in any location of the body. This method of treatment can be used before and after surgery as well.