Laryngeal cancer is a rare form of cancer in which malignant cells grow in the voice box or the larynx. Drinking alcohol and smoking tobacco are the main risk factors for laryngeal cancer. The larynx is a short, triangular passageway located just below the pharynx in the neck and it is about 2 inches wide.
The voice box has three main parts:
- The glottis is the middle part of the larynx and it contains the vocal cords
- The supraglottis is the tissue which is above the glottis
- The subglottis is the tissue which is below the glottis that connects to the trachea, which takes air to the lungs
Cancer can develop in any part of the voice box, but it usually starts in the glottis. Most laryngeal cancers begin in the flat, scale-like squamous cells which line the inner walls of the larynx.
If laryngeal cancer spreads, it can reach the nearby lymph nodes in the neck. The cells can also spread to the back of the tongue, other areas of the throat and neck, the lungs, and other sections of the body.
When this happens, and a tumour forms at the new area, it will contain the same kind of abnormal cells as the original tumours in the voice box. This is diagnosed as metastatic laryngeal cancer.
Risk Factors of Laryngeal Cancer
Smoking is the number one risk factor for laryngeal cancer. Death from laryngeal cancer is much more common among individuals who smoke than those who do not. Second-hand smoking can also be a risk factor for laryngeal cancer, in addition to alcohol consumption.
Other risk factors include:
- Vitamin deficiency and poor nutrition
- HPV – human papillomavirus
- Being male: Males are four times more likely to develop laryngeal cancer as women
- Being above the age of 40 years
- A previous history of head or neck cancer
- Exposure to certain chemicals, such as paint fumes and some chemicals in metalworking
- Low immunity
Genetic factors also sometimes play a role in the development of laryngeal cancer.
Individuals with Fanconi anaemia, which is a condition that causes blood issues from a young age, and dyskeratosis congenita – a syndrome that affects the skin, blood and nails – might be at a higher risk of developing numerous types of head and neck cancer.
Symptoms of Cancer of the Larynx
Laryngeal cancer symptoms include:
- Persistent cough
- Sore throat
- Abnormal lump in the throat or neck
- Pain or difficulty when swallowing
- Frequent chocking on food
- Noisy or difficult breathing
- Unusual sensation in and around the skin of the ear or persistent ear pain
- Unplanned, significant weight loss
- Persistent bad breath
Diagnosis of Cancer of the Larynx
Cancer of the larynx may present itself as a visible lump on the outside of the neck. In these instances, a biopsy is recommended by your doctor to help make a definite diagnosis.
If an individual’s symptoms suggest a laryngeal or other head and neck tumour, a doctor may use a Laryngoscope to help with the diagnosis. A laryngoscope is a small camera with a light on one the end which allows a doctor to look into the mouth and down the throat.
Fiber-optic nasal Endoscopy involves the use of a thin flexible scope that the doctor inserts into the nostril. It allows the doctor to see the entire larynx and pharynx. Local anesthesia is usually used for this form of diagnosis.
A CT scan of the head or neck, or an MRI to see the size or extent of the tumour may be suggested by your doctor. This helps in determining if the cancer has spread to lymph nodes in the neck.
If the tumour appears to be small and limited to one area, the surgeon may do an excisional biopsy, in an attempt to remove the tumour completely and send it to the pathology for review. A pathological analysis is carried out on any tissues or tumours that appear abnormal to confirm the diagnosis of cancer.
If the lab tests confirm laryngeal cancer, additional tests may be ordered by your doctor to find out if the cancer has spread to other parts of the body. Early diagnosis can help in supporting the successful treatment of laryngeal cancer.
Treatment Options for Cancer of the Larynx
Treatment for laryngeal cancer usually depends on the stage of the cancer. Conventional treatment for early-stage laryngeal cancer includes radiation therapy or surgery. At the later stages, a person may need either a combination of radiation and chemotherapy, or surgery followed by radiation.
Surgery involves the removal of the cancerous tumour and nearby tissue. The surgeon can carry out a neck dissection so as to remove any cancerous lymph nodes in the neck. Surgeries for laryngeal cancer include partial laryngectomy, total laryngectomy and endoscopic resection.
Depending on the type of surgery, some patients may need a temporary or permanent tracheostomy. This is a stoma or hole, in the neck that helps in promoting healing after surgery. Some individuals need a permanent stoma that helps them to breathe. They will also require an assistive device to allow speech.
Radiation therapy shrinks tumours and kills cancer cells. In external beam radiation, the doctor usually directs a beam of radiation at the tumour in the neck. The beam is powerful and is capable of burning the skin alongside any cancer cells, which can be painful.
Chemotherapy uses a combination of drugs to kill cancer cells and also to enhance the effects of radiation therapy. Chemotherapy may be used before surgery to reduce the size of a large tumour. This can help to improve the surgical procedure.
The doctor either gives these drugs as an infusion or in pill form. The chemotherapy enters the bloodstream and travels through the body, killing any cells that are growing rapidly, which may include both the cancerous and healthy cells. However, chemotherapy can lead to potent side effects, such as weight loss, nausea and hair loss.
At King’s College Hospital Dubai, we focus on offering an exemplary service from initial consultation through to the final diagnosis and treatment and beyond. Our team of expert doctors and nurses are here to offer tailored management and treatment of your condition, and to answer any questions that you might have throughout your time with us. Whatever you need us for, we’re only a phone-call away.
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